Kidney Stones

Overview of kidney stones

The National Institute of Health reports that nearly 15% of India’s current population suffers from kidney stones.Improper diet and overdose of few medications can have far-reaching consequences on human health. The organ that suffers maximum damage in such cases is the kidney. It is one of the vital organs of the body that excretes waste products and other toxic materials via urine. Any infection or abnormal functioning of the kidney can trigger the formation of “kidney stones”, which is becoming a life-threatening condition in recent years. Recent survey by American Urological Association reveals that about 12% men and 7% women normally suffer from kidney stones worldwide. Doctors around the world are predicting an increase in this percentage.  Immediate attention to dietary habits and environmental hygiene is necessary to prevent kidney diseases in general.

What is a kidney stone?

A kidney stone is a solidified mass of salts and minerals that are normally present in urine.

An increase in the normal concentration of these minerals such as calcium, oxalates, phosphates or uric acid impedes the normal mechanism of waste secretion by the kidneys and leads to the formation of crystals within kidneys.

Kidney stones vary in shape and size.

Very small kidney stones can easily pass through the urine without causing any trouble.

But larger stones induce stress in the ureter while approaching the bladder and can even block the normal flow of urine in extreme cases, causing tremendous pain, infection and bleeding in kidneys.

What causes kidney stones?

Kidney stones or “Urolithiasis” may result due to multiple etiological factors. It mainly arises due to existing diseases within the body like-

• Hypercalciuria: In this condition the urine contains a very high quantity of calcium.
• Cystic kidney diseases: In this condition, fluid-filled sacs are form on the kidneys.
• Hyperparathyroidism: It causes excess calcium in blood due to hyperactivation of thyroid gland.
• Renal tubular acidosis: In this condition the blood becomes highly acidic due to failure of kidney to excrete excess acid into the urine.
• Cystinuria: In this condition, excess amino acid (cystine) is present in urine.
• Hyperoxaluria: Large amount of oxalate is present in urine.
• Hyperuricosuria: It arises from defective uric acid metabolism.
• Medullary sponge kidney: Small stones are present in kidney.
• Gout: It causes accumulation of uric acid crystals.

Other generalized causes include-

• Clogging of urinary tract due to accumulated wastes
• Chronic inflammation of bowel (Crohn’s disease) or other digestive disorders (diarrhoea)
• Gastrointestinal tract surgery in the past
• A family history of kidney diseases
• Frequent urinary tract infections (due to the use of unhygienic toilets)
• Diet rich in protein and salt, but deficient in Vitamin B6 (leads to excess oxalate in urine)
• Extreme dehydration
• Excess intake of Vitamin C, Calcium supplements or antacids containing calcium
• Hormonal changes during menopause or pregnancy
• Cysts or scars in kidneys
• Increased alkalinity of urine
• Decreased intake of fluids
• Diabetes conditions (Type 2 Diabetes)
• Obesity

What symptoms does the patient exhibit?

Kidney stones in very small forms are benign. The kidneys can excrete them through urine. But as they grow in size, kidney stones manifest themselves through some major symptoms which nee an immediate diagnosis. These are as follows-

• Swelling of kidney (hydronephrosis) which causes tremendous pain
• A sudden shooting pain in the back which often extends to lower abdomen
• Excessive urge to urinate but inability to pass urine properly
• Burning sensation while urinating
• Frequent urination in few cases
• Dark brown or reddish urine due to presence of blood in urine (hematuria)
• Persistent pain at the tip of genitals
• Nausea and vomiting
• Feeling of dehydration
• Occasional fever in critical situations

What are the types of kidney stones?

Kidney stones usually range from microscopic to macroscopic in size, have a rough texture and can be found in kidneys, ureter or bladder. Kidney stones can be broadly categorized into the following types-

• Calcium stones: 80% of kidney stones are formed due to the presence of excess calcium mainly in two forms- calcium phosphate and calcium oxalate. Calcium phosphates are formed by the combination of alkaline urine and calcium. Oxalates are formed by excess excretion of oxalate wastes.
• Uric acid stones: These are formed due to excess uric acid in urine, which deposits along with calcium to form kidney stones. The acidic nature of urine, in this case, is attributed to obesity, diabetes or chronic diarrhea. It is mainly caused by purine-rich diet (meat, fish, sea-foods).
• Struvite stones: These are formed due to kidney infections. They disappear after the infections are gone.
• Cystine stones: These form due to the presence of excess amino acid (cysteine) in urine. This occurs as a result of the leakage of cystine through kidneys into the urine. A hereditary metabolic disorder called “Cystinuria” predisposes a person to this disease.

Who are more likely to develop kidney stones?

According to a survey conducted by World Health Organization (WHO), inhabitants of tropical and subtropical areas suffer most from kidney stones due to extreme dehydration. The American Urological Association has projected the steady rise of kidney stone cases in the next few years due to global warming.

Diagnosis

Diagnosis of kidney stones varies according to the size and location of the stone. Extracorporeal Shock Wave Lithotripsy (ESWL) breaks down the stones to smaller sizes.In the next step, shockwave treatment takes place. Percutaneous Nephrolithotomy is necessary when kidney stone size is larger than 2-3 cm. For stones present in the distal ureter, pathologists employ the Cystoscopic-ureteroscopic techniques.

Treatment & Prevention

The treatment procedure used for kidney stones depends on the size of the stone. If it is of smaller size and the symptoms are minimal, then it can be treated by drinking lots of water and eating painkillers that will ease the flushing out of the stone, along with drugs that will help in passing the kidney stones easily. But if the kidney stones are too big in size, then surgical intervention would be required.  Sometimes, sound waves are also used to break the kidney stones so that it can be passed along urine.  Ureteroscope (a thin lighted tube that passes along your ureter to locate the stones) can also be used to break the large stones in smaller, easily passable form.

Drinking adequate amount of water and eating a low sodium diet is helpful in preventing the formation of kidney stones. If your diet is high in calcium oxalates, you are more likely to develop kidney stones. You might be asked by your doctor to eat lesser oxalate foods such as beets, ladyfingers, sweet potatoes, soy products, and tea.

Studies show that a patient suffering from kidney stones has a 50% risk of forming kidney stone within the next 7 years. Also, men are more prone to kidney stones than women. In recent years, kidney stones have started affecting children as well. Doctors worldwide are therefore recommending a hygienic and healthy diet consisting of moderate sodium and less animal protein. Global health organizations are stressing upon the need to consume uncontaminated food and fluids to prevent kidney stones altogether.

Kidney Stones Home Remedies

There are a plethora of home remedies for treating kidney stones. Some of them are mentioned below. However, if you have a pre-existing medical condition you should first consult your doctor before applying any of these home remedies for treating the condition.

• Lemon is rich in citrate that can slow down the calcified growth within the kidney and also break down the existing calcium build-up. Drinking one glass of lemon water in empty stomach can help in reducing the size of kidney stones naturally.
• Acetic acid can hinder the growth and formation of kidney stones by stabilizing uric acid levels. It is found in apple cider vinegar and basil extract. Mix one part apple cider vinegar and 2 parts water and drink this mixture twice a day. 1 tsp of basil leaf extract is also effective in treating kidney stones.
• Wheatgrass is rich in minerals that naturally inhibit the formation of kidney stones. 1 glass of wheatgrass juice per day will help in breaking down the kidney stones and flushing it out of the body.
• Magnesium is a mineral which can effectively prevent the formation of kidney stones and reduce the severity of the symptoms. It is found abundantly in kidney beans. Drinking plain kidney bean broth is an effective home remedy for treating kidney stones.
• Mix 1 tbsp of extra virgin olive oil in one glass of water and drink this mixture in empty stomach. This will add lubrication to the urinary tract and help in passing the kidney stones easily.
• Pomegranate can lower the acidic content of the urine and thus make kidney stone formation difficult.

TL;DR?

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