The urinary system is made of a tract that leads from the kidneys towards the bladder via ureters and then passes out via urethra. Kidney produces urine by filtering the blood and removing urea, excess water and minerals.
Sometimes, when an individual is producing very concentrated urine either due to excess of minerals and stone forming substance or due to dehydration, the waste settles along the urinary tract, forming kidney stones medically known as nephrolithiasis.
TYPES OF KIDNEY STONES
There are two main types of kidney stones.
1) Calcium stones, which are very common and form in combination with phosphate or oxalate.
2) Struvite stones, which are formed by urci acid and magnesium ammonium phosphate.
The kind of stone an individual may develop depends on the health, lifestyle and genetic predisposition of that individual. People who live in dry climate, are obese, have increased level of calcium and uric acid are more likely to develop kidney stones. Urinary tract infections are also closely related to kidney stones.
SYMPTOMS
Once a stone develops it comes in the way of urine and it cannot be excreted out. This causes the muscle of the pathway to contract and causes colicky pain in the flanks radiating towards the groin and back.
The pain develops suddenly, it is excruciating and does not relieve with change in position. It also causes blood in urine medically known as hematuria. It is also accompanied by nausea and vomiting; fever and chills in case of urinary tract infection. It can also remain silent and symptom-less.
TREATMENT
Once a kidney stone develops, and causes symptoms, medical attention is required. Most of the stones that develop pass out themselves if given time. Medication for pain is given and plenty of water ingestion is advised.
Analgesics such as nsaids and aspirin are contraindicative in nephrolithiasis as they may aggravate the condition. Acetaminophen and narcotics are the advised medication for pain. Kidney stones are often associated with urinary tract infection for which injectible anti inflammatory drug such as toradol is given.
A heavy weight person, pregnant female and prostate enlargement may cause hindrance in treatment of nephrolithiasis as they directly affect the person’s ability to pass the stone. It also depends on the size of the stone itself. The size of the stone is confirmed using ultrasound. A stone of 4mm or less has 80% chances of passing out via urine. Stones bigger may require treatment. Stones over 9mm require specific treatment.
Medication is given to assist passage of the stone which include beta blockers and alpha blockers. Further treatment involves lithotripsy for kidneys that are not able to pass the stone. Ultrasonic shock waves are used to break the stone into smaller pieces which then pass out.
The last resort that doctors go to is surgical technique. The surgical technique for removing stones is known as percutaneous nephrolithotomy. It involves making an incision and passing an uteroscope through urethra, bladder and ureters.
PREVENTION
Unfortunately, once a person develops kidney stones, the chances of developing more kidney stones persist even after treatment. Therefore, the best way is to prevent the development of kidney stones.
The major risk factor of developing kidney stones is dehydration. Every person should have at least eight glasses of water a day and up to 15 glasses if they live in very hot arid climate such as Karachi. Have at least one glass of detox drink a day or lemonade if detox drinks are unpleasant to your taste buds.
Avoid taking over-the-counter analgesics medicines like aspirin (disprin) and nsaids over pain and headache as these medicines are metabolized by the kidney. People who already have developed kidney stones and have been treated need specific diet to prevent kidney stones in future. This is done keeping in mind their lab reports so that specific measures can be taken.
If there is increased blood calcium levels, intake of oxalate should be restricted. Foods such as spinach, rhubarbs, wheat and peanuts should be taken in limited amount.
Footnote: Seek urgent medical attention in case of kidney stones.