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Kidney Stones
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Kidney stones are also referred to as nephrolithiasis or renal lithiasis. They are actually small stones made from crystals that form in the urine and coalesce into a stone. There are several causes of kidney stones and such stones are made from many different possible substances. They are more common when water intake is low and the urine is chronically too concentrated. Treatment of kidney stones is not always necessary as they often pass on their own.
The major symptoms of kidney stones include pain in the flank or in the back, where the kidneys are located beneath the lower ribs. Pain can spread to the lower abdomen or to the groin area. There is often pain on urination and the urine is pink, brown or red. Nausea and vomiting are common and urinary urgency is also common. If the kidney stone causes an infection, there can be fever, chills and increased pain in the kidney area.
There are no specific causes to kidney stones. They seem to occur whenever there is an imbalance between the amount of urine and the amount of minerals in the urine. The major forms of kidney stones include the following kidney stone types:
- Calcium stones-these form calcium oxalate and occur when a person can't process the oxalate found in many fruits and vegetables, nuts and chocolate. High dose vitamin D and having bypass surgery will cause the stones to form.
- Struvite stones-form as a result of an infection and can get really big.
- Uric acid stones-these can form when the person has gout and elevated uric acid in their system along with dehydration.
- Cystine stones-these are rarer stones that occur if you have a hereditary problem causing an increased amount of cystine in the body.
Your risk of developing kidney stones increases with age, with a family or personal history of having stones in the past, being male, being dehydrated or eating a diet high in protein, sugar and sodium. Overweight individuals have a higher rate of kidney stones and those who have chronic diarrhea or inflammatory bowel disease have a higher risk of developing kidney stones. If you have certain medical conditions, such as urinary tract infections, hyperparathyroidism or cystinuria, you can get kidney stones more easily.
Tests can be done to determine the presence of kidney stones and their cause. A blood test for uric acid or excess calcium in the blood can be done to see if these may be causing the kidney stone. Urine tests are done to see if there is blood in the urine. Doctors can do an IVP or intravenous pyelogram, which uses dye to see if there is a urinary tract blockage due to kidney stones. CT scans can show the presence of stones and stones can be strained and identified as to cause under the microscope.
The treatment of kidney stones may involve simply drinking more fluids and taking pain pills. The more dilute urine will push the stone through the ureter so that it passes easily into the bladder. This technique works best for small stones.
Larger stones may need to be broken up. Sound waves can be used in a procedure called an extracorporeal shock wave lithotripsy that can break up a bigger stone into several smaller stones which pass through the bladder and urethra. Surgery is used to open up the kidney and take care of those kidney stones that are locked up inside the kidney. This is called a nephrolithotomy. A ureteroscope can be passed up into the kidney and the stone can be grabbed by the scope. The stone can also be broken up via the ureteroscope.
In rare cases the parathyroid glands need to be removed to keep the calcium level in the kidneys and urine to normal levels. The parathyroid glands are located within the thyroid gland, making for easy entry by the surgeon to remove the glands.