Kidney stones are a common cause of pain, often referred to as renal colic. Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they are recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In a few cases other forms of therapy might be needed.
What are kidney stones
Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.
A kidney stone begins as a tiny piece of crystal in the kidney. When the urine leaves the kidney, it may carry the crystal out, or the crystal may stay in the kidney. If the crystal stays in the kidney, over time more small crystals join it and form a larger kidney stone.
Most stones leave the kidney and travel through the urinary tract when they are still small enough to pass easily out of the body. No treatment is needed for these stones.
Larger stones may become stuck in the tubes that carry urine from the kidney to the bladder (ureters). This can cause pain and possibly block the urine from flowing to the bladder and out of the body. The pain often becomes worse over 15 to 60 minutes until it is severe. The pain may ease when the stone no longer blocks the flow of urine. The pain often goes away when the stone passes into the bladder. Medical treatment is often needed for larger stones.
Who gets kidney stones?
Kidney stones are relatively common across all age groups, occurring in approximately 12 per cent of men and six per cent of women. The higher rate of occurrence in men is influenced by diet. Kidney stones can develop in one or both kidneys and most often affect people aged 30 to 60.
Higher incidences are also seen in tropical climates, as in Anguilla and in individuals with certain occupations, such as taxi drivers, secretaries and chefs, who often go long periods between hydration. Kidney stones vary in size, they can be as small as grains of sand or as large as table tennis ball.
What causes kidney stones?
The waste products in the blood can occasionally form crystals that collect inside the kidneys. Over time, the crystals may build up to form a hard stone-like lump.
This is more likely to happen if you do not drink enough fluids, if you are taking some types of medication, or if you have a medical condition that raises the levels of certain substances in your urine. Two to three litres of water daily, combined with a diet rich in fibre and low in salt, can be protective against stone formation. High red meat consumption contributes to the risk factors for kidney stone formation. The body naturally produces inhibitors of stone formation, magnesium and citrate and low levels can thus predispose one to stone formation.
Are kidney stones dangerous to you?
Most kidney stones, although possibly excruciatingly painful while being passed, are usually not harmful in the long term. However, a kidney stone can cause obstruction of the kidney and can lead to acute or irreversible kidney dysfunction. An acute infected and obstructed kidney could lead to serious health problems. Urgent medical attention is needed in these cases.
Treatment for kidney stones
Management commences with adequate hydration and pain relief plus imaging to determine the size and location of the stone and the possible degree of kidney obstruction.
A kidney stone causing kidney obstruction may require minimally invasive intervention with placement of a plastic stent or small tube into the kidney through the flank.
Laser endoscopic fragmentation or dusting of the kidney or ureteric stone is available. Shock wave therapy to pulverise the stone is a possibility.
Very large stones in the kidney require a minor surgery called percutaneous nephrolithotomy(PCNL). In this procedure, a tube is placed into the kidney and the stone is directly broken down and sucked out.
Nowadays, open surgery for kidney stones is rare.
Prevention
Prevention is always better than cure. Stay hydrated and consume red meat, salt and foods with high oxalate levels, such as peanuts, rhubarb, spinach, beets, chocolate and sweet potatoes in moderation.
Conclusion
Any one can get kidney stones, but they tend to occur in individuals who are dehydrated and have other risk factors. As the body tries to pass these stones severe pain might occur especially if the stones are large. Once diagnosed there are effective treatment options. The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-five years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
