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A man with Kidney Stones

The Modern Rules Of Kidney-stones Symptoms-Causes & Treatment.


Kidney stones (also known as renal calculi, nephrolithiasis, or urolithiasis) are hard deposits made of salts and minerals which form within your kidneys.

Diet, excessive body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.

Kidney stones can affect any part of your urinary tract — from your kidneys to your bladder. Many times, stones form when the urine becomes more concentrated, letting minerals crystallize and stick together.

Passing kidney stones can be very painful, however, the stones usually cause no permanent damage if they’re recognized in a timely fashion.

Depending on your circumstances, you may need nothing more than to take pain medication and drink a lot of water to pass a kidney stone. In other cases — for instance, if stones become lodged in the urinary tract, are correlated with a urinary infection, or trigger complications — operation may be required.

Your physician may recommend preventive treatment to reduce your risk of recurrent kidney stones if you’re at increased risk of developing them. 

Symptoms of Kidney Stone:

A kidney stone usually will not cause symptoms until it moves around within your kidney or passes into your ureters — the tubes connecting the kidneys and the bladder.

In case it becomes lodged in the ureters, it may block the flow of urine and cause the kidney to swell and the ureter to spasm, which can be quite painful. At that point, you may encounter these signs and symptoms:

  • Intense, sharp pain in the side and back, under the ribs
  • Pain that radiates into the lower abdomen and groin
  • The Pain that comes in waves and fluctuates in intensity
  • Burning feeling while urinating

Other signs and symptoms may include:

  • Pink, reddish or brown urine
  • A constant need to urinate, urinating more often than normal or urinating in Smallish quantities
  • Vomiting and Nausea
  • Fever and chills when an infection is present

Pain caused by a kidney stone may change — for instance, changing to another location or increasing in strength — as the stone moves through your urinary tract.

When to see a Physician:

Make an appointment with your physician if you have any signs and symptoms that worry you.

Seek prompt medical attention if you experience:

  • Pain so intense you can’t sit still or find a comfortable position
  • Pain accompanied by fever and chills
  • Blood in your urine
  • Difficulty passing urine

Causes of Kidney Stones:

Kidney stones often have no definite, single cause, although several factors may increase your risk.

Kidney stones form when your urine includes more crystal-forming substances — such as calcium, oxalate, and uric acid — compared to the fluid from your urine that may dilute.

At precisely the same time, your urine may lack substances that prevent crystals from adhering together, creating a perfect atmosphere for kidney stones to form.

Types of kidney stones:

Knowing the sort of kidney stone you have helps determine its cause, and may give clues about the best way best to lessen your chance of getting more kidney stones.

If possible, attempt to conserve your kidney stone if you pass one so that you can bring it to your doctor for analysis.

Types of kidney stones include:

  • Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a substance made every day by your liver or absorbed in the diet.

Certain vegetables and fruits, as well as nuts and chocolate, have high oxalate content.

Dietary aspects, high levels of vitamin D, intestinal bypass operation, and many metabolic disorders can increase the concentration of calcium or oxalate in urine.

Calcium stones may also occur in the form of calcium phosphate. This kind of stone is more common in metabolic conditions, such as renal tubular acidosis.

It may also be associated with certain drugs used to treat seizures or migraines, such as topiramate (Topamax, Trokendi XR, Qudexy XR).

  • Struvite stones. Struvite stones form in reaction to a urinary tract infection. These stones can grow rapidly and become rather big, sometimes with few symptoms or little warning.
  • Uric acid stones. These stones can form in people who lose too much fluid because of chronic diarrhea or malabsorption, those who consume a high-protein diet, and those with diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.
  • Cystine stones. These stones form in people who have a hereditary disorder called cystinuria which causes the kidneys to excrete too much specific amino acid.

Risk Factors for Kidney Stones:

Factors that increase your risk of developing kidney stones include:

  • Family or personal history. If someone in your family has had kidney stones, you’re more likely to develop stones, also.

If you’ve already had one or more kidney stones, you’re at increased risk of developing another.

  • Dehydration. Not drinking enough water each day can increase your risk of kidney stones.

Individuals who reside in hot, dry climates and those who sweat a great deal may be at higher risk than others.

  • Certain diets. Eating a diet that’s high in protein, sodium (salt), and sugar may increase your risk of some types of kidney stones. This is particularly true with a high-sodium diet.

Too much salt in your diet increases the amount of calcium your kidneys have to filter and significantly increases your risk of kidney stones.

  • Fat Loss High body mass index (BMI), high waist dimensions, and weight gain have been connected to an increased risk of kidney stones.
  • Digestive diseases and operation. Gastric bypass surgery, inflammatory bowel disorder, or chronic diarrhea may cause fluctuations in the digestive process that affect your absorption of calcium and water, increasing the quantities of stone-forming substances in your urine.
  • Other health conditions like renal tubular acidosis, cystinuria, hyperparathyroidism, and recurrent urinary tract infections also can increase your risk of kidney stones.
  • Certain supplements and medications, such as vitamin C, dietary supplements, laxatives (when used too ), calcium-based antacids, and certain medicines used to treat depression or migraines, can raise your risk of kidney stones. 
Kidney stone
Kidney stone

Diagnosis for Kidney Stones:

If your doctor suspects that you have a kidney stone, You Might Have diagnostic tests and procedures, for example:

Blood testing. Tests may reveal an excessive amount of calcium or uric acid in the blood.

It results in helping monitor the health of your kidneys and might lead your doctor to check for other medical conditions.

Urine testing. The 24-hour urine collection test will demonstrate that you are excreting a lot of stone-forming minerals or too few stone-preventing substances.

For this test, your doctor may request that you perform two urine sets over two successive days.

Imaging. Imaging tests may show kidney stones in your urinary tract. High-speed or dual energy computerized tomography (CT) may reveal even little stones.

Simple abdominal X-rays are used less often because this type of imaging test may overlook small kidney stones.

Ultrasound, a noninvasive test that is quick and easy to perform, is just another imaging choice to diagnose kidney stones.

Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Your doctor uses this information to ascertain what’s causing your kidney stones and also to form a plan to prevent more kidney stones.

Treatment of Kidney Stones:

Treatment for kidney stones varies, depending on the form of rock and the cause.

Small stones with minimal symptoms:

Many small kidney stones will not need invasive treatment. You may be able to pass a little stone by:

Drinking water. Drinking as much as 2 to 3 quarts (1.8 to 3.6 liters) per day will keep your urine dilute and may prevent stones from forming.

Unless your doctor tells you otherwise, drink enough fluid — ideally mostly water — to produce clear or nearly clear urine.

Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).

Medical therapy. Your doctor may provide you a medication to help your kidney stone. This type of medication called an alpha-blocker, calms the muscles in your ureter, assisting you to pass the kidney stone more quickly and without pain.

Examples of alpha-blockers include tamsulosin (Flomax) along with the drug mix dutasteride and tamsulosin (Jalyn).

 Large Kidney Stones cause and symptoms:

Kidney stones that are too large to pass on their own or cause discomfort, kidney damage, or continuing urinary tract infections may require more-extensive treatment. Procedures may include:

Using sound waves to break up stones.

For specific kidney stones — based on size and place — your doctor may recommend a process known as extracorporeal shock wave lithotripsy (ESWL).

ESWL uses sound waves to make powerful vibrations (shock waves) that break the stones into tiny pieces that can be passed into your urine.

The procedure lasts approximately 45 to 60 minutes and can cause moderate pain, which means you may be under sedation or light anesthesia to make you comfortable.

ESWL can lead to blood in the urine, bruising on the back or stomach, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

Surgery to remove huge stones in the kidney.

A procedure known as percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a tiny incision in your back.

You will receive general anesthesia during the surgery and be in the hospital one to two times as you recuperate. Your doctor may recommend this operation if ESWL is ineffective.

Using a scope to remove stones.

To remove a smaller stone on your ureter or kidney, your doctor can pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder into your ureter.

Once the stone is located, special tools can snare the stone or break it into pieces that will pass on your urine.

Your doctor can then put a tiny tube (stent) in the ureter to relieve swelling and promote healing. You might require local or general anesthesia during this process.

Parathyroid hormone operation.

Some calcium phosphate stones are brought on by overactive adrenal glands, which are located on the four corners of your thyroid gland, just below your Adam’s apple.

When these glands produce too much parathyroid hormone (hyperparathyroidism), the calcium levels can become too large and kidney stones may form as a result.

Hyperparathyroidism occasionally happens when a small, benign tumor forms in one of your parathyroid glands or you build a different condition which leads the glands to produce more parathyroid hormone.

Taking away the development from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that’s causing your parathyroid gland to overproduce the hormone.

Prevention of Kidney Stones:

Prevention of kidney stones may have a combination of lifestyle changes and medications.

 Lifestyle changes:

You may Lower Your risk of kidney stones if you:

 Drink water throughout the day. For people with a history of kidney stones, doctors usually recommend drinking sufficient fluids to pass around 2.1 quarts (2 liters) of urine a day.

Your doctor may ask you to measure your urine output to make certain that you’re drinking enough water.

If you live in a warm, dry climate or you exercise regularly, you might have to drink even more water to produce enough urine. If your urine is light and clear, you’re probably drinking enough water.

 Eat fewer oxalate-rich foods. If you tend to form calcium oxalate stones, your doctor might recommend restricting foods rich in oxalates.

These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate, black pepper, and soy products.

 Choose a diet low in salt and animal protein. Reduce the amount of salt you consume and choose nonanimal protein sources, such as legumes. Consider using a salt substitute, such as Mrs. Dash.

 Continue eating calcium-rich foods, but use caution with calcium supplements. Calcium in food does not have an effect on your risk of kidney stones.

Request your doctor before taking calcium supplements, because these have been linked to a greater risk of kidney stones.

You may lessen the danger by taking supplements with meals. Diets low in calcium may increase kidney stone formation in certain people.

Ask your doctor for a referral to a dietitian who will help you develop an eating plan that reduces your risk of kidney stones.

Medications of Kidney Stones:

Medicines can control the number of salts and minerals in the urine and may be useful in people who form certain kinds of stones.

The type of medicine your doctor prescribes will depend on the kind of kidney stones you have.

Calcium stones. To help prevent calcium stones from forming, your doctor can prescribe a thiazide diuretic or a phosphate-containing preparation.

Uric acid stones. Your doctor may prescribe allopurinol (Zyloprim, Aloprim) to decrease uric acid levels in your blood and urine and medication to keep your urine alkaline.

In some cases, allopurinol and an alkalizing agent can violate the uric acid stones.

Struvite stones. To prevent struvite stones, your doctor may recommend strategies to maintain your urine free of bacteria that cause disease, including drinking fluids to maintain decent urine flow and frequent voiding.

In rare instances, long-term use of antibiotics in irregular or small doses may help achieve this objective. For instance, your doctor can recommend an antibiotic before and for some time after surgery to treat your kidney stones.

Cystine stones. Along with suggesting a diet lower in protein and salt, your doctor may advise that you drink more fluids so that you generate a lot more urine,.

If that alone doesn’t help, your doctor may also prescribe a medicine that increases the solubility of cystine in your urine.

Clinical trials for Kidney Stone:

Research Clinic studies testing new treatments, interventions, and tests as a way to prevent, detect, treat or handle this condition.

Preparing for your appointment

Small kidney stones that don’t block your kidney or cause other problems can be treated by your family doctor.

But in case you have a large kidney stone and experience acute pain or kidney problems, your doctor can refer you to a doctor who treats problems in the urinary tract (urologist or nephrologist).

 Everything you can do:

To Get Ready for your appointment:

  1. Ask if there is anything you have to do before your appointment, for example, limit your diet.
  2. Write down your symptoms, such as any that seem unrelated to kidney stones.
  3. Keep tabs on how much you drink and urinate during a 24-hour period.
  4. Make a list of medications, vitamins, or other nutritional supplements you take.
  5. Take a family member or friend along, if at all possible, so you can remember what you talk with your doctor.
  6. Write down questions to ask your doctor.

For kidney stones, some fundamental questions include:

  1. Do I have a kidney stone?
  2. What size is your kidney stone?
  3. Where’s the kidney stone located?
  4. What type of kidney stone do I have?
  5. Will I need medication to treat my affliction?
  6. Will I need surgery or another process?
  7. What’s the chance that I’ll develop another kidney stone?
  8. How do I prevent kidney stones in the long run?
  9. I have other health conditions. How do I best manage these collectively?
  10. Do I need to follow any constraints?
  11. Can I see a specialist? If this is so, does insurance typically cover the assistance of a specialist?
  12. Can there be a generic solution to the medicine you are prescribing?
  13. Do you have any educational material I can take with me? What websites do you recommend?
  14. Do I need a follow-up trip?

Apart from the questions, you prepare in advance, do not hesitate to ask any other questions during your appointment as they happen to you.

What to expect from the doctor  for Kidney stones:

Your doctor is likely to ask you a number of queries, for example:

  1. When did your symptoms start?
  2. Have your symptoms been continuous or intermittent?
  3. How severe are your symptoms?
  4. What, if anything, seems to boost your symptoms?
  5. What, if anything, seems to worsen your symptoms?
  6. Has anybody else in your family had kidney stones?

Ask your friends and loved ones for support. If you’re feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain…

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