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Kidney Stone Treatments

  • medical_centre
  • January 4, 2020

Kidney stone is one of the most painful medical conditions for humans. Kidney stones as the name suggests, usually originate in the kidneys. However, stones can develop anywhere along the urinary tract, which consists of these parts:

  • Ureters
  • Urinary Bladder
  • Urethra

Kidney stones vary in size; can be as small as a grain or as large as a pearl. A kidney stone of any size if stuck in the urinary tract, block urine from getting through.

Causes of Kidney Stone

Kidney stones are formed when urine has high levels of certain minerals like Calcium, Oxalate, Uric Acid.

However, other risk factors make one more likely to get kidney stones. These include:

  • Family history or personal history: a person is more likely to develop kidney stones if someone in his/her family has kidney stones. In addition, if someone already had one or more kidney stones, that person is at increased risk of developing another stone.
  • Dehydration or less intake of fluids: People who do not drink enough water each day can increase the risk of developing kidney stones in them.
  • Certain type of diets: Diet that has high amount of protein, sodium (salt) and sugar may increase the risk of some types of kidney stones development. Excessive salt in diet increases the amount of calcium our kidneys must filter and eventually increases the risk of kidney stones.
  • Obesity or overweight
  • Other medical conditions: Few conditions like renal tubular acidosis, hyperparathyroidism and some urinary tract infections may increase the risk of kidney stones.
  • Digestive diseases: Diarrhoea for long time or Inflammatory bowel disease can cause changes in the digestive process, which further affects the absorption of calcium and water that increase the level of stone developing substances in urine.
  • Low Urine Volume: Low urine volume may be a result of dehydration or hard exercise or living in a hot place, or not drinking enough fluids. Urine becomes concentrated and dark in colour when urine volume is low. Concentrated urine indicates there is less fluid to keep salts dissolved which may increase the risk of kidney stone formation.

Types of Kidney Stone

If the patient is suspected to be carrying a kidney stone, he or she is advised to take up the following tests:

  • Calcium stones: the most common type of kidney stone is calcium stone. Calcium stones are of two types: calcium oxalate and calcium phosphate.
    Our liver makes calcium Oxalate regularly also it is a naturally occurring substance found in food. Foods including some fruits and vegetables, as well as nuts and chocolate, have high oxalate content.
    Calcium phosphate stone is found in metabolic conditions, such as renal tubular acidosis.
  • Struvite stones: This type of stone is formed in response to an infection, such as a urinary tract infection. Such stones can grow quickly and become quite large.
  • Uric acid stones: Uric acid stones can develop when urine is too acidic.
  • Cystine stones: These stones develop in people with a hereditary disorder, which causes the kidneys to excrete too much of certain amino acids-cystinuria.

Signs and symptoms of Kidney Stone

One experiences signs and symptoms when the stone can move around within the kidney, or into the tube that connects the kidney to urinary bladder.

  • Severe pain in the side or back, below the ribs
  • Pain in lower abdomen radiating to groin
  • Painful urination
  • Blood in the urine
  • Nausea and vomiting
  • Pink, red, or brown urine with a bad smell
  • Feeling like to pee all the time
  • Fever and chills in case of an infection

Kidney Stone: Diagnosis

Following investigations are used as diagnostic tools to rule out the presence of kidney stones.

  1. Blood tests: Blood tests determine the amount of calcium or uric acid in the blood.
  2. Urine test: It is done to check on any infection.
    • Abdominal x-ray: Abdominal x-rays shows the location of kidney stones in the urinary tract, however not all stones are visible on abdominal x-ray.
    • Computed tomography (CT) scans: CT scans show the size and location of a kidney stone also shows if the stone is blocking the urinary tract.
    • Ultrasound KUB: Shows the size and location of the kidney stone. It is the most commonly recommended diagnostic tool in case of kidney stone.

Treatment options for kidney stones

Several treatment options for kidney stone removal are discussed below:

Medication


There are prescription medications that relax the walls of the ureter and widen the passage so that body pass a kidney stone. Medicines are helpful in very small size stones. Medications are beneficial to get rid of any infection in urine. Also for pain relief, medications are recommended.

Extracorporeal Shock Wave Lithotripsy


ESWL or Extracorporeal Shock Wave Lithotripsy is a procedure in which high-energy shock waves are passed through the kidney(similar to a normal X-ray procedure) to break a kidney stone into little pieces. The small pieces then pass out through the urinary tract more easily over a few weeks.
This procedure takes about an hour, and patient can go home about an hour later. This does not involve any surgical cut or incision. But ESWL does not work well on stones with size more than 8mm.

Surgical options for kidney stones removal

Kidney stones if cause repeated infections in the urine or pain or they are blocking the flow of urine from the kidney,then surgical options are recommended to remove stones in the kidneys or ureters.

Ureteroscopy or URS


Ureterescopy is done when the stone has moved from the kidney and is close to the bladder. In this procedure, a small telescope called Ureteroscope is made to pass into the bladder, up the ureter and into the kidney and stone is removed using a small cage. A camera is attached with Ureterscope.
URS is carried out in General Anaesthesia. No cut is made in this procedure as the scope is passed through Urethra.
In this procedure, patient can be discharged to home on the very same day and can start normal activities after 2-3 days.

Percutaneous Nephrolithotomy or PCNL


Percutaneous Lithotripsy is the gold standard treatment for large kidney stones. PCNL is performed under general anaesthesia. In PCNL, a rigid telescope called “Nephroscope” is passed into the hollow center part of the kidney where the stone is located making a small incision (cut) in the back or side.
An instrument passed through the nephroscope suctions out the stones after breaking into pieces. Hospital stay is of 1 day in PCNL. Patient can start normal activities after 1 week.

Retrograde Intrarenal surgery or RIRS


RIRS is an advanced procedure for doing surgery within the kidney to remove the stones. It is considered to be the best mode of treatment till date. In this procedure, the flexible scope is passed through the urinary opening into the bladder and then the scope is moved up to the urinary tract system (retrograde) to within the kidney (intrarenal). RIRS is performed by a urologist who is expert in performing RIRS. It is done under general or spinal anaesthesia. No cut is involved in this procedure.
Patient can go home after a day of procedure and start daily routine within a week.
RIRS offers a quicker solution of the problem, minimal pain after surgery, and much faster recovery.

Book an appointment for Kidney Stone Treatment at medical treatment Center in Delhi.

To know more, Read other Kidney Stone Blog.

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