Kidney Stones Treatment: Which treatment might suit you?
Kidney stones, scientifically known as “Renal Calculi” is a condition characterized by the presence of hard mineral and salt crystals in one or both kidneys. The causes range from genetics and diet to medications and metabolic diseases. Kidney stones vary in size as well as shape. The smaller ones may pass on their own while passing urine with little or no pain, but those that are larger may get obstructed, leading to severe pain and bleeding. On experiencing any symptoms, one must seek care from a doctor or urologist to avoid any further complications.
The causes of kidney stones are multifactorial. It forms due to an excess amount of the minerals and salts in the urine that crystallize and stick together, becoming more in composition than the fluid in the urine can dilute.
Kidney stones can be made up of different types of crystals depending upon their composition. Identifying it helps determine the course of treatment and prevents its reoccurrence. The various types are:
There are several risk factors that can increase a person's chances of developing kidney stones. These include:
It is important to note that having one or more of these risk factors does not necessarily mean that a person will develop kidney stones, but it does increase the likelihood.
The following medical conditions that could also lead to kidney stones:
A patient with kidney stones may be asymptomatic unless the stones move through the urinary tract, with the most common symptom being, severe abdominal pain (known as renal colic) associated with nausea and vomiting.
Complications that arise from leaving kidney stones untreated are:
In rare cases, untreated kidney stones can lead to serious complications, such as sepsis, a potentially life-threatening infection that can spread throughout the body.
Kidney stones can be diagnosed using the following:
Imaging tests that can help to rule out obstruction are:
Note: The contrast dyes used in imaging tests can cause kidney damage in those with impaired kidney function and hence patients must inform about medications that he/she is taking prior to tests being performed.
Treatment depends on the type of stone and intensity of symptoms. The kidney stones which are smaller with minimal symptoms can be treated with pain relievers, by drinking an adequate amount of water, and through medical therapy.
Medical Therapy
Medications known as an alpha-blocker, relax the muscles in the ureter, helping the patient pass the kidney stone more quickly and with less pain. Kidney stones that are larger in size and cause severe pain, and blood in the urine, and those associated with urinary tract infections may require extensive treatment options such as:
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL is a procedure that uses sound waves to break up kidney stones, depending on size and location. It may require sedation or light anesthesia.
Ureteroscopy
This procedure uses a ureteroscope to remove a smaller stone in the ureter or kidney. The scope has a small wire with a camera attached when inserted into the urethra and is passed into the bladder. The doctor then uses an instrument to remove the stone.
Retrograde Intrarenal Surgery (RIRS)
This procedure may require general or spinal anesthesia. An endoscope with fiber optics is inserted in the retrograde fashion i.e. through the urinary tract opening, via the ureter that connects to the kidneys. Once the stones can be accessed, they are subjected to a Holmium laser and fragments may be grabbed by forceps or ancillary devices-stone baskets.
Percutaneous Nephrolithotomy
This surgery uses a small incision on the back that removes the larger stones in the kidney under general anesthesia. The doctor may recommend this surgery if ESWL is unsuccessful.
Parathyroid Gland Surgery
Parathyroid gland surgery may be considered as a treatment option for kidney stones if they are caused by hyperparathyroidism, which is a condition characterized by overactive parathyroid glands that produce too much parathyroid hormone (PTH). PTH regulates calcium levels in the blood, and when the levels are too high, it can lead to the formation of calcium-based kidney stones. In such cases, surgery to remove the affected parathyroid gland(s) may help to normalize calcium levels and prevent further stone formation.
Kidney stones can be prevented with a combination of medications and lifestyle changes.
Lifestyle changes to reduce the risk of kidney stones:
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The most common way to avoid kidney stones is associated with our diet. Drinking an adequate amount of fluids and eating stone causing food (for example calcium oxalate-rich foods that cause calcium oxalate kidney stones) in moderation are the first line of defence. Other measures include taking special care and addressing any underlying risk factors associated with stones (for example hyperparathyroidism, obesity etc.).
If symptoms appear to be minor at first and not treated by a proper medical professional, it may lead to haematuria (blood in urine) and severe renal colic pain. At a later stage, it may lead to infection, kidney damage, and chronic kidney disease. Hence, prompt treatment is necessary for detection.
Yes, kidney stones are as common in pregnant women as in non-pregnant women.
Having foods that are rich in salt, sugar and animal protein may lead to an increased risk with some type of kidney stones. High doses of vitamin D could also lead to kidney stones.
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