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Kidney Stones

renal stones


Kidney stones can form within the kidney, within the ureter (the tube draining urine from the kidney) or in the bladder. They can be many different sizes and shapes. The size of kidney stones ranges from tiny microscopic crystals to stones as large as table tennis balls.

How common are kidney stones?

About 5 in 20 men and 3 in 20 women in the India develop a kidney stone at some stage in their life. They can occur at any age but most commonly occur between the ages of 20 and 40. About half of people who develop a kidney stone will have at least one recurrence at some stage in the future.

How do kidney stones form?

The kidneys filter the blood and remove excess water and waste chemicals to produce urineMany waste chemicals are dissolved in the urine. The chemicals sometimes form tiny crystals in the urine which clump together to form a small stone.

What are the symptoms of kidney stones?

  • Pain. A stone that is stuck in a kidney may cause pain in the side of the abdomen.
  • Renal colic. This is a severe pain which comes and goes and is caused by a stone that passes into the ureter (the tube that leads from the kidney to the bladder). The stone becomes stuck. The ureter squeezes the stone towards the bladder, which causes intense pain in the side of your abdomen. The pain may spread down into the lower abdomen or groin. You may sweat or feel sick due to the pain.
  • Blood. You may see blood in your urine caused by a stone rubbing against the inside of your ureter.
  • Infection. Infections can cause fever, pain on passing urine and increased frequency of passing urine.

What causes kidney stones?

Unknown cause

In most cases, there is no known reason why a stone forms.
Underlying causes are uncommon
In a small number of cases, a medical condition is the cause.

Medicines

Taking certain medicines can make you more prone to making kidney stones. Examples include diuretics (water tablets), some chemotherapy medicines for cancer and some medicines used to treat HIV.

You are also more prone to develop kidney stones if you have:

  • Recurrent urine or kidney infections.
  • A kidney with scars or cysts on it.
  • A close relative who has had a kidney stone.

Are any tests needed?

Tests to confirm the presence of a kidney stone
If you have symptoms that suggest a kidney stone, special X-rays or scans of the kidneys and ureters may be done.
Tests to rule out or confirm an underlying cause

  • A blood test to check that the kidneys are working properly.
  • Blood tests to check the level of certain chemicals such as calcium and uric acid.
  • Urine tests to check for infection and for certain crystals.
  • An analysis of the stone if you pass it out. To catch a stone, pass urine through gauze, a tea strainer.

What are the possible complications from kidney stones?

Complications from kidney stones are uncommon. Sometimes a large stone can completely block the passage of urine down one ureter. This may lead to infection or damage to the kidney.

What is the treatment for kidney stones?

The common situations

Most stones that cause renal colic are small and pass out with the urine in a day or so. You should drink plenty of fluids to encourage a good flow of urine. Strong painkillers are often needed to ease the pain until you pass the stone.
Some stones that form and stick in the kidney do not cause symptoms or any harm. They can just be left if they are small.
Sometimes you may be offered medicines to help the stone pass through, such as nifedipine or tamsulosin.

In some cases

  • Extracorporeal shock wave lithotripsy (ESWL). This uses high-energy shock waves which are focused on to the stones from a machine outside the body to break up stones. You then pass out the tiny broken fragments when you pass urine.
  • Percutaneous nephrolithotomy (PCNL) is used for stones not suitable for ESWL. A nephroscope (a thin telescope-like instrument) is passed through the skin and into the kidney. The stone is broken up and the fragments of stone are removed via the nephroscope. This procedure is usually done under general anaesthetic.
  • Ureteroscopy is another treatment that may be used. In this procedure, a thin telescope is passed up into the ureter via the urethra and bladder. Once the stone is seen, a laser (or other form of energy) is used to break up the stone. This technique is suitable for most types of stone.
  • Stone removal can be done by a traditional operation where the skin has to be cut to allow access to the ureter and kidney.

What can I do to help prevent a recurrence of a kidney stone?

Have plenty to drink
The aim is to keep the urine dilute. To do this, you should drink between two and three litres a day. If you work or live in a hot environment, you should drink even more.


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