What are kidney stones?
Kidney stones are stones that form in the kidney or the bladder; they are known by doctors as 'urinary calculi'. Kidney stones can vary in size from tiny microscopic fragments to huge stones that fill up much of the kidney. It is a relatively common condition and may affect up to one per cent of adults in Western countries. Men are affected about four times more frequently than women.
What causes kidney stones and who is at risk?
The kidneys filter blood and the fluid produced is concentrated and drains out of the kidney as urine into the bladder. Urine contains various substances called 'salts' (eg calcium salts), which can potentially form stones if they become too concentrated. Urine also contains substances that inhibit the formation of stones.
Two common known causes of hypercalciuria are:
kidneys that 'leak' excess calcium into the urine,
Absorption of too much calcium from food, which is excreted into the urine.
Sometimes calcium is excreted into the urine because the blood level of calcium is too high. This can be caused by:
vitamin D overdose,
overactive thyroid gland,
overactive parathyroid gland,
certain kidney diseases,
cancer,
A condition called sarcoidosis.
A substance called oxalate, which is present in foods such as rhubarb, spinach and nuts, can also increase the formation of calcium stones.
What are the common symptoms and complications of kidney stones?
The affected person may also have chills and a fever, and usually blood is present in the urine. As the stone passes down the ureter towards the bladder, the need to urinate frequently often occurs.
The two major complications of kidney stones happen when a stone completely blocks the flow of urine out of the kidney. The urine trapped above the blockage can become infected and, as the back pressure of urine builds up, the kidney can become swollen and damaged.
What is the treatment for kidney stones?
Small stones that produce no symptoms pass out unnoticed in the urine. If a stone causes symptoms, usually you will be admitted to hospital so that strong painkillers can be given. Drinking plenty of fluids and moving around as much as possible often helps the stone to pass out on its own. All the urine you pass is collected and sieved in the hope of catching the stone for analysis.
If the stone does not pass and causes complications, it can be removed surgically through a small incision. Infected stones are almost always removed with surgery.
Stones may also be removed from the lower part of the ureter using a flexible tube with a snare on its end (a cystoscope), which is passed up the urethra, through the bladder and into the ureter.
Prevention
Once the stone has passed, steps must be taken to prevent another stone forming. This depends on the reason the stone formed in the first place. Excess calcium in the urine can be controlled by: drinking plenty of fluids,
drugs called 'thiazide diuretics',
a low-calcium diet,
cellulose phosphate, which reduces the absorption of calcium from food,
avoiding foods that contain oxalate, such as rhubarb, spinach, nuts, tea, and coffee,
Potassium citrate can help prevent the formation of calcium stones.
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