Kidney stone – Causes, symptoms and treatment

Kidney stone disease – Nephrolithiasis is one of the most common urological diseases today. For every 10,000,000 population, approximately 400,000 suffer from this disease.  Nephrolithiasis most often affects people aged 20-50 years and leads to disability in 20% of patients. What are the causes of this dangerous disease?

As you know, the function of the kidneys in the body is to filter metabolic products and excrete waste along with urine. Unfortunately, often the kidneys do not fully cope with their task, allowing some chemical compounds to linger and form crystals.  Subsequently, these crystals are deposited on the walls of the kidney, forming calculi.

Causes of kidney stone

The causes of kidney stones are still not fully understood. However, it is known that often the formation of calculi in the kidneys is facilitated by:

• metabolic disorders, most often associated with improper diet
• urinary tract infections
• endocrine disease
• hereditary metabolic disease
• lifestyle (eating habits, hot climate, with poor fluid intake
• the composition of the water you drink (Water with a high content of calcium salts)
• vitamin deficiency (constant lack of vitamins in food)
• chronic gastrointestinal diseases
• diseases of the genitourinary system (cystitis, pyelonephritis, prostatitis, prostate adenoma, etc.)

Symptoms of kidney stone

Often, especially in the initial stages, kidney stones are asymptomatic. Often, a person learns about his diagnosis by chance, during an ultrasound or X-ray examination. Often calculi in the kidneys make themselves felt with dull pain in the lumbar region, which intensifies after physical exertion.

But the main symptom of kidney stones remains renal colic , which occurs when one of the stones leaves the kidney and tends down the ureter. At this moment, the patient feels an acute sharp pain in the lumbar region.

As the stone progresses, the localization of pain also changes – the pain moves to the lower abdomen, groin, genitals. In this case, in most cases, the body temperature rises, blood pressure rises, nausea, vomiting, chills occur. The patient feels a frequent urge to urinate, which is painful.  Usually, renal colic lasts no more than a day – during this time, the stone leaves the body along with urine. Often after the stone comes out, the patient detects blood impurities in the urine.

If the calculus moving along the ureter is too large, it can get stuck in the ureter. This condition is very dangerous, since the obstruction of the patency of the ureter interferes with the outflow of urine, as a result of which acute renal failure develops.  In this case, the patient should immediately consult a doctor.

Treatment for kidney stone

The urologists of a good Hospital have devoted many years to the study of diseases of the urolithiasis in order to acquire expertise in the selection of the most effective method of cure for the Patient. For example, it is very important to identify the chemical composition of the patient’s stone (after all, they are completely different and, accordingly, react differently to treatment methods):

1. Calcium stones. Most common. The hardest and difficult to dissolve. They are divided into two types:
   • Oxalate stones (composed of calcium and oxalic acid)
   • Phosphate (composed of calcium and phosphoric acid salts). This type of stones is softer than oxalate and easier to crush and dissolve.
2. Uric acid stones are composed of uric acid salts. Colored yellowish and easy to dissolve.  However, if litholytic therapy did not give the desired effect, crushing is prescribed.
3. Structural stones. They arise as a result of the action of bacteria on urea.  They are more common in women than in men.  Poorly soluble with medications
4. Cystine. They arise due to congenital metabolic anomalies. The stones are colorless and dense enough
5. Santinova. Reddish, smooth, rare
6. Cholesterol stones
7. Protein stones, etc.

In order to diagnose the composition and location of stones, to develop the correct strategy for treating the disease (minimally traumatic, taking into account the individual specifics of the Patient), a good health center organizes a quick passage of the following steps according to a specially compiled schedule:

• Examination by a urologist
• Abdominal ultrasound
• Laboratory diagnostics (urine examination, biochemical blood test, urine analysis for salt transport), excretory urography (allows you to see the presence of a stone, its location, location and see impaired renal excretory function)
• If necessary, radioisotope nephroscintigraphy and CT are performed

It is very important to identify urolithiasis at an early stage, the so-called “urine diathesis” (popularly called “sand in the kidneys”). In this case, the size of calculi does not exceed 5 mm, and doctors usually prescribe conservative treatment:

1. Litholytic therapy – drugs whose action is aimed at dissolving calculi. This is a drug that includes madder dye and herbal medicine is also used
2. Lithokinetic therapy – drugs whose action is aimed at stimulating the elimination of calculi from the body. Antispasmodic therapy and analgesic therapy are used. If the stone is in the lower third of the ureter, alpha- blockers can be used

We draw your attention to the fact that if the size of calculi makes their natural excretion impossible, the doctors of a good Hospital recommend resorting to lithotripsy – crushing stones using ultrasound or a laser beam, and in the most advanced cases – to surgery.

Removal of kidney stones

If even before the 80s of the last century, the only method of removing stones from the kidneys was an open surgery, but now this method is used only in the most extreme cases. Surgical operations that require a long recovery period and carry the risk of complications are gradually giving way to minimally invasive stone removal operations.

The following methods of lithotripsy can be distinguished:

1. Distant or remote extracorporeal shock wave therapy. The principle of this method is ultrasonic waves, which are generated by a device located outside the patient’s body. Thanks to the waves, stones begin to collapse. Side effects of this method are the risk of developing hematoma. The procedure cannot be carried out during pregnancy, with some types of oncological diseases, inflammatory processes and blood clotting disease.
2. Contact lithotripsy – defragmentation of stones using ultrasonic waves, compressed air or a laser beam and further extraction of fragments through the urethra. The “gold standard” of lithotripsy today is precisely contact lithotripsy performed with a laser beam, since the use of a flexible uretero- renoscope allows determining the location of the stone with maximum accuracy. It turned out that the laser beam makes it possible to pointwise act on the stone without touching the surrounding tissues, and the flexible ureterenoscope allows you to get into the kidney without making a single surgical incision.