About to the kidneys and urinary system
The kidneys are fist-size organs that handle the body’s fluid and chemical levels. Most people have two kidneys, one on each side of the spine behind the liver, stomach, pancreas and intestines. Healthy kidneys clean waste from the blood and remove it in the urine. They control the levels of sodium, potassium and calcium in the blood.
The kidneys, ureters and bladder are part of your urinary tract. The urinary tract makes transports and stores urine in the body. The kidneys make urine from water and your body’s waste. The urine then travels down the ureters into the bladder, where it is stored. Urine leaves your body through the urethra.
What are Kidney Stones or urolithiasis (urinary stone)?
Kidney stones are hard deposits of minerals and acid salts that stick together in concentrated urine. Kidney stones can start small but can grow larger in size even filling the inner hollow structures of the kidney. Some stones stay in the kidney and do not cause any problems. Sometimes, the kidney stone can travel down the ureter (tube between the kidney and the bladder). If the stone reaches the bladder, it can be passed out of the body in urine. If the stone becomes lodged in the ureter, it blocks the urine flow from that kidney and causes pain. Kidney stones form in the kidney. Some stones move from the kidney into the ureter. The ureters are tubes leading from the kidneys to the bladder. If a stone leaves the kidney and gets stuck in the ureter, it is called a ureteral stone.
What are Kidney Stones Made of?
Kidney stones come in many different types and colors. How you treat them and stop new stones from forming depends on what type of stone you have:- Calcium stones (80 percent of stones)- Calcium stones are the most common type of kidney stone. There are two types of calcium stones:- calcium oxalate and calcium phosphate. Calcium oxalate is by far the most common type of calcium stone. Some people have too much calcium in their urine, raising their risk of calcium stones. Even with normal amounts of calcium in the urine, calcium stones may form for other reasons. Uric acid stones (5-10 percent of stones)- Uric acid is a waste product that comes from chemical changes in the body. Uric acid crystals do not dissolve well in acidic urine and instead will form a uric acid stone. Having acidic urine may come from:- Chronic diarrhea, Type 2 diabetes (high blood sugar),Gout and Being overweight, A diet that is high in animal protein and low in fruits and vegetables. Struvite/infection stones (10 percent of stones)- Struvite stones are not a common type of stone. These stones are related to chronic urinary tract infections (UTIs). Some bacteria make the urine less acidic and more basic or alkaline. Magnesium ammonium phosphate (struvite) stones form in alkaline urine. These stones are often large, with branches, and they often grow very fast. Cystine stones (less than 1 percent of stones)- Cystine is an amino acid that is in certain foods. it is one of the building blocks of protein. Cystinuria (too much cystine in the urine) is a rare, inherited metabolic disorder. It is when the kidneys do not reabsorb cystine from the urine. When high amounts of cystine are in the urine, it causes stones to form. Cystine stones often start to form in childhood.
Symptoms
Common symptoms of kidney stones include a sharp, cramping pain in the back and side.This feeling often moves to the lower abdomen or groin. The pain often starts suddenly and comes in waves. It can come and go as the body tries to get rid of the stone. other signs of a kidney stone include:-
- A feeling of intense need to urinate.
- Urinating more often or a burning feeling during urination.
- Urine that is dark or red due to blood. Sometimes urine has only small amounts of red blood cells that can’t be seen with the naked eye.
- Nausea and vomiting.
- For men, you may feel pain at the tip of the penis.
Symptoms of Urinary tract infection due to kidney stone
- Painful urination (Dysuria) – Burning or discomfort while urinating.
- Frequent urination – A frequent urge to urinate, often with little urine passing.
- Blood in urine (Hematuria) – Pink, red, or brown urine due to blood.
- Cloudy or foul-smelling urine – Urine that looks or smells unusual.
- Flank pain – Severe pain in the back, side, or lower abdomen, often radiating to the groin.
- Fever and chills – A sign of infection, especially in more serious cases.
- Nausea and vomiting – May occur due to the pain and infection.
If you experience these symptoms, seek medical attention as untreated kidney stones causing a UTI can lead to serious complications like kidney infection (pyelonephritis).
Causes
Low Urine Volume
A major risk factor for kidney stones is constant low urine volume. Low urine volume may come from dehydration (loss of body fluids) from hard exercise, working or living in a hot place or not drinking enough fluids. When urine volume is low, urine is concentrated and dark in color. Increasing fluid intake will dilute the salts in your urine. By doing this, you may reduce your risk of stones forming.
Diet
Diet can also affect the chance of forming a stone. One of the more common causes of calcium kidney stones is high levels of calcium in the urine. High urine calcium levels may be due to the way your body handles calcium. A diet high in animal protein, such as beef, fish, chicken and pork, can raise the acid levels in the body and in the urine. High acid levels make it easier for calcium oxalate and uric acid stones to form. The breakdown of meat into uric acid also raises the chance that both calcium and uric acid stones will form.
Bowel Conditions
Certain bowel conditions that cause diarrhea (such as Crohn’s Disease or ulcerative colitis) or surgeries (such as gastric bypass surgery) can raise the risk of forming calcium oxalate kidney stones. Diarrhea may result in loss of large amounts of fluid from the body, lowering urine volume. Your body may also absorb excessive oxalate from the intestine, resulting in more oxalate in your urine. Both low urine volume and high levels of urine oxalate can help to cause calcium oxalate kidney stone formation.
Obesity
Obesity is a risk factor for stones. Obesity may change the acid levels in the urine, itl leads to stone formation.
Medical conditions Family History
Some medical conditions have an increased risk of kidney stones. Abnormal growth of one or more of the parathyroid glands, which control calcium metabolism, can cause high calcium levels in the blood and urine. This can lead to kidney stones. Another condition called distal renal tubular acidosis, in which there is acid build-up in the body, can raise the risk of calcium phosphate kidney stones.
Medication
Some medications -calcium and vitamin C supplements may increase your risk of forming stones. Be sure to tell your health care provider all the medications and supplements you take, as these could affect your risk of stone formation.
Family History
The chance of having kidney stones is much higher if you have a family history of stones, such as a parent or sibling.
Diagnosis
“Silent” kidney stones, those that cause no symptoms are often found when an X-ray is taken during a health exam. Other people have their stones diagnosed when sudden pain occurs while the stone is passing and medical attention is needed.
Blood and Urine Tests
After taking a complete history and doing a physical exam, your health care provider may take blood and urine samples for testing. Blood tests can help find if a medical problem is causing your stones. Your urine can be tested to see if you have a urinary tract infection or crystals that are typical of different stone types. This test will reveal the levels of different stone-forming substances in your urine. If you are at high risk for getting stones in the future, a 24-hour urine collection can be done
Imaging Tests
When a person has blood in the urine (hematuria) or sudden abdominal or side pain, tests like an ultrasound or a CT scan may diagnose a stone. These imaging tests tell the health care provider how big the stone is and where it is located. A CT scan is often used in the ER when a stone is suspected. It is used because it can make a quick and exact diagnosis. They will do this to see if there are any stones in your urinary tract. Imaging tests may be repeated over time to check for stone growth. You may also need this test if you are having pain, hematuria (blood in your urine) or recurrent infections.
Treatment
Treatment depends on the type of stone.There are different treatments to choose from. It is important to talk to your health care provider about what is best for you. At Global Poly Clinic,Dhanaura we offer a comprehensive approach combining modern medicine, Unani, and herbal treatments.
Wait for the stone to pass by itself
Often you can simply wait for the stone to pass. Smaller stones are more likely than larger stones to pass on their own. Waiting up to four to six weeks for the stone to pass is safe as long as the pain is bearable, there are no signs of infection, the kidney is not completely blocked and the stone is small enough that it is likely to pass. While waiting for the stone to pass, you should drink normal amounts of water. You may need pain medication when there is discomfort.
Medication
Certain medications have been shown to improve the chance that a stone will pass. You may also need pain and anti-nausea medicine as you wait to pass the stone. Global Poly Clinic offers specialized herbal and Unani treatments that can help dissolve and pass kidney stones naturally.
Surgery
Kidney stones should be removed by surgery if they cause repeated infections in the urine or because they are blocking the flow of urine from the kidney.Surgery may be needed to remove a stone from the ureter or kidney if:-
- The stone fails to pass.
- The pain is too great to wait for the stone to pass.
The stone is affecting kidney function. Small stones in the kidney may be left alone if they are not causing pain or infection.
Surgeries to remove stones in the kidneys or ureters are:
Percutaneous nephrolithotomy (PCNL)
Percutaneous Lithotripsy (PCNL) is the best treatment for large stones in the kidney. General anesthesia is needed to do a PCNL. PCNL involves making a half-inch incision (cut) in the back or side, just large enough to allow a rigid telescope (nephroscope) to be passed into the hollow center part of the kidney where the stone is located. An instrument passed through the nephroscope breaks up the stone and suctions out the pieces.The ability to suction pieces makes PCNL the best treatment choice for large stones. After the PCNL, a tube is usually left in the kidney to drain urine into a bag outside of the body. This will allow for drainage of urine and stop any bleeding. You may have to stay in the hospital overnight after this operation. Your urologist may choose to do X-rays while you are still in the hospital to see if any stone pieces remain. If your urologist may want to look back into the kidney with a telescope again to remove them. You can begin normal activities after about one-to-two weeks.
Shock wave lithotripsy (SWL)
Shock Wave Lithotripsy (SWL) is used to treat stones in the kidney and ureter. Shock waves are focused on the stone using X-rays or ultrasound to pinpoint the stone. Repeated firing of shock waves on the stone usually causes the stone to break into small pieces.These smaller pieces of stones pass out in the urine over a few weeks.Because of possible discomfort caused by the shock waves and the need to control breathing during the procedure. SWL does not work well on hard stones such as cysteine or some types of calcium oxalate and calcium phosphate stones or very large stones. With SWL, you may go home the same day as the procedure. You may be able to resume normal activities in two to three days. You may also be given a strainer to collect the stone pieces as they pass. Although SWL is widely used and considered very safe, it can still cause side effects. You may have blood in your urine for a few days after treatment. Most stone pieces pass painlessly. Larger pieces may get stuck in the ureter, causing pain and needing other removal procedures.
Ureteroscopy (URS)
Ureteroscopy (URS) is used to treat stones in the kidney and ureter. URS involves passing a very small telescope (It is called an ureteroscope) into the bladder, up the ureter and into the kidney. Rigid telescopes are used for stones in the lower part of the ureter near the bladder. Flexible telescopes are used to treat stones in the upper ureter and kidney. The ureteroscope lets the urologist see the stone without making an incision (cuts). General anesthesia keeps you comfortable during the URS procedure.If a stone is too large to remove in one piece, it can be broken into smaller pieces with a laser or other stone-breaking tools. Once the stone has been removed whole or in pieces, the health care provider may place a temporary stent in the ureter. A stent is a tiny, rigid plastic tube that helps hold the ureter open so that urine can drain from the kidney into the bladder. Unlike a catheter or PCNL drain tube, this tube is completely within the body and does not require an external bag to collect urine. You may go home the same day as the URS and can begin normal activities in two to three days. If your urologist places a stent, he or she will remove it four to 10 days later. Leaving the stent in for long periods can cause an infection and loss of kidney function.
Other surgery
Other kidney surgery is rarely used to remove stones. Open, laparoscopic or robotic surgery may be used only if all other less invasive procedures fail.
Prevention of Future kidney Stones
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications.There is no “one-size-fits-all” diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form.
Diet Changes
Drink enough fluids each day
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But it’s best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces (2.5 liters) of urine daily. Health care providers recommend people who form cystine stones drink more liquid than other stone formers. Usually 4 liters of liquid is advised to reduce cystine levels in your urine.
Reduce the amount of salt in your diet
This tip is for people with high sodium intake and high urine calcium or cystine. Sodium can cause both urine calcium and cystine to be too high. Your health care provider may advise you to avoid foods that have a lot of salt. The following foods are high in salt and should be eaten in moderation:-
- Cheese,
- Most frozen foods and meats,
- Canned soups and vegetables,
- Breads, bagels, rolls and baked goods,
- Salty snacks,
- Bottled salad dressings and certain breakfast cereals,
- Pickles and olives,
- Mixed foods, pizza and lasagna,
- Canned and bottled sauces,
Eat the recommended amount of calcium
If you take calcium supplements, make sure you aren’t getting too much calcium. On the other hand make sure you aren’t getting too little calcium either. Good sources of calcium to choose from often are those low in salt. Eating calcium-rich foods or beverages with meals every day is a good habit. There are good choices especially if you avoid dairy. You can usually get enough calcium from your diet without supplements if you eat three-to-four servings of calcium-rich food. Many foods and beverages have calcium in them.
Eat plenty of fruits and vegetables
Eating at least five servings of fruits and vegetables daily is recommended for all people who form kidney stones. Eating fruits and vegetables give you potassium, fiber, magnesium, antioxidants, phytate and citrate, all of which may help keep stones from forming.A serving means one piece of fruit or one potato or one cup of raw vegetables.
Eat foods with low oxalate levels
This recommendation is for patients with high urine oxalate. Eating calcium-rich foods with meals can often control the oxalate level in your urine. Urinary oxalate is controlled because eating calcium lowers the oxalate level in your body. But if doing that does not control your urine oxalate, you may be asked to eat less of certain high-oxalate foods. Nearly all plant foods have oxalate, but a few foods contain a lot of it. These include spinach, rhubarb and almonds. It is usually not necessary to completely stop eating foods that contain oxalate.
Eat less meat
If you make cystine or calcium oxalate stones and your urine uric acid is high, eat less animal protein. If your health care provider thinks your diet is increasing your risk for stones, he or she will tell you to eat less meat, fish, seafood, poultry, pork, lamb, mutton and game meat than you eat now. This might mean eating these foods once or twice rather than two or three times a day, fewer times during the week, or eating smaller portions when you do eat them. The amount to limit depends on how much you eat now and how much your diet is affecting your uric acid levels.
Incidence
The incidence of kidney stones has been steadily increasing worldwide, affecting about 10-15% of the global population. In developed countries, the lifetime risk of developing a kidney stone is estimated to be around 9-12% in men and 5-6% in women. Men are more likely to develop kidney stones, especially between the ages of 30 and 50. However, recent trends show a rise in cases among women and younger individuals, possibly due to dietary and lifestyle changes. Factors like dehydration, high-sodium diets, obesity, and sedentary lifestyles contribute to the growing incidence of kidney stones globally.
Conclusion
In conclusion, renal calculus, or kidney stones, is a common yet potentially painful condition that requires timely diagnosis and management. While the formation of these stones can often be linked to factors like diet, hydration, and genetics, understanding the symptoms and seeking early treatment is crucial. At Global Poly Clinic, we offer a comprehensive approach to treating kidney stones, utilizing modern, Unani, and herbal medicine to ensure effective and holistic care. Prevention strategies, such as maintaining proper hydration and dietary adjustments, are essential in reducing the risk of recurrence. By taking proactive steps and following medical advice, you can minimize the impact of kidney stones on your health and well-being.