Kidney Stones

Kidney stones are small, hard deposits that form inside the kidneys.

Stones are composed of acid and mineral salts, and kidney stones form as a result of many causes.

It can affect any part of the urinary tract - from the kidneys to the bladder.

Passing kidney stones can be painful, but they usually do not cause permanent damage to the kidneys

Depending on your condition, you may need nothing more than to take pain relievers and drink plenty of water to get rid of a gallstone, and in some cases, surgery may be required.

Your doctor can recommend preventive treatment to reduce your risk of recurrent kidney stones

Symptoms

A kidney stone may have no symptoms until it moves into the kidney or travels to the ureter, the tube that connects the kidneys to the bladder.  At this point, you may have these signs and symptoms:

1- Severe pain in the flank, back and under the ribs.
2- Pain spreading to the lower abdomen and groin area.
3- Pain that comes in waves and changes in intensity.
4- Pain during urination.
5- Pink, red, or brown urine.
6- Cloudy or foul-smelling urine.
7- Nausea and vomiting.
8- An urgent and constant need to urinate.
9- Urinating more than usual.
10- Fever and chills in case of infection

reasons

Mostly, there is no single specific cause of kidney stones

Kidney stones form when the urine contains more crystal-forming substances, such as calcium, oxalate and uric acid, than the fluid in the urine can dilute.

Meanwhile, urine may not contain substances that prevent the crystals from sticking together

Types of kidney stones

Knowing the type of kidney stone helps determine the cause and may give clues on how to reduce your risk of developing more of them in the future.  Types of kidney stones include:

1- Calcium stones
Most kidney stones are of the calcium stone type, often in the form of calcium oxalate.

Some fruits and vegetables, as well as nuts and chocolate, contain high levels of oxalate.  The liver also secretes this substance

Nutritional factors, high doses of vitamin D, gastric bypass surgery, and several metabolic disorders can contribute to an increased concentration of calcium or oxalate in urine.

2- Struvite stones

Struvite stones form as a result of an infection, such as a urinary tract infection.  These stones can grow quickly and become very large, sometimes with few symptoms or little warning.

3- Uric acid stones

Uric acid stones can form in people who don't drink enough fluids or lose a lot of fluids, people who eat a high-protein diet and people who have gout.  Certain genetic factors contribute to an increased risk of developing uric acid stones.

4- cystine stones

These stones form in people with a genetic disorder that causes the kidneys to excrete large amounts of certain amino acids.

risk factors

Factors that increase the risk of developing kidney stones include:

1. Family or personal history
If someone in your family has had kidney stones, you are likely to get them too, and if you already have one or more kidney stones, you are at greater risk of developing another.

2.  puberty
Kidney stones are more common in people 40 and older, although they can occur at any age

3. Gender
The risk of developing kidney stones increases among men, although the number of women with them is increasing

4. Dehydration
Not drinking enough water every day can increase the risk of developing kidney stones

5.  specific diets

A diet high in protein, sodium (salt) and sugar increases the risk of some types of kidney stones.
Containing a large proportion of salt in your diet increases the amount of calcium that the kidneys need to filter and significantly contributes to the increased risk of developing kidney stones.

6.  obesity
A high body mass index (BMI) and a large waist size are associated with an increased risk of kidney stones.

7. Gastrointestinal diseases and surgery
Gastric bypass surgery, inflammatory bowel disease, or chronic diarrhea can cause changes in the digestive process that, in turn, affect the body's ability to absorb calcium and water.

treatment

Treatment for kidney stones varies depending on the type of stone and the cause of its formation.

First: small pebbles with minor symptoms

- Drinking more water
Drinking 2-3 liters of water a day can help purify the urinary system from sediment. Make sure you drink enough fluids - mostly water - so that the urine that the body secretes is completely clear

Pain relievers
The exit of a small pebble can cause some pain. To relieve mild pain, your doctor may recommend pain relievers.

- The medical treatment
This type of treatment, known as an alpha-blocker, relaxes the muscles of the ureter and helps you get rid of kidney stones more quickly and with less pain.

Second: large stones and stones accompanied by symptoms

Kidney stones that cannot be treated by conservative measures, either because they are too large to leave the body alone, or because they cause bleeding, kidney damage, or persistent infection in the urinary tract, may require more surgical intervention.

Actions may include:

1.  Using sound waves to break up stones

For certain types of kidney stones - depending on the size and location of the stones - the doctor may recommend a procedure called extracorporeal shock wave lithotripsy - ESWL. This technique uses sound waves to create strong vibrations (shock waves).

The procedure lasts about 45 to 60 minutes and can result in moderate pain, so your doctor may give you a light anesthetic until you feel comfortable.

Extracorporeal shock wave lithotripsy can cause blood in the urine, bruising on the back or abdomen, and bleeding around the kidneys and other nearby organs

2.  Surgery to remove very large stones

It involves surgical removal of stones using small endoscopes and tools inserted through a small incision in the back, and the surgery is done under general anesthetic.

3.  Use of endoscopes to remove stones

The doctor passes a ureteral tube (ureteroscope) equipped with a camera through the urethra and bladder to the ureter, and once the stones are located, special tools can be used to catch them or break them into pieces that come out with urine, then the doctor places a small tube (stent) in the ureter to reduce swelling and promote the healing process

4.  Parathyroid surgery

Some calcium stones are formed as a result of overactive parathyroid glands, which are the glands on all four sides of the parathyroid gland. When these glands secrete parathyroid hormone in large quantities, calcium levels in the body can rise too high and kidney stones can form as a result.

prevention

First: lifestyle change
You can reduce your risk of developing kidney stones by following these steps:

- Make sure to drink water throughout the day
For people who have a history of kidney stones, the doctor usually advises them to drink enough water that makes their bodies excrete about 2.5 liters of urine per day.

Eat less oxalate-rich foods

If your body tends to form calcium oxalate stones, your doctor may recommend limiting your intake of foods rich in oxalate, which include rhubarb, beets, okra, spinach, chard, sweet potatoes, nuts, tea, chocolate and soy products.

Choose a low protein diet
Reduce the amount of salt you consume, and choose non-animal sources of protein, such as legumes.

Continue to eat calcium-rich foods unless your doctor advises you otherwise, but use caution when taking calcium supplements as they have been associated with an increased risk of kidney stones.

Second: drug therapy

Medications can control the amount of minerals and acids in your urine. The type of medication your doctor prescribes depends on the type of kidney stone you have. Some examples:

Calcium stones
To help prevent calcium stones from forming, your doctor may prescribe a thiazide diuretic or a phosphate-containing preparation.

- Uric acid stones

Your doctor may prescribe the medication allopurinol to reduce uric acid levels in your blood and urine, as well as medication to keep your urine alkaline. In some cases, allopurinol and the alkaline agent dissolve uric acid stones.

- struvite stones

Your doctor may recommend strategies to keep your urine free of bacteria that cause infection, and long-term use of antibiotics in small doses helps.
For example, your doctor may recommend taking an antibiotic before and for a while after undergoing kidney stone surgery

- cystine stones

Drinking enough water to maintain urine output of at least 2.5 liters per day is an acceptable measure to prevent cystine stones.  The patient should be given nutritional advice and followed, with increased alkalinity of urine.