Kidney Stones

What are kidney stones?
Kidney stones are small, hard bits of crystals that have grown in the kidney, made of minerals like calcium that are filtered by the kidney. They can be small, much smaller than a pea, but the symptoms the stone causes and it's adverse effects on the upper urinary tract can be significant and complicated.

How do kidney stones form?
Kidneys filter the blood by removing excess water and metabolic end-products of ingested food and drugs, to produce urine. Urine passes from each kidney down a conduit called the ureter into the urinary bladder, then out of the body through the urethra once the bladder becomes full. Many constituents of urine are soluble in the urine and these pass as solution in urine. But there are some constituents which are not soluble in urine. These chemicals pass in urine as small crystals in urine which can clump together to form a stone.

What are the symptoms of kidney stones?
Passing a kidney stone has been described as one of the worst pains, one can experience! Not surprising that female patients with urinary calculi often describe this pain as akin to labour pain. They're usually without symptoms when they're growing in the kidney, but when they pass down the very narrow tube called the ureter, they can get stuck and cause severe pain called ‘renal colic’. Renal colic is an intermittent severe pain in your back or side that might move into your pelvis, upper thighs or towards the external urinary opening as the stone is passing down to the bladder. It's often associated with nausea and vomiting and frequent urination. There may be blood in the urine, occasionally patients may get fever also.

What are kidney stones made up of and how are they caused?
There are different kinds of minerals in kidney stones, but the most common are calcium-containing stones. There are some disease that are associated with kidney stones, like gout, overactive parathyroid gland and others. But the most common stones just happen without any predisposing metabolic condition.

Can kidney stones damage kidneys?
Yes, but rarely. Kidney stones can cause damage if they cause repeated or serious infections. Or, they can damage kidneys if there is a blockage for a long time. Some stones, if left untreated, can cause the kidney to stop working.

How can kidney stones be treated?
Very small stones may pass out spontaneously within 4 weeks; for such stones, your doctor may ask you to drink plenty of water to facilitate the spontaneous expulsion, and monitor you closely at regular intervals; you may be prescribed analgesics if you have pain. Some stones may be treated with medication, called as medication expulsion therapy or MET. For larger stones, there are various treatment options for managing kidney stones. Yet larger stones may require surgical removal. With advances in the field of medicine, we have minimal-invasive options available too.

What are the ways to help prevent kidney stones?

1. Limit your salt intake to not more than 4-5 gm per day. Avoid a high-salt diet, snack foods, and preservative-rich foods such as processed foods, canned foods, fast foods. Avoiding these are all part of the healthy diet anyway, and the rise of these foods in our diet has been associated with the obesity epidemic.
2. Eat your fiber, fruits and veggies, without salt, or less salt.
3. Restrict animal protein intake (0.8 gm per kg body weight per day).
4. Make sure you drink enough water. Getting dehydrated or low fluid intake is a risk for stone formation. Balance any excessive fluid loss. Aim for 2 - 2.5 litre of water per day.
5. Some studies suggest that increased calcium increases the risk of kidney stones, some show that it doesn't. Don’t restrict your calcium, but don’t get too much, because some sources of calcium like cheese are high in sodium. Eat the recommended amount of calcium (1000-1200 mg per day).
6. Maintain a healthy weight (Body mass index: 18-25). Obesity is a risk, Have adequate physical activities and regular exercising.
7. Keep your diabetes or high blood pressure under control.
8. Avoid smoking. Smoking slows the flow of blood to the kidneys, which may reduce their function.
9. Limit stress. Poor life style, lack of exercise, sedentary life increase chances of getting stones.
10. It you’ve had a stone, talk to your doctor about what kind of stone you’ve made, what minerals were the crystals made of, and what should you do to decrease your risk of recurrence. Avoid skipping scheduled follow up visits to your doctor.

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