Kidney stones is a common and painful medical condition which can affect both men and women, in one or both kidneys. Commonly, the condition affects people aged between 30 and 60-years-old, with around three in 20 men and up to two in 20 women developing them at some stage of their lives.
Today's post will look at the symptoms you need to watch out for, the causes of kidney stones and the treatment available. We'll also touch upon the ways in-which you can lower your risk of having them.
What are Kidney Stones?
The medical term for kidney stones as nephrolithiasis. If they cause severe amounts of pain, then they are known medically as renal colic. The kidney stones themselves are hard stones which can form in one or both of your kidneys.
The stones come in different shapes and sizes and are made from salts and minerals which come together to create crystals. Speaking about the stones themselves, Bupa explain:
Most kidney stones (about four out of five) are made up of calcium salts (calcium oxalate or calcium phosphate or both). They can also be made up of other substances including uric acid, cystine and struvite. They vary in size from very small stones under 2mm to large ones over 1cm."
Many kidney stones are too small to cause any problems, with one in 10 people having them without even knowing it.
Kidney stones can form due to a build-up of salts and minerals in your urine. Over time, these create crystals which can build-up within your kidney to form a stone. Once this kidney stone has been created, your body will try to pass it out through your urine. This takes the stone on a journey through your urinary system - kidneys, kidney tubes and your bladder.
According to the NHS, there are four main types of kidney stone:
- Calcium Stones - Caused by too much calcium in your urine. This can occur due to an overactive parathyroid gland, an inherited condition known as hypercalciuria and kidney disease.
- Struvite Stones - Caused by infections, such as a urinary tract infection. These stones are more common in women than men.
- Uric Acid Stones - Caused by large amounts of acid in your urine. This can be triggered by eating a high-protein diet which include plenty of meat, gout and inherited conditions leading to an increase in acid in your body.
- Cystine Stones - This is the rarest form of kidney stone, caused by an inherited condition known as cystinuria. This affects the amount of acid which is passed in your urine.
There is evidence to suggest that recurrent kidney stones can be caused by taking certain medications. This list includes aspirin, certain antibiotics, antacids, diuretics, some antiretroviral medication and certain anti-epileptic medication. A lack of fluids in your body may also cause kidney stones.
Once you’ve had a kidney stone, you're more likely to get another, compared to someone who has never had one. One in 10 people will have them on several occasions, however half of people who’ve had a kidney stone may only get another once in their lifetime.
Some kidney stones are so small that they may go undetected and by passed painlessly in your urine. However, larger stones can get stuck in your ureter, the tube connecting the kidney to the bladder, and the urethra, the tube which urine passes through on its way out of your body.
This can cause severe pain in your abdomen and/or groin and can lead to a urinary tract infection. Other symptoms to look out for include:
- Severe pain or aching in one or both sides of your lower back, which can last for minutes or even hours.
- Feeling restless and unable to lie still.
- Sudden spasms of pain in your tummy, groin or genitals.
- Needing to urinate more often.
- Pain during urination (dysuria).
- Blood in your urine.
- Feeling feverish and sweaty.
These symptoms can also signify that a blockage has indeed caused an infection. Where you feel pain and the type of pain you have depends on where a stone is, not its size. It makes a difference how far down your ureter the stone has travelled before it gets stuck.
A kidney stone which has blocked your ureter can lead to a kidney infection, as waste products are unable to pass by the blockage and a build-up of bacteria is caused. Added symptoms of a kidney infection to look out for include:
- Chills and shivering.
- Feeling weak or tired.
- A high temperature of 38C or over.
- Cloudy and bad-smelling urine.
By looking at your symptoms and medical history, your doctor will usually be able to make a straightforward diagnosis. It will be even easier to diagnose if you've suffered from kidney stones in the past.
To help diagnosis, you may go through a series of tests such as:
- Urine Tests - To check for pieces of stones or any infections.
- Stone Examination - Used on any stones which pass in your urine.
- Blood Tests - To check that your kidneys are working properly, and the level of substances in your body which could lead to kidney stones.
Having a stone available to test will make diagnosis much easier and can also make your doctor's decision on treatment much simpler. You can collect a kidney stone by urinating through some gauze or a stocking.
If you have a high temperature alongside your pain, it may be that you're referred to a urologist, who is a specialist in treating urinary problems. If you're referred to hospital for an imaging test, several techniques may be used:
- CT Scan.
- Ultrasound Scan.
- Intravenous urogram OR an intravenous pyelogram.
These imaging tests can help to confirm your diagnosis and may even identify precisely where any kidney stones are.
Most small kidney stones (less than 4mm in diameter) can be passed out in your urine and may even be treated at home, if you're not in severe pain and don't have any complications. The time spent waiting for your stone(s) to pass can vary depending on the shape and size. On average, this could be anywhere from a week and six weeks.
Stones above 6mm in diameter usually won’t pass on their own and your doctor may want to monitor you on a weekly basis if you've still got symptoms and haven't passed the stone after six weeks.
If you're in severe pain, your doctor can provide pain relief by injection. A second dose can be given after half an hour if you're still experiencing pain. You may also be given a prescription for painkillers, anti-emetics or both to take home with you.
You may be admitted to hospital if your kidney stone has moved into the ureter and is causing severe pain and discomfort. This option is may be necessary if you're at an increased risk of kidney failure, are dehydrated and vomiting too much to keep fluids down, your over 60-years-old or are pregnant.
Should your kidney stone be too large to be passed naturally, 6-7mm in diameter or larger, it may need to be removed another way. Treatment options here include:
- Extracorporeal Shock Wave Lithotripsy - The most common form of treatment for large stones. An ultrasound pinpoints the exact location of your kidney stones, before an ultrasound shock wave is sent through to the stone to break it into smaller pieces. This allows the smaller pieces to pass through your urine.
- Ureteroscopy - Involves a long, thin telescope being passed through your urethra, up into your bladder and then the ureter. The surgeon may either try to gently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so that it can be passed naturally in your urine.
- Percutaneous nephrolithotomy - An alternative procedure used for larger stones. A thin telescopic instrument is passed through an incision in your back and into your kidney. The stone is then pulled out or broken into smaller pieces. This is 86% effective for stones that are 21-30mm in diameter.
- Open Surgery - This is extremely rare, with less than 1% of cases requiring open surgery. During the procedure, an incision will be made in your back to allow access to your ureter and kidney. The stone(s) will then be removed.
For uric acid stones, you may be advised to drink around three litres of water each day to try and dissolve the kidney stones. These stones are much softer than other types of kidney stone, and they can be made smaller if they're exposed to alkaline fluids.
Preventing Kidney Stones
One of the best ways of preventing kidney stones is to ensure that you drink plenty of water each day to avoid dehydration. Being hydrated helps to keep your urine diluted, which in-turn helps to stop waste products from getting to concentrated and forming stones.
You can tell how diluted your urine is by its colour. The darker it is, the more concentrated it is. Urine is commonly darker in the mornings as it contains a build-up of waste products that your body has produced overnight.
Drinks such as tea, coffee and fruit juice can count towards your fluid intake, however water is the healthiest option and is the best fluid for preventing kidney stones. Remember to drink more on hot days and whilst exercising to replenish any fluids lost through sweating.
To avoid calcium stones, you could try to reduce the number of oxalates in your body. This can be done by cutting down on foods such as:
Of course, don't reduce the amount of calcium in your diet unless your GP advises you to as it is very important in maintaining healthy bones and teeth. To avoid developing a uric acid stone, you should reduce the amount of meat, poultry and fish in your diet.
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