Nephrolithiasis is the condition of having kidney stones. Sometimes, stones may be found at any location in the urinary tract; it is referred as urolithiasis, and the term ureterolithiasis is used when the stones are located in the ureters.
Basics – The kidneys play role in filtering of blood ,removing waste products from the body and making urine.
It helps in regulating electrolyte levels that are important for body function. Urine drains from the kidney through a narrow tube called the ureter into the bladder.
A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. They often cause severe pain in the abdomen, flank, or groin.
They are also called renal calculi.The size of the stone can be as small as a grain of sand to one as large as the size of a golf ball.
Mortality of Kidney Stones
Renal colic affects approximately 1.2 million people each year and accounts for approximately 1% of all hospital admissions.
Urinary tract stones are more common in men than in women. It is estimated that about 12% of men and 7% of women in the U.S. will develop stones in the urinary tract at some point in their lives.
Calcium stones are the most common type and are formed by a build-up of calcium, combining with oxalate, phosphate or carbonate. They are more likely to occur in men.
• Uric acid stones are formed by a build-up of uric acid. Uric acid stones account for 5 to 10 percent of all stones and are more likely to occur in men.
• Struvite stones (infection stones) are formed by a build-up of calcium, magnesium and ammonium phosphate. Struvite stones account for 10 to 15 percent of all stones, are mainly found in women.
• Cystine stones are formed by a build-up of cystine, combining with lysine, arginine and ornithine.
• Cystine stones account for 1 percent of all stones.Cystinuria occurs as a result of the kidney tubules not reabsorbing certain amino-acids adequately.
• Cystine stones occurs in both men and women equally.
• Family history of kidney stones
• Recurrent UTI
• Gout results in chronically increased amount of uric acid in the blood and urine and can lead to the formation of uric acid stones.
• Hypercalciuria -high calcium in the urine
• Other conditions associated with an increased risk of kidney stones include hyperparathyroidism, kidney diseases such as renal tubular acidosis, cystinuria and hyperoxaluria.
• Chronic diseases such as diabetes and hypertension are also associated with an increased risk of developing kidney stones.
• IBS patients are likely to develop kidney stones.
• Some medications also raise the risk of kidney stones. These medications include some diuretics, calcium-containing antacids.
• Dietary factors – In particular, inadequate fluid intake predisposes to dehydration, which is a major risk factor for stone formation. Apart from this high intake of animal protein, a high-salt diet, excessive sugar consumption, excessive vitamin D supplementation.
• Excessive consumption of alcohol
• Severe pain, which usually starts suddenly and may last from minutes to hours, followed by long periods of relief. Kidney stone pain usually starts in the kidney or lower abdomen and later may move to the groin.
• Nausea , vomiting , sweating
• burning and the urge to pass urine
• frequent urination
• cloudy or foul-smelling urine
• fever (if infection is present)
• blood in the urine (hematuria)
• pus in the urine
• Abdominal abscess
• Biliary colic
• Duodenal ulcers
• Diagnostic tests include a blood test, a urine test and a 24-hour urine collection test.
• The 24-hour urine test is done to monitor urine volume.
• kidney-ureter-bladder (KUB) x-ray
• kidney ultrasound
• Intravenous pyelogram (IVP) and CT scan.
• Fortunately, most stones can be treated without surgery.
• In addition to extra water consumption, the doctor may prescribe antibiotics to fight infection, pain relievers to help with the pain, an antispasmodic to relax the ureter muscles or diuretics to prevent urine from staying in the kidney.
• Currently there are four (4) methods of stone removal:
• Extracorporeal Shockwave Lithotripsy (ESWL)
• Percutaneous Nephrolithotomy (PNL)
• Ureteroscopic Stone Removal
• Surgical Treatment
Most kidney stones will pass on their own, and successful treatments have been developed to remove larger stones or stones that do not pass.
• Abscess formation
• Serious infection of the kidney that diminishes renal function
• Urinary fistula formation
• Ureteral scarring and stenosis
• Ureteral perforation
• Renal loss due to long-standing obstruction
With adequate water intake,three litres a day, small crystals can be flushed out spontaneously without causing damage to the kidneys. Other fluids such as – coconut water , barley water and fruit juices
• Avoiding high protein diet
• Avoiding vitamin and mineral supplements
• Bed rest
• Avoiding preparations that may contain Vitamin D
• Avoiding Spinach , lady finger , brinjal , water melon .
Spasmodic crampy straining along ureter through which calculus has to pass.Blood in the urine .
Berberis vulgaris –
Tearing cutting pains in kidneys, extending down the ureters to the bladder or urethra, or shooting all through the pelvis and into the hip; burning, cutting and sticking pain in bladder and urethra; pain extends to testicles of affected side.
Cantharis vesicatoria –
Renal region sore and sensitive to touch; dull pressing pains in kidneys; cutting, contracting pains in ureters, extending to bladder and urethra and down the spermatic cord, with retraction of the testicles or shooting into the legs or thighs; frequent urging to urinate; urine passes in drops; burning and cutting pains before, during and after micturition.
China officinalis –
Urine clear, pale, copious, depositing a red-rose or brickdust sediment; deposits of crystals of urates, oxalates and other salts.
Lycopodium clavatum –
Renal colic, pain extending down (right) ureter to the bladder, with frequent urging to urinate; urine scanty, high colored and deposits a red or yellowish-red sandy sediment; severe backache relieved by passing urine; haematuria; children scream out with pain when awaking from sleep and kick all around.
Sarsaparilla officinalis –
Urine dribbles away when sitting, on standing passes urine freely; passes gravel or small calculi, blood with last of urine; painful retention of urine; sand in urine or on diaper, child screams before and while passing it; severe pain at conclusion of urination.
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