Renal Stone Disease

The kidneys are two bean-shaped organs that help in the removal of wastes from the body. They are joined to the bladder by 2 think tubes called ureters.

UreterSource: http://www.daviddarling.info/encyclopedia/U/ureter.html

As the kidneys filter blood of impurities, minerals and acid, certain substances can accumulate and harden over time. These solid crystalline deposits are called renal (kidney) stones, and can form in one or both kidneys. The stones can travel down the urinary tract and can and block the flow of urine, causing pain and bleeding.

Renal stone formation is a common urinary system disorder that can form in any individual. However, men, and overweight people are at a higher risk of developing them.

Causes

Renal stones form when certain salts and minerals in the urine become highly concentrated and build up. This can happen due to

  • Insufficient water intake
  • Treatments for renal diseases and cancer
  • Certain medications
  • Family history
  • Intestinal disease such as Crohn’s disease
  • Single functional kidney

Signs and Symptoms

Symptoms of renal stone formation may not manifest until the stone moves around the kidney or down into the urinary tract. Symptoms may include

  • Severe pain below the ribs, back, sides, lower abdomen, groin and during urination
  • Pain that fluctuates in intensity
  • Frequent urge to urinate
  • Pink, brown or red urine that is cloudy or foul smelling

You should call your doctor if you find it difficult to pass urine, or the pain is uncontrolled by oral pain medication and is accompanied with fever, chills or vomiting.

Diagnosis

When renal stones are suspected, your doctor may order blood, urine and imaging tests (X-ray, CT scans, Ultrasound) to diagnose the condition. You may also be asked to urinate through a sieve to collect the renal stones that pass through. These stones can be analysed in the laboratory and the results will help your doctor to determine the cause and formulate an appropriate plan for treatment and prevention.

Conservative Treatment

Treatment depends on the type of stone and its underlying cause. Small renal stones can be flushed out by drinking plenty of water every day or through medication. Additionally, your doctor may prescribe medication to relieve pain.

Treatment Options

For stones that are unable to pass through quickly or for larger stones, your doctor may suggest certain procedures based on the location and size of the renal stones.

A non-invasive, day case procedure called extracorporeal shock wave lithotripsy (ESWL) may be recommended to break down large stones. This is generally performed using some sedation. The location of the stones is determined with the help of ultrasound or X-rays. Using a device called a lithotripter, high energy sound waves are passed over the area to be treated from outside the body. The shock waves will vibrate and break the stones down without harming the rest of the body. The stone fragments can now pass out through the urine.

Sometimes, your surgeon may insert a stent or tube before or after the procedure through the bladder or the back into the kidney to hold the urinary tube open, preventing the pieces from blocking the tube.

Another alternative procedure your doctor may suggest is ureteroscopy. A thin lighted tube called an ureteroscope is inserted through your urinary tract opening, so no incisions are needed for the procedure. Once the stone is located, tiny forceps or a basket shaped instrument at the end of the scope grabs and removes the stones. Larger stones are first broken down with a laser before extraction.

For very large stones, sometimes, a more invasive procedure called percutaneous nephrolithotomy may be performed. For this a 2 cm hole is made in your kidney through your back and a hollow tube with a probe is inserted into the incision. Your surgeon can then remove the stones directly.

Prevention

Renal stones can be prevented by making some lifestyle changes like drinking more water and reducing the intake of excess salt and animal proteins.

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