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Kidney stone

Conditions We Treat

Kidney Stones

What are Kidney Stones?
Kidney stones are hard deposits of minerals and salts that form inside the kidneys. These stones vary in size and shape, ranging from tiny grains of sand to larger formations several inches in size. They may be smooth or jagged. Some stones remain in the kidneys, while others travel down the urinary tract, which can be quite painful.

Signs and Symptoms of Kidney Stones
• Sharp pain in the back or lower abdomen
• Persistent, dull discomfort, similar to a stomach ache
• Pain or a burning sensation while urinating, often accompanied by a frequent urge to urinate or blood in the urine
• For men, testicular pain
• Cloudy or foul-smelling urine
• Nausea and occasional vomiting
• Fever and chills

Causes of Kidney Stones
Kidney stones form when substances in urine become highly concentrated. Low fluid intake is a major risk factor, as insufficient hydration can cause these substances to crystallize into stones. Other contributing factors include:
• Physical inactivity or excessive exercise
• Personal or family history of kidney stones
• Diets high in salt or sugar
• Urinary tract infections
• Certain medications
• Obesity
• Weight-loss surgery

Types of Kidney Stones
1. Calcium Stones
Most kidney stones are made of calcium, typically in the form of calcium oxalate. Oxalate, produced by the liver or absorbed from food, is found in high amounts in certain fruits, vegetables, nuts, and chocolate. A high intake of vitamin D, intestinal bypass surgery, or metabolic disorders can increase calcium or oxalate concentrations in urine. Calcium stones can also form as calcium phosphate, particularly in conditions like renal tubular acidosis and with certain migraine or seizure medications.
2. Struvite Stones
These stones form in response to urinary tract infections (UTIs). Struvite stones can grow rapidly and become quite large, sometimes without noticeable symptoms.
3. Uric Acid Stones
Uric acid stones develop in individuals who lose too much fluid (e.g., chronic diarrhea or malabsorption), those who consume high-protein diets, or those with diabetes or metabolic syndrome. Genetic factors may also play a role.
4. Cystine Stones
These are rare and form in individuals with cystinuria, a genetic disorder that causes the kidneys to excrete excess cystine, an amino acid.

Conditions We Treat

Diagnosis

Diagnosis
If you experience symptoms suggestive of kidney stones, it is important to consult your doctor for diagnosis. During your visit, the doctor will:
• Perform a physical exam
• Take a detailed medical history, including any family history of kidney stones, dietary habits, and gastrointestinal conditions
Diagnostic tests may include:
• Blood test: To check for biochemical imbalances that can lead to kidney stones
• Imaging tests: X-ray, ultrasound, or CT scan to locate stones and identify potential causes
• Urinalysis: To detect infections or substances that could form stones
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Prevention
The most effective way to prevent kidney stones is by staying well-hydrated. Your doctor may recommend drinking two to three liters of water daily, or other pH-neutral drinks. Try to spread your fluid intake evenly throughout the day, monitor urine output, and ensure your urine remains light in color. In hot weather or during intense physical activity, increase fluid intake.
Additional preventive measures may include:
• Eating more vegetables, fruits, and fiber while reducing animal proteins and salt intake
• Maintaining a healthy weight
• Exercising regularly (2–3 times per week) and managing stress
• Taking prescribed medications if recommended by your doctor
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Treatments
Treatment varies depending on the stone’s type, size, and symptoms. Discussing the most appropriate treatment with your urologist is essential.
1. Wait for the Stone to Pass
Smaller stones may pass on their own, and you can usually manage the process with hydration and pain management. However, this option is only viable if the pain is manageable, there are no signs of infection, and the kidney is not obstructed.
2. Medications
Certain medications can help relax the ureter, making it easier for stones to pass. Your doctor may prescribe medications to facilitate this process.
3. Extracorporeal Shockwave Lithotripsy (ESWL)
ESWL uses shockwaves to break stones into smaller particles, which can then be passed through the urine. It is a non-invasive procedure that is effective for most stones, though not all stones respond well to shockwave treatment.
4. Laser Lithotripsy and Ureteroscopy (URS)
URS involves inserting a small telescope (ureteroscope) through the urinary tract to locate and remove stones. If the stone is too large, it can be fragmented using a laser. A temporary stent may be placed in the ureter to facilitate urine flow after the procedure. Stents are typically removed within 4–10 days.
5. Percutaneous Nephrostolithotomy (PCNL)
PCNL is a surgical option for large or complex stones that cannot be treated with other methods. It involves a small incision in the back to directly remove the stone. This treatment is often reserved for stones larger than 2 cm.

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