Overview
A kidney stone is generated when a mineral particle settles out of the urine and into the kidney or ureter, the tube that connects the kidney to the bladder. Over time, other minerals will adhere to the speck, transforming it into a stone.
According to the chemicals that make up the stones, there are four basic forms of kidney stones: calcium salts (calcium oxalate, calcium phosphate, combined calcium oxalate/phosphate), magnesium ammonium phosphate (struvite), uric acid, and cystine. Rarely, certain drugs can occasionally cause the formation of urinary stones by crystallization. Calcium oxalate, which occurs naturally in urine, is the primary component of the most frequent kidney stones.
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In North America, kidney stones are a common reason for hospitalizations. It is anticipated that 10 percent of North Americans will get kidney stones at least once in their lifetime, with incidence peaking between the ages of 20 and 50.
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Frequently, the stones are tiny and can pass on their own through the urinary system. In warm climates and throughout the summer, kidney stones are more likely to form. When people get dehydrated, the concentration of minerals in their urine increases. Small mineral particles therefore have an easier time settling out of the urine and initiating a kidney stone. Men are three times as likely than women to have kidney stones. Also, they appear to run in families. Those who have already experienced a kidney stone have a greater-than-average risk of developing another.
Epidemiologic data
More than 500,000 patients visit emergency rooms annually for kidney stone concerns. An estimated one in ten individuals will get a kidney stone at some point in their lives.
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In the United States, the prevalence of kidney stones grew from 3.8% in the late 1970s to 8.8% in the late 2000s. In 2013–2014, the prevalence of kidney stones was 10 percent. The incidence of kidney stones is approximately 11% in males and 9% in women. Other conditions such as hypertension, diabetes, and obesity may increase the likelihood of developing kidney stones.
Risk factors
- Whites are more likely than African Americans or other races to have kidney stones.
- Men are more likely to get kidney stones than women, but the number of women with stones has increased during the past decade.
- This may be related to the increase in female obesity relative to male obesity, since obesity is a known risk factor for kidney stones.
Symptoms
Kidney stones that are extremely tiny may pass out of the body in the urine without creating any symptoms.
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The ureter may become clogged with larger stones. This can lead to:
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- Excruciating back or side pain
- Nausea and nausea
- Blood present in the pee (urine may look pink, red, or brown)
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The position of the pain may move closer to the groin. Typically, this signifies that the stone has migrated further down the ureter and is now closer to the bladder. As the stone nears the bladder, you may experience:
- An intensified need to urinate
- A sense of burning when urinating
When kidney stones flow through your urinary tract, you may be able to see them.
Types of kidney stone
The component of most stones is calcium oxalate. This stone may also contain a trace amount of calcium phosphate.
- Patients with repeated urinary tract infections may develop calcium ammonium phosphate stones (struvite). The bacteria in the urine cause the urine pH to become alkaline, resulting in the rapid precipitation of stone salts, which can grow to fill the kidney (they may look like a dear antler).
- Less common stone compositions include uric acid stones in around 8 to 10 percent of patients, and cystine stones are even less prevalent. This amino acid is one of the building blocks of proteins, and it tends to develop in children during the beginning of puberty.
When to see a physician
Make an appointment with your doctor if you experience any concerning signs and symptoms.
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Seek emergency medical care if you experience:
- Extreme pain that makes it unable to sit still or find a comfortable position
- Soreness with nausea and vomiting
- Soreness accompanied by fever and shivering
- Blood in urination
- Difficulty in urinating
Diagnosis
Kidney stones are suspected when the normal sequence of symptoms is observed and other potential explanations of stomach or flank discomfort have been ruled out. Controversy surrounds the optimal test for diagnosing kidney stones. Typically, imaging studies are used to confirm the diagnosis. Many individuals who visit the emergency room will undergo a CT scan without contrast. This is a quick procedure that can help rule out alternative reasons of flank or stomach pain. However, a CT scan exposes patients to severe radiation, and ultrasound in conjunction with plain abdomen X-rays has recently been demonstrated to be an effective method for identifying kidney stones.
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Pregnant women or individuals who should avoid radiation exposure may get an ultrasound examination to aid in diagnosis.
Treatment
Natural medicine
Other foods and substances that may help protect the kidneys, according to proponents of natural therapies, are:
- Basil
- Celery
- Apples
- Grapes
- Pomegranates
- Vitamin b6 supplements
- Pyridoxine supplements
Some study indicates that vitamin D deficiency is common among individuals with kidney stones, however there is insufficient evidence that vitamin D supplements are either safe or beneficial for avoiding stones.
Medications
A physician may prescribe medication for:
- Reduce pain. Your healthcare professional may advise you to take an over-the-counter drug such as ibuprofen or, if you’re in the emergency room, an intravenous narcotic.
- Manage nausea/vomiting.
- Relax your ureter so the stones can slide through. Medicines such as tamsulosin (Flomax®) and nifedipine (Adamant® or Procardia®) are frequently recommended.
- You should see your physician before taking ibuprofen. Taking this medication during an acute episode of kidney stones can raise the risk of kidney failure, particularly in patients with a history of renal disease and related conditions such as diabetes, hypertension, and obesity.
Lithotripsy
The kidney stone is fragmented into little pieces by shock waves in lithotripsy. Following therapy, the kidney stone fragments will travel through your urinary tract and into your urine. This treatment may be administered under general anesthesia, which will render you unconscious and unable to feel the process.
Ureteroscopy
During a ureteroscopy, a doctor inserts a long tube-like instrument into your ureter to remove the stone (if it is little) or shatter it into small pieces (with a laser if it is large) so that it can travel through your urinary tract and be expelled through your urine.
Surgery
In uncommon circumstances, surgery is required to remove a kidney stone. A doctor will inject a tube into your kidney during surgery in order to remove the stone. You will need two to three days in the hospital to recover from this procedure.
Complications
Among the complications of kidney stones are:
- Recurrent kidney stones, as those who have had them at least once have an 80% probability of developing them again.
- Blockage or obstruction of the urinary tract
- Renal failure
- Sepsis, which can develop following the removal of a big kidney stone
- A ureter damage sustained after surgery for the removal of a kidney stone
- Urinary tract disease
- Extreme pain
- Heavy bleeding during the removal of kidney stones
- Pyelonephritis
