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RENAL STONES

kidney-stones

Renal stones are hard crystalline structures containing minerals, they may be present within the kidney, ureter, bladder or urethra.

There are different types of renal stones. The commonest are Calcium stones. The other types include Struvite stones, Uric acid stones, Cystine stones and Other variant stones which are rare.

The symptoms of renal stones are:

  1. Flank pain – pain radiates from sides of lower abdomen to genitals.
  2. Low back ache
  3. Nausea
  4. Vomiting
  5. Fever
  6. Blood or pus in the urine

The major risk factors of renal stones are as under:

  • Low fluid intake
  • Dehydration
  • Hot climate
  • High intake of animal protein, salt, sugar, grape juice, apple juice.
  • Obesity
  • Medullary sponge kidney
  • Metabolic disorders – gout, hyperparathyroidism, cystinuria, oxaluria
  • Renal tubular acidosis
  • Inflammatory bowel diseases
  • Drugs

Investigations include:

  1. Urine examination – microscopic culture, calcium, magnesium, sodium, oxalate, phosphorous
  2. Blood examination – calcium, magnesium, uric acid, electrolytes
  3. Kidney function test like urea createnine
  4. Imaging techniques: Ultrasound and X Ray
  5. CT scan and MRI of the abdomen
  6. Intravenous pyelography
  7. Retrograde pyelography

Treatment:

Depending on site and size of the stone treatment varies. Pain killers are often prescribed to treat the patient symptomatically. Based on the size the treatment is done as below:

  • If the stone is less than 5mm, then spontaneous passage of stone through urine happen within 4 weeks of onset of symptoms.
  • If stone size is less than 1cm, then Flush therapy, IV fluids and Diuretics are given to promote passage of stones in urine.
  • If stone is more than 1cm, then the below methods are used:
  1. Lithotripsy – It is done using ultrasound waves or laser.
  2. Ureteroscopy – In this a stent is passed through the urethra and stone is removed
  3. Percutanious nephro lithotomy – It is minimally invasive technique used to remove stones
  • If stone is more than 5cm, then Open nephrolithotomy is done.

Treatment will also to continue to cure the underlying cause.

Complications:

If it is unattended then it may lead to complications like Urinary tract obstruction, Urinary tract infection, Hydronephrosis and Renal failure.

Prevention Measures to be taken are:

  1. Drink at least 2 to 3 litres of water everyday
  2. Limit your diet which is rich with animal protein, salt, spinach, nuts, wheat and bran.
  3. Avoid soft drinks
  4. Drink orange & lemon juice

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