What are kidney stones?

Dr. Dadouch Hachem
Damascus - Syria

hdadouch@net.sy

 

Kidney stones are solid substances, which precipitate in the kidney, generally without symptoms, but if it moves through the ureter (the tube that connects the kidney to the bladder), it may cause severe pain.

   

What are the Causes of kidney stones?

Kidney stones may be formed of calcium, oxalate or uric acid. Most kidney stones are formed for no apparent reason, but some of the medical conditions that may cause kidney stones are:

1- Hyperparathyroidism. 2- High intake of calcium. 3- Gout. 4- Inherited susceptibility to form kidney stones. 5- Some enteric disease. 6- Renal infections especially recurrent ones.

Low intake of fluids and dehydration contribute to the formation of kidney stones.

What are the symptoms of kidney stones?

Most stones do not cause any symptoms. The symptoms occur only when the stone moves through the ureter, and where it is manifested as:

1- Severe pain in the abdomen, back or groin. 2- Bloody urine. 3- Passage of hard substances in the urine. 4- Nausea and vomiting.

What are the tests needed to diagnose kidney stones?

The tests that may be needed are:

1- Urine analysis.

2- Simple x ray of the abdomen.

3- Intravenous contrast urography.

4- Abdominal ultrasound.

5- Analysis of the stone.

What are the treatments of kidney stones?

A- Acute attacks:

Acute attack are usually treated with analgesics and oral or intravenous fluids. If the pain is controlled, the patient is advised to drink a lot of fluids, and to use analgesics until the stone passes (most pass spontaneously within a few days).

B- Prevention of new stones formation.

1- General measures: Maintain large amount of fluids in take, at least 8 glasses of water daily. Studies show that this reduce the formation of new stones.

2- Diet: Certain kinds of food play a role in the formation of new stones. The kind of food to avoid depends on the structure of the stone.

In calcium stones, the amount of calcium and vitamin D should be decreased (but not completely eliminated from the diet). In oxalate stones, calcium intake should be increased and food rich in oxalate such as spinach, nuts and chocolate should be avoided.

3- Medications: Some medications are used to prevent the formation of new stones, and depending on the structure of the stones, it may include: Thiazde diuretics used to prevent calcium stones, Allopurinol to prevent uric acid crystals, and antibiotics to treat recurrent urinary infections.

4- Surgery: is indicated only in certain cases:

1- kidney stone that does not pass spontaneously.

2- kidney stone that completely occlude the ureter.

3- kidney stone that cause a severe pain or hemorrhage.