Kidney Stones

What are the kidney stones?

• Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.
• A kidney stone isn’t actually made of stone. But if you have to pass one when you pee, it may feel like it is.
• Kidney stones are usually between the size of a kernel of corn and a grain of salt, but they may vary in size.
• The smaller the kidney stone, the more likely it will pass on its own. If it is smaller than 5 mm, there is a 90% chance it will pass without further intervention. If the stone is between 5 mm and 10 mm, the odds are 50%.
• If a stone is too large to pass on its own, several treatment options are available. Some kidney stones can become so large they take up the entire kidney.
• The stones can be brown or yellow, and smooth or rough.

What are the chances of getting kidney stones and at what ages can kidney stones occur?

• Kidney stones are very common: In Germany, 1 to 2% of the population has them each year. Estimates for the U.S. show that 7% of women and 13% of men are diagnosed with kidney stones at least once during their life.
• Both men and women can get kidney stones, but men’s chances of getting them are about double that of women’s.
• Most urinary stones develop in people 20 to 49 years of age, and those who are prone to multiple attacks of kidney stones usually develop their first stones during the second or third decade of life.
• People who have already had more than one kidney stone are prone to developing further stones.

Do children get kidney stones?

• Kidney stones are found in children as young as 5 years.
• The two most important reasons are not drinking enough fluids and eating foods that are high in salt. Kids should eat less salty potato chips and French fries.
• There are other salty foods: sandwich meats, canned soups, packaged meals, and even some sports drinks. Sodas and other sweetened beverages can also increase the risk of stones if they contain high fructose corn syrup.

Kidney stones in older children and teens

• The most common sign of kidney stones in older children and teens is the sudden onset of pain in the back or side.
• Young children with kidney stones are usually unable to tell exactly where the pain is and just complain that their tummy hurts.
• A number of young children will have no pain at all and the stones are discovered during the evaluation of a urinary tract infection or as an unexpected finding on an x-ray or ultrasound study done for another reason.

Symptoms of kidney stones

Smaller kidney stones that remain in the kidney often don’t cause any symptoms.

You might not notice anything is amiss until the stone moves into your ureter — the tube that urine travels through to get from your kidney to your bladder.  This causes a blockage, which makes pressure build up in the kidney.

At this point, you may experience these signs and symptoms:

1. Severe pain in the side and back, below the ribs
   • Kidney stone pain — also known as renal colic— is one of the most severe types of pain imaginable.  Some people who’ve experienced kidney stones compare the pain to childbirth or getting stabbed with a knife.
   • The pain is intense enough to account for more than 1 million visits to emergency rooms each year.
   • Usually the pain starts when a stone moves into the narrow ureter. The pressure activates nerve fibers that transmit pain signals to the brain.
   • Kidney stone pain often starts suddenly. As the stone moves, the pain changes location and intensity.
   • Pain often comes and goes in waves, which is made worse by the ureters contracting as they try to push the stone out. Each wave may last for a few minutes, disappear, and then come back again.
   • You’ll feel the pain along your side and back, below your ribs. It may radiate to your belly and groin area as the stone moves down through your urinary tract.
   • Large stones can be more painful than small ones, but the severity of pain doesn’t necessarily relate to the size of the stone. Even a little stone can be painful as it moves or causes a blockage.
2. Pain or burning during urination

• Once the stone reaches the junction between the ureter and bladder, you’ll start to feel pain when you urinate (Your doctor might call this dysuria)
• The pain can feel sharp or burning. If you don’t know you have a kidney stone, you might mistake it for a urinary tract infection. Sometimes you can have an infection along with the stone.

3. Urgent need to go

• Needing to go to the bathroom more urgently or frequently than usual is another sign that the stone has moved into the lower part of your urinary tract.
• You may find yourself running to the bathroom, or needing to go constantly throughout the day and night. Urinary urgency can also mimic a urinary tract infection symptom.

4. Blood in the urine

• Blood in the urine is a common symptom in people with urinary tract stones. This symptom is also called hematuria.
• The blood can be red, pink, or brown. Sometimes the blood cells are too small to see without a microscope (called microscopic hematuria), but your doctor can test for this symptom.

5. Cloudy or smelly urine

• Healthy urine is clear and doesn’t have a strong odor. Cloudy or foul-smelling urine could be a sign of an infection in your kidneys or another part of your urinary tract.
• One study found that about 8 percent of people with acute kidney stones had a urinary tract infection.
• Cloudiness is a sign of pus in the urine, or pyuria. The smell can come from the bacteria that cause urinary tract infections. An odour may also come from urine that’s more concentrated than normal.

6. Going a small amount at a time

• Large kidney stones sometimes get stuck in a ureter. This blockage can slow or stop the flow of urine.
• If you have a blockage, you may only urinate a little bit each time you go.
• Urine flow that stops entirely is a medical emergency.

7. Nausea and vomiting

• It’s common for people with a kidney stone to have nausea and vomiting.
• These symptoms happen because of shared nerve connections between the kidneys and GI tract.
• Stones in the kidneys can trigger nerves in the GI tract, setting off an upset stomach.
• The nausea and vomiting can also be your body’s way of responding to intense pain.

8. Fever and chills

• Fever and chills are signs that you have an infection in your kidney or another part of your urinary tract.
• This can be a serious complication to a kidney stone.
• It can also be a sign of other serious problems besides kidney stones.
• Any fever with pain requires urgent medical attention. Fevers that occur with an infection are usually high — 100.4˚F (38˚C) or more. Chills or shivering often occur along with the fever.

Causes of kidney stones

• Kidney stones often have no definite, single cause, although several factors may increase your risk.
• Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid — than the fluid in your urine can dilute.
• At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Types of kidney stones

Knowing the type of kidney stone helps determine the cause and may give clues on how to reduce your risk of getting more kidney stones. If possible, try to save your kidney stone if you pass one so that you can bring it to your doctor for analysis.

Types of kidney stones include:

• Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food and is also made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate content.
• Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.
• Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain migraine headaches or with taking certain seizure medications, such as topiramate (Topamax).
• Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.
• Uric acid stones. Uric acid stones can form in people who don’t drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.
• Cystine stones. These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).

Diagnosis of kidney stones

• Diagnosis of kidney stonesis best accomplished using an ultrasound, intravenous pyleography (IVP), or a CT scan.
• Most kidney stoneswill pass through the ureter to the bladder on their own with time.
• Treatment includes pain-control medications and, in some cases, medications to facilitate the passage of urine.

Treatment of kidney stones

Passing Kidney Stones

• Most small kidney stones won’t require invasive treatment. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone.
• Drinking as much as 1.9 to 2.8 litres a day may help flush out your urinary system. Unless your doctor tells you otherwise, drink enough fluid — mostly water — to produce clear or nearly clear urine.
• Although passing kidney stones can be quite painful, the stones usually cause no permanent damage if they’re recognized in a timely fashion.

Other Treatments

• Certain muscle-relaxing medications (alpha blockers) can make it easier to pass kidney stones that are 5 to 10 millimetres in diameter.
• Larger kidney stones usually need to be removed. Depending on how large the kidney stones are and where they’re located, sound waves can be used to destroy them or they can be removed using endoscopy or surgery.
• Your doctor may recommend preventive treatment to reduce your risk of recurrent kidney stones if you’re at increased risk of developing them again.

Factors that increase your risk of developing kidney stones:

• Family or personal history.If someone in your family has kidney stones, you’re more likely to develop stones, too. And if you’ve already had one or more kidney stones, you’re at increased risk of developing another.
• Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may be at higher risk than others.
• Certain diets.Eating a diet that’s high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in your diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.
• Being obese.High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones.
• Digestive diseases and surgery.Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.
• Other medical conditions.Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections.

When to call a doctor such as doctors on call

Call Doctors on Call if you have any of the signs and symptoms discussed above that worry you.

Call Doctors on Call immediately if you experience:

• Pain so severe that you can’t sit still or find a comfortable position
• Pain accompanied by nausea and vomiting
• Pain accompanied by fever and chills
• Blood in your urine
• Difficulty passing urine

Having Doctors- on- Call, your house-call doctor service, available should you or your family experience any of the above Kidney Stone symptoms, especially the more extreme ones, is an absolute necessity for everyone.

It is a good idea to have a ‘house call doctor’ like Doctors-on-Call number at hand, because as we have seen Kidney stones can attack people of any age, at any time and the pain can be extremely severe & debilitating

Doctors- on- Call will ensure the timeous and effective diagnoses and treatment of Kidney stones which will go a long way towards alleviating unnecessary suffering & pain, as well as the avoidance of any unwanted side effects