Kidney Stones: Symptoms, Diagnosis & Treatment

Kidney stones are made of chemicals found in urine and cause sharp pain in the abdominal region. Learn more about the symptoms, diagnosis & treatment..

Kidney stones are a common occurrence affecting about 5% of the world's population. While in some cases, the symptoms of kidney stones are extremely mild, in others, individuals may suffer from extreme pain and severe bleeding. Although various treatments are available for kidney stones, patients can face serious consequences if the condition is not diagnosed and treated early enough.

Here’s a complete guide regarding the types, symptoms, diagnosis, and treatment options available for kidney stones. Let’s take a look -

What is a Kidney Stone?

Kidney stones are hard objects that form when the concentration of the chemical substances present in urine exceeds a certain level, i.e. there are too many substances in too little liquid. The size of kidney stones may vary from being too small to be noticed to being so large that they can fill the inner hollow parts of the kidney.

Although kidney stones generally originate in the kidney, they can travel to other regions of the urinary tract. They can be in the kidneys, ureters, bladder, and urethra. In various cases, stones move from the kidney to the ureters, the tubes that link the kidneys to the bladder. If the stone passes past the ureter and into the bladder, it might be excreted in the urine. However, if it gets stuck in the ureter, it obstructs urine flow and causes muscle spasms, resulting in excruciating pain, blood in urine (hematuria), urine infection and if the stone is causing the obstruction for a long time, it can irreversibly damage the kidney.

Types of Kidney Stone

1. Calcium: By far, calcium stones are the most common type of kidney stone, consisting of calcium oxalate and sometimes, calcium phosphate or maleate. To reduce the risk of developing a calcium stone, it is advisable to cut down on foods with high oxalate content like rhubarb, tomato, chocolate, nuts, and spinach etc., but calcium in the diet should not be reduced as low calcium is found to be a risk factor for stone formation. Calcium stones are also formed when excessive amount of calcium is excreted through kidneys, as occurs in some diseases.

2. Uric Acid: Mostly found in men, Uric Acid kidney stones are more likely to develop in patients suffering from diabetes, gout, obesity, and other metabolic syndromes. This kind of kidney stone forms when the urine becomes too acidic or there is low urine volume and high amounts of uric acid in the blood i.e. patients with gout. It can happen sometimes due to the heavy consumption of purine-rich foods such as fish, meat, and shellfish.

3. Struvite: Struvite is a form of kidney stone that is more frequent in women than in males. It is most common in people who have urinary tract infections (UTIs). The struvite kidney stone is larger than other types of kidney stones and, thus, often causes urinary obstruction.

4. Cystine: Cystine stones are rare and are found in individuals having a genetic disorder called Cystinuria. Cystine is a naturally occurring acid in the body that seeps into the urine from the
kidneys.

5. Drug induced stones: sometimes stones can form due to some drugs like indinavir, acyclovir etc.

Symptoms of Kidney Stone

Kidney stone symptoms may not become apparent until the stone has passed from the kidney to the ureters. When these stones enter the ureters, they block them and dilate them. This causes muscle spasms that result in excruciating pain, known as renal colic. The following are some of the most prevalent symptoms of kidney stones:

• Severe pain in the side of the back and below the ribs
• Sharp pain in lower abdomen and groin area
• Pain comes in waves and fluctuates intensely
• Burning sensation while urinating

Other symptoms of kidney stones include:

• Red, brown, or pink urine
• Vomiting
• Nausea
• Discoloured urine
• Foul-smelling urine
• Frequent urge to urinate
• Fever and chills
• Urinating in small amounts

If the size of the kidney stone is small, there might be no pain, and the stone will pass out of the body with urine.

Diagnosis of Kidney Stone

The diagnosis of a kidney stone includes a study of medical history, imaging tests, and physical examination. Typically, it involves a few diagnostic procedures such as:

1. Blood Test: Through a blood test, doctors can calculate the amount of calcium, oxalate, uric acid, citrate, and uric acid and many other tests to see risk factors for kidney stones in the blood and determine the overall health of the kidney.

2. Urine Test: Most patients with recurrent stone formation need to undergo 24 hour urine test to assess the amount of stone-forming chemicals present in the urine.

3. Imaging Test : An ultrasound of kidney, ureter and bladder is the initial test for patients suspected to have a kidney stone, however CT scan is the best test to detect the stone, its size and required if one needs a surgery for removal of stone.. An Intravenous Pyelogram is rarely used now a days as CT scans are widely available except in places where there are no facility of CT Scan.. It is a type of x-ray in which images are captured after a dye is injected into an arm vein as it travels through the kidneys and bladder.

4. Analysis of passed kidney stones: After passing the urine through a strainer, the kidney stones so collected are analysed in a lab to determine the type of stone.

Treatment of Kidney Stone

There are numerous ways to treat kidney stones tailored according to the type, size, location, and shape of the stone. The kidney stone surgery cost varies from treatment to treatment. . Smaller stones of less than 6-7 mm may pass spontaneously in many patients without the need of surgery , however those causing obstruction and pain or larger stones > 1 cm in size would need surgery.

Some common ways to treat kidney stone are:

1. Medication: As the kidney stone usually causes excruciating pain, patients may require some pain relievers to alleviate the pain. Antibiotics are also prescribed to deal with kidney infections.

2. Laser Lithotripsy: Laser Lithotripsy is a laser kidney stone removal procedure in which surgeons use laser fiber to transmit Holmium energy to break large stones into smaller pieces so that they can easily pass through the ureters into the bladder.

3. Extracorporeal Shock Wave Lithotripsy (ESWL): Surgeons use sound waves to break down large kidney stones into tiny particles so that they can move via the ureters into the bladder. This treatment may cause pain and bleeding in the areas surrounding the kidneys.

4. Tunnel Surgery : Surgeons use this procedure to remove kidney stones through a tiny incision in the back. Tunnel surgery is performed when the stone causes blockage, infection, or harms the kidneys. It is also done when the kidney is too big to pass through the ureter or when the pain is unbearable.

5. Ureteroscopy: Surgeons perform ureteroscopy when the stone gets stuck in the ureter or the bladder. They use a special instrument called a ureteroscope. In this procedure, a camera is attached to a short wire and placed into the urethra. The surgeon then uses a tiny cage to collect and remove the stone.

Conclusion:

To summarise, kidney stones form due to the concentration of chemical substances present in the urine. While the body gets rid of small-sized stones naturally, larger kidney stones can cause significant discomfort and pain. As there are different types of kidney stones, the symptoms, risk factors, and treatment options may vary from person to person. It is therefore advisable to get an early diagnosis and consult a doctor as soon as possible to determine the most suitable treatment option. Delaying the treatment of stone can lead to gradual damage to kidney and some of these kidneys do not regain their functions, when stones are removed after a lot of delay. For more information on kidney stone-related issues and best treatment options, visit Medanta Hospital and get medical assistance from our expert team of doctors.