Kidney stone:Information for common man

1. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract.


2. Kidney stones are a common cause of blood in the urine and often severe pain in the abdomen, flank, or groin. One in every 20 people develops a kidney stone at some point in their life.



3. Kidney stones form when there is a decrease in urine volume (dehydration) or an excess of stone-forming substances in the urine(more calcium, oxalate /uric acid). The most common type of kidney stone contains calcium in combination with either oxalate or phosphate. Other chemical compounds that can form stones in the urinary tract include uric acid and the amino acid cystine.


4. The incidence of kidney stones begins to rise when men reach their 40s, and it continues to climb into their 70s (But no age is bar for kidney stone disease). People who have already had more than one kidney stone are prone to develop more stones. A family history of kidney stones is also a risk factor for the development of kidney stones.
5. While some kidney stones may not produce symptoms (known as "silent" stones), people who have kidney stones often report the sudden onset of excruciating, cramping pain in their low back and/or side, groin, or abdomen. Changes in body position do not relieve this pain. The pain typically waxes and wanes in severity, characteristic of colicky pain. It may be so severe that it is often accompanied by nausea and vomiting. Kidney stones also characteristically cause blood in the urine. If infection is present in the urinary tract along with the stones, there may be fever .





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6. Ultrasound is the most commonly used modality for the screening of the renal stone disease but the final and the most informative modality is the helical CT or IVP(X-Ray with the contrast injection.)




7. Most kidney stones less than 4 mm eventually pass through the urinary tract on their own within 48 hours, with ample fluid intake.



8. Pain medications can be prescribed for symptom relief. Certain stones made up of uric acid can get dissolved with the alkalinizing therapy.
9. There are several factors which influence the ability to pass a stone. These include the size of the person, prior stone passage, prostate enlargement, pregnancy, and the size of the stone. A 4 mm stone has an 80% chance of passage while a 5 mm stone has a 20% chance. Stones larger than 9-10 mm rarely pass on their own and usually require treatment.



10. Some medications have been used to increase the passage rates of kidney stones. (alpha blockers such as tamsulosin.) These drugs may be prescribed some people who have stones that do not rapidly pass through the urinary tract.
11. For kidney stones upto 2 cm a procedure called lithotripsy is often used. In this procedure, shock waves are used to break up a large stone into smaller pieces that can then pass through the urinary system. The Lithotripsy(colloquial language LASER) is a day care procedure with more than 80 % success but may need repeated procedures or stenting simultaneously.


12. Surgical techniques have also been developed to remove kidney stones. This may be done through a small incision in the skin (percutaneous nephrolithotomy) or through an instrument known as an ureteroscope passed through the urethra and bladder up into the ureter.
13. The stone is fragmented with LASER (Holmium LASER) before removal with the endoscope.








14. Open surgery is very rarely performed for renal stone disease because of length of hospitalization and recuperation on the part of the patient.


15. Rather than having to undergo the treatment it is better to avoid kidney stones in the first place.(The National Institutes of Health recommend drinking up to 12 full glasses of water a day, if you've already had a kidney stone.) Water helps to flush away the substances that form stones in the kidneys.
16. Depending on the cause of the kidney stones and an individual's medical history, dietary changes or medications are sometimes recommended to decrease the likelihood of developing further kidney stones. It is particularly helpful, if one has passed a stone, to have it analyzed in a laboratory to determine the precise type of stone so specific prevention measures can be considered.
17. Certain foods are better avoided-red meat,fish,cucmber,tomato.cauliflower,chikoo,amla,berries,brinjal,mushroom,cashew nuts, pumpkin, milk products( in excess). palak, chaulai, black grapes etc.
18. Certain food actually help in preventing the stone disease-coconut water, Kulith dal, Barley, pineapple, bananas, almonds, lemons, Carrots, karela.