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1. Kidney stones
Kidney stones are solids formed in the kidneys when substances like calcium,
oxalate and phosphorus that are excreted through the urine become
concentrated. A kidney stone may either settle down in the kidneys or travel
through the urinary tract. Kidney stones usually vary in size. So a smaller
crystal may comfortably travel down the urinary tract and get expelled on its
own without causing any pain or discomfort.
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However, when the crystals increase in size they may from larger hard stones
which tend to get stuck as they pass along the urinary tract. This can cause
several problems. Mainly it may block the usual flow of urine, causing extreme
pain and bleeding. Other symptoms of kidney stones include pain in the
lowerback region, vomiting and nausea.
Various factors put an individual to risk for kidney stones. Most common
factors include a family history of kidney stones, repeated urinary tract
infections, blocked urinary tract, or any health condition that increases the
level of substances usually excreted through the urine. Lack of sufficient
intake of water and certain medications can also cause kidney stones.
Prevention of kidney stones include medications and dietary modification.
Types
There are four types of kidney stones which include:
Uric acid stones: The factors that can contribute to the formation of uric acid
stones is a high protein diet, malabsorption, diabetes, chronic diarrhoea or
metabolic syndrome.

2. Calcium stones: Calcium stones are the most prevalent type of kidney stones.
These are in the form of calcium oxalate stones.
Metabolic disorders, high consumption of vitamin D can increase oxalate
levels in urine. Another form in which calcium stones are found is calcium
phosphate stones. Medical treatment of migraines with topiramate may also
be associated with the formation of calcium stones.
Cystine stones: The aetiology of cystine stones is related to cystinuria, a
hereditary condition that promotes kidneys to excrete a higher amount of
amino acid.
Struvite stones– these stones are caused due to a urinary tract infection.
Struvite stones are large and fast-growing.
Symptoms
Unfortunately, kidney stones do not cause any symptoms until they move
around in your kidney or pass through your ureter, the tube connecting the
kidneys and urinary bladder. Small stones may pass out even without causing
any symptoms. But, with larger stones, the following symptoms may be seen:
 Back and groin pain
 Pain on urination
 Abnormal urine colour
 Nausea and vomiting
 Persistent urge to urinate
Causes And Risk Factors
Causes
Accumulation of uric acid, calcium or oxalate in the urine in the levels higher
than your urine can dilute, can cause Kidney stones. These accumulations are
in the form of crystals.
Risk Factors
As men have more muscle mass than women, they are at an increased risk of
kidney stones. This is because the daily breakdown of muscle mass leads to a
tendency to form stones in the kidneys.
Other common risk factors of kidney stones include –
Family history: You are more susceptible to develop kidney stones if someone

3. in your family has had stones.
Personal history: The risk of having a kidney stone is much greater if you
already have a stone.
Age: Though kidney stones can occur at any age, they are most commonly
diagnosed in adults aged 40 and above.
Obesity: High body mass index (BMI), large waist size and weight gain have
been linked to an increased risk of kidney stones.
Dehydration: Less fluid intake will increase your risk of getting kidney stones.
People that live in hot regions or those who work in environments where they
tend to sweat a lot will have a higher risk of developing stones.
Existing medical conditions: Gastric bypass surgery, inflammatory bowel
disease or chronic diarrhoea may cause changes in the digestive process that
affect your absorption of calcium and water, increasing the levels of stone-
forming substances in your urine. Renal tubular acidosis, cystinuria, thyroid
problem (hyperparathyroidism) and urinary tract infections can increase
stone formation.
Certain diets: Eating a diet that’s high in animal protein, sodium and has low
fibre content can increase your risk for kidney stones. This is especially true
for a high-sodium diet. Too much sodium increases the calcium load on your
kidneys, significantly increases your risk of kidney stones.
Prevention
Here are 10 simple ways to prevent kidney stones –
 Drink lots of water
 Drink healthy beverages
 Eat smartly
 Eat more dairy foods every day(no scientific data)
 Limit the intake of seafood
 Reduce the intake of salt
 Maintain a healthy weight
 Know your risk
 Don’t hold your pee for too long
 Avoid alcohol and cigarettes
Diagnosis
Ultrasound of the kidney, ureter and bladder (KUB) is the most convenient
and frequently used investigation to diagnose kidney stones. An X-ray KUB

4. can further assist in diagnosis. However, if the stones are small, the patient is
obese, or there is an unusual formation of gas in the abdomen, a CT scan is a
better method of diagnosis.
Urine testing is significant in the detection of stone-forming minerals. A blood
test can help in marking high levels of calcium or uric acid, which help in the
diagnosis of kidney stones.
Treatment
Treatment is based on the size of the stones. Smaller stones can be treated
with plenty of fluids, pain medications and certain antispasmodic drugs (pain
and spasm relieving), which help in passing the stone out. But even when the
symptoms disappear, it is essential to confirm whether the stone has been
eliminated through an ultrasound or a CT scan.
Larger stones which do not pass out easily require medical therapy and more
advanced treatments such as –
Sound waves: Depending on the size and location of the stones, extracorporeal
shock wave lithotripsy (ESWL) may be done. ESWL uses sound waves to
create strong vibrations (shock waves) that break the stones into tiny pieces,
making them easier to be passed through urine. The procedure lasts for about
45 to 60 minutes. It can cause moderate pain, so it is preferably performed
under sedation or light anaesthesia. ESWL can also cause blood in the urine
and discomfort as the stone fragments pass through the urinary tract.
Depending on the size of the stones, one or more sessions may be needed.
Percutaneous Nephrolithotomy (PCNL): This treatment is used for very large
stones or where ESWL is unsuccessful. The procedure involves surgically
removing the stone using small telescopes and instruments inserted through a
small incision in the back.
Ureteroscopic Removal: Smaller stones in the ureter or kidneys may be
removed by passing a thin, lighted tube (ureteroscope) equipped with a
camera through the urethra and urinary bladder to the ureter. Once the stone
is located, special tools can snare the stone or break it into pieces, making
them easier to pass through the urine. A small tube (stent) may be placed in
the ureter to relieve symptoms like swelling and promote healing.

5. Laser Lithotripsy: Some stones cannot be treated with ESWL because of their
size, location, type. In such cases, ureteroscopic laser lithotripsy may be used.
In this procedure, a tiny fiberoptic camera is passed into the urinary tract
through the urethra to locate the stones in the bladder, kidney or ureter. Then
using laser technique, larger stones are fragmented into thousands of small
pieces, which are flushed out through urine.
Lifestyle/management
Stay hydrated – a daily requirement of drinking enough fluids should be
fulfilled to pass about 2 litres of urine all day.
Salt restriction – restrict the amount of salt in your diet.
Avoid oxalate-rich food, such as spinach, beets, okra, tea, black pepper, Soy
products and chocolate should be restricted as they are found to have higher
levels of oxalate.
Choose calcium-rich foods instead of calcium supplements – calcium-rich food
does not affect kidney stones; however, calcium supplements increase the risk
of kidney stones. Therefore, use calcium supplements with caution.
Prognosis And Complications
Prognosis
The chances of recurrence of kidney stones are quite high. More than half of
the people, who have had a stone in the past, will develop a new stone in their
lifetime.
Complications
Untreated kidney stones can significantly damage the kidneys and even lead
to end-stage renal disease (ESRD), requiring dialysis. But early detection and
treatment may completely reverse the damage, even in those on dialysis.
Unfortunately, many a time, kidney stones remain undetected for years
because minor symptoms are ignored/neglected. By the time the patient
consults a doctor, the damage becomes irreversible or only partially
reversible.
source: thehealthsite