Question

Write about a personal experience you or a family member has had with kidney stones. How do they form? What was the treatment and prevention?

Answer 1

The experience to have a kidney stone was devastating. It was a very painful experience. I had suffered from kidney stones past 10 years ago during my vacations. I had severe flank pain radiating to groin with nausea, vomiting, hematuria, fever with chills, persistant tendency to urinate.

I was hospitalized for couple of days from where I got discharged against medical advise as the doctors were planning for surgery.I consulted urologist who did ceratin investigation like ultrasound, urine analysis. I was diagnosed to have renal stones which was multiple of small size in both the kidneys.He prescribed me some medications for 3 months and asked me to drink plenty of water. He also asked me to avoid tomatoes, green leafy vegetables. The doctor instructed that one should have adequate fluid intake inorder to prevent the occurence of kideney stones.

Kidney stone or renal calculi are hard, crystalline deposits made up of minerals and salt that forms inside the kidney or urinary tract. Kidney stones are formed when urine becomes concentrated allowing minerals to crystallize and stick together. Based on its constitution the renal stones are of different types:

• Calcium stones: It is the most common type in which the stone is formed of calcium oxalate. It may be caused due to excessive intake of calcium in diet, Increased calcium content of blood (hypercalcemia) and intake of water rich in calcium. High oxalate foods are potato chips, peanuts, spinach, beets, chocolate.
• Uric acid stones: It is most common in men than women. Mainly occurs in person with gout or undergoing chemotherapy. It develops when urine is too acidic. DIet rich in purines increase uric acid content of the body. Purine is mainly found in animal protein like fish, shellfish,meat.
• Struvite stones: mainly found in women with urinary tract infection. These are large stones which develops due to urinary infections and may lead to urinary gtract obstruction.
• Cystine stones: These type of stone are rare. These are mainly found in people with genetic disorder cystinuria. In this disorder, cystine which is naturally present in kidneys leaks into urine.

Risk group and factor causing renal calculi are:

1. Men are more prone to have stones than women.
2. Age between 20- 50 years.
3. Family history
4. Dehydration
5. Obesity
6. High intake of oxalate and purine diets.
7. Hyperparathyriodism
8. Gastric bypass Surgery
9. Inflammatory bowel disease increases calcium absorption
10. Medications like diuretics, antiepileptic,and calcium based antacids.

Treatment:

The treatment depands on the type of stone. Some common measures are:

• High intake of water approximately 8-10 glasses of water a day. In patients having dehydration with nausea and vomiting, intravenous fluids is prescribed.
• Pain relieve by use of narcotic medications. Other medications include Allopurinol for uric acid, acetaminophen, diuretics,sodium bicarbonate, phosphorus solutions, ibuprofen, Naproxen sodium.
• Surgical interventions:

1. Lithotripsy: Its an external shock wave treatment which breaks the large stone into small fragments so that they can easily pass from ureter, bladder in urine.
2. Percutaneous Nephrolithotomy: In this method the stone is removed from a small hole in the back, mainly done when the stone is too large to pass, pain is untolerable and when stone results in ostruction.
3. Ureteroscopy: This procedure is mainly done when the stone gets obstruct in ureter or bladder. An instrument called ureteroscope is introduced into the ureter through urethra. A small wire with camera is inserted into bladder. The doctor then uses a small cage to grasp the stone and remove it.

Prevention:

• Plenty of fluids: The increased intake of fluid is the main preventive measure. A person should pass 2.6 quarts of urine per day. Intake of plenty of fluids will flush the kidneys.
• Diet : Moderate intake of oxalate foods, salts, animal protein can lower your risk of stone.
• Treatment of underlying diseases like hyperparathyroidism, cystinuria,obesity