Kidney stones, or concrements, are small hard deposits of mineral salts and acids that are located on the inner surface of the kidneys.
Normally, these stones are dissolved in the urine.
However, when the urine is concentrated, the minerals can crystallize, stick together, and form solid stones.
Even if they are painful, they usually do not pose a danger and do not cause permanent damage.
The largest stones are formed in the calyx of the kidney, that is, in the “tube” where urine is directed from the kidney to the ureter.
They usually occur in adults, but they can also occur in young people aged 20 years or less due to improper diet.
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Types of kidney stones
Struvite stones: This type of kidney stone is most common in women. Usually they form due to infections, especially in the female urinary tract.
These stones can cause discomfort as they increase in size.
Cystine stones: The main cause of the formation of these stones is a genetic condition called cystinuria.
In this disease, the amino acid cystine, found in the kidneys, penetrates into the urine, crystallizes and forms stones.
If there is a family history of cystinuria, there is a predisposition to kidney stones.
Calcium stones: This category is the most common and includes two types of stones: calcium oxalate stones (black or light yellow) and calcium phosphate stones.
The former are the result of oxalate concentration (a substance found in food) and high calcium levels.
The latter are caused by too alkaline urine (pH above 7.5) with an increased calcium content.
Uric acid stones: Uric acid has its origin in purine metabolism, that is, in the substances contained in food products such as fish, meat, mushrooms, anchovies, crustaceans, etc.
High levels of uric acid can cause the formation of these stones.
Causes of kidney stones
Women are less prone to kidney stones than men due to their physiology.
Women have a higher proportion of citrate in their urine, which partially prevents the formation of kidney stones.
The male hormone testosterone increases the level of uric acid and oxalate in the body, and thus the likelihood of developing kidney stones.
In addition, men are more susceptible to this disease than women, as they consume more animal protein (for example, red meat) due to greater muscle mass and appetite.
Men excrete more waste from the body because larger amounts of urine are filtered through the kidneys and produce waste products.
Therefore, the excess of waste products in the body is more likely to lead to the formation of kidney stones.
In women, some of the main causes of kidney stones are:
Urinary tract infections (UTIs): Women are more susceptible to urinary tract infections than men and have a higher risk of forming struvite stones.
These stones are caused by the bacteria of the urinary tract infection and the waste products that contain the protein components ingested through food.
Pregnancy: Pregnancy causes many changes in a woman’s body.
In this phase, the amount of calcium in the body increases.
The enlarged uterus reduces the capacity of the bladder to store urine, so the woman needs to urinate more often.
The increase in the hormone progesterone favors the filtration of urine. All these factors can lead to the formation of kidney stones.
However, very few pregnancies (1 in 1500) are affected by this condition.
Obesity and eating habits: Women (or men) who suffer from obesity are more likely to develop kidney stones than those who maintain a healthy body weight.
Eating habits play an important role in controlling body weight.
Eating foods high in sodium, animal protein, calcium, vitamin D, and sugar can cause kidney stones. The extra pressure on the kidneys to filter these components increases the risk of kidney stones.
Dehydration: Lack of fluid increases the concentration of urine and increases the risk of crystallization and stone formation.
People who don’t drink enough water or healthy fluids, and those who consume a lot of wine, beer, and spirits, can develop kidney stones.
Alcohol causes dehydration because it increases the urge to urinate. If you also eat foods that contain a lot of sodium, sugar and protein, but do not keep the body sufficiently hydrated, you can get kidney stones.
Some people are more prone to dehydration than others. For example, people who live in hot and humid regions need to drink more fluids than usual.
In addition, people who exercise intensively must replace the fluid lost through sweating.
Other diseases: There are several diseases that occur together with kidney stones.
These include:
- Cystinuria: increased excretion of the amino acid cystine in the urine.
- Hypercalciuria: increased excretion of calcium in the urine.
- Hyperoxaluria: increased excretion of oxalate in the urine.
- Hyperparathyroidism: excessive secretion of the hormone of the parathyroid glands located in the neck, which causes the release of calcium in the blood.
- Renal tubular acidosis: excessive accumulation of acids in the blood due to the inability of the kidneys to excrete them in the urine.
- Hyperuricosuria: high levels of uric acid in the urine.
- Other pathologies, such as gout, cystic kidney disease, chronic diarrhea (diarrhea), etc., can cause the formation of kidney stones.
A family history of kidney stones increases the risk of this condition. The stones may recur. Therefore, prevention is important.
Certain medications: Some medications such as diuretics, calcium-containing antacids, protease inhibitors such as Crixivan for the treatment of HIV, and the antiepileptic Topamax.
Symptoms of kidney stones
Not always kidney stones are accompanied by obvious symptoms. If the stones are reasonably small, there are usually no symptoms and the stone is excreted in the urine.
In the case of larger stones, the symptoms may be marked and unpleasant. Some of the most common symptoms that indicate the presence of kidney stones are:
Sudden and constant pain: Kidney stones can cause intense pain in the right or left flank, back, groin, or genitals (penile or vagina pain).
Sometimes the pain manifests itself spasmodically in the form of renal colic, as the muscular wall of the ureter contracts to push the stone towards the bladder.
Colic can occur in the left flank or in the middle of the abdomen. Sometimes they also radiate into the groin.
The pain can be so severe that it makes normal movements such as sitting or standing impossible.
Blood in the urine (hematuria): There may be traces of blood in the urine.
Sometimes they are visible or can be detected by laboratory tests.
Blood in the urine is a sign of damage to the tissue wall of the ureter or inside the kidney.
Pain when urinating and frequent urge to urinate: This symptom occurs when the stone is in the ureter or has left the bladder.
A urinary tract infection may be accompanied by pain when urinating.
Pain with fever and chills: If you have a fever with pain, you should talk to your doctor, who can prescribe appropriate medication (usually antibiotics).
Urine tests may be done to see if white blood cells are present. In this case, the patient is likely to suffer from an infection.
Pain with vomiting and nausea: Nausea and vomiting associated with abdominal, flank or back pain can indicate a serious problem.
In this case, one should immediately consult a doctor.
There are also other symptoms, such as loss of appetite, profuse sweating, weakness, discolored (pink, red or dark), foul-smelling and frothy urine, the inability to urinate, etc.
Diagnosis of kidney stones
When the doctor examines the patient, a patient with kidney stones usually experiences terrible pain.
To see if the patient has kidney stones, the doctor will order an X-ray or an ultrasound scan of the abdomen. Radiation-impermeable stones (from calcium oxalate) are most common and appear on the X-ray, while radiolucent stones (from uric acid) can only be visualized during a urography with a contrast agent.
Therapy for kidney stones
Surgery is not always required to remove kidney stones.
If the pain is moderate and the doctor assumes that the stone will go away on its own, it is recommended to drink plenty of water and urinate frequently.
One should drink a sufficient amount of water to keep the urine light.
This means that you should drink 2 glasses every 2 hours or so during the day.
You should inform your doctor about any diseases of the liver, heart or kidneys and about fluid restrictions.
There are helpful drug treatments to temporarily relieve the pain, for example, the doctor may prescribe the following medications:
- nonsteroidal anti-inflammatory drugs such as diclofenac (Voltaren),
- analgesics such as paracetamol (ben-u-ron),
- Antispasmodics, such as butylscopolamine (Buscopan®), which facilitates the excretion of the stones in the urine.
It is impossible to predict the time required for the excretion of the stone, usually this happens within two weeks.
When should you have surgery for kidney stones?
If the kidney stones cannot be eliminated with these forms of treatment, surgery is required.
Surgical options include:
Extracorporeal shock wave lithotripsy (ESWL): It is often used to treat kidney stones. The shock waves serve to break the stones into small pieces, which are then excreted in the urine.
During this procedure, you are partially under water or on a soft pillow.
Most of the time, a mild sedative or anesthesia is given in this surgery to relieve the moderate pain caused by the shock waves.
The crushed stone is excreted in the urine in the form of kidney semolina. These are very small, solid particles the size of a grain of sand.
Percutaneous nephrolithotomy/nephrolithotripsy: This is used when the ESWL does not work or the stone is very large. In this procedure, the surgeon inserts a small telescope into the kidney through a small incision in the back.
This allows the doctor to remove the stones directly or after crushing them.
Ureteroscopy: It is generally used to remove kidney stones from the ureter. In this procedure, the surgeon inserts a urethroscope, a very thin telescopic tube, into the urinary tract until it reaches the kidney stone.
Then he uses special instruments to remove the stone or he smashes it with laser or ultrasound.
Open surgery: The surgeon makes an incision on the affected side of the abdomen to get to the kidney and remove the stones. Today, this operation is performed very rarely.
Natural remedy for kidney stones
Most often, patients immediately turn to the emergency room of a clinic due to the severe pain.
After discharge, pain can be relieved with home remedies such as warm baths, etc.
What should you eat? Diet and nutrition
You should drink plenty of water and eat foods rich in fiber. A high-fiber diet is a natural remedy to remove kidney stones.
Magnesium supplements help dissolve uric acid, calcium, and phosphorus in the urine.
An alkaline diet (consisting of foods that lower the acidity of the blood) is the best prevention for kidney stones.
For the time being, you should avoid foods such as chocolate, spinach and nuts, which contain a lot of oxalates.
Movement
To facilitate the elimination of stuck kidney stones, one should exercise daily.
Changing a sedentary lifestyle through physical exercise helps eliminate and prevent kidney stones.
Herbal remedies or herbal medicine
Herbal teas are very effective against kidney stones. These herb-based beverages have been used for centuries to eliminate uric acid deposits. They contain herbs that cleanse the kidney, such as hydrangea root, wild yam, ribwort leaves, and viburnum.
2 to 3 cups of herbal tea daily will help eliminate kidney stones.
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