Kidney stone disease is a common problem in tropical countries like India. The stones are formed when there are high levels of calcium, oxalate, phosphate, cysteine or uric acid in the urine. These chemicals initially precipitate to form small crystals. Crystals attach to the surface and form an anchor for further build up of chemicals over them. The crystals get bigger and bigger over time and form, what we call a calculi (or stone).

The stone can stay in its place or may move through the urinary tract to eventually pass put in urine. But when the stone gets stuck somewhere, it causes symptoms like pain.

Symptoms of kidney stones

A. Small stones may not cause any symptom
B. Pain- it is the most common and most distressing symptom of a passing kidney stone. Pain may begin in the flank (lower back, in one of the sides) and may go upto groin. It is often severe and may last for several minutes only to come back again.
C. Blood in urine- many patients may notice reddish color of the urine. In other cases, blood may be seen on dipstick test of urine.
D. Other symptoms like nausea, vomiting, pain while passing urine, etc.

Detection

Kidney stones are suspected on the basis of clinical symptoms, but usually a CT scan is recommended to know more about it. CT scan provides important information regarding- size and location of stone, evidence of obstruction to passage of urine, associated infection in the kidney. An ultrasound can also be useful to detect kidney stones, however smaller stones and stones in ureter may often be missed. However, it is useful in situations like detection fo stones in a pregnant lady.

Treatment

Treatment depends on the size and location of stones. Smaller stones may pass off by themselves.
You may need medicines to treat symptoms like pain, nausea and infections.
If the stone is stuck somewhere, there are various treatment options depending on location and type of kidney stones. This may include
Ureteroscopic stone retrieval
Shock wave lithotripsy
Percutaneous nephrolithotomy

Prevention of kidney stones

A. Increasing fluid intake is the single most important way to prevent kidney stones. Drinking good amount of fluid dilutes urine and washes away the chemicals which promote kidney stones. Fluid intake should be spaced out throughout the day to ensure hydration.

B. It is impotent to limit the amount of salt you take. High intake of sodium increases the amount of calcium in urine, which increases the risk of stone formation.

C. Patients with certain types of stones like oxalate stone require specific dietary changes to reduce the future risk.

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