Jon Halty - Kidney stones, also known as nephrolithiasis, is a condition of mineral buildup resulting from the process of filtering waste substances in the kidneys or urinary tract, which settles and forms hard clumps like stones. Kidney stones have different sizes, shapes and colors.
Broadly speaking there are 4 types of kidney stones :
1. Calcium stone. Most kidney stones that occur are calcium stones. This type of kidney stone is generally formed from calcium oxalate. However, there are also those formed from phosphate. Calcium oxalate stones generally form naturally from foods high in oxalate, such as chocolate, nuts, vegetables and fruit, and formation by the liver. In addition, consumption of vitamin D in high doses and gastrointestinal surgery can also form this type of kidney stone. As for phosphate stones, it is generally caused by metabolic disorders, such as renal tubular acidosis.
2. Magnesium ammonium phosphate stone (struvite stone). It is a kidney stone that is formed due to a response to infection, such as a urinary tract infection. This condition can develop to form large stones quickly.
3. Uric acid stone. This type of kidney stone contains high uric acid, which can be caused by someone drinking less or losing large amounts of fluid. In addition, it can be caused by a high-protein diet and high uric acid levels. Some conditions can also be caused due to genetic factors.
4. Systine stone (cystine stone). This condition is due to hereditary factors which cause the kidneys to secrete amino acids excessively (cystinuria).
Dignosis
In general, kidney stones are rarely diagnosed before pain arises. In the process of establishing a diagnosis of kidney stones, there needs to be a series of laboratory tests and other clinical examinations, including :
Blood test: Used to determine the amount of calcium or uric acid in the blood. This blood test helps to monitor kidney health and other medical conditions.
Urine test: Taking a 24-hour urine sample can indicate whether a person has mineral deposits decomposite to form stones or as a form of preventing crystal stone formation. Generally, doctors will recommend collecting urine samples for 2 days.
Descriptive test: This picture test will show whether or not kidney stones are formed in the urinary tract. The range of test options that can be done ranges from simple tests, such as abdominal X-ray test (this test is difficult to detect small-sized kidney stones) or high-speed or dual energy computerized tomography (CT) tests that can detect small-sized kidney stones even though. Other tests that can be used include ultrasound, noninvasive test, and intravenous urography, which will be administered by intravenous dye to provide contrast color to the kidneys and bladder during X-rays and CT images (CT urogram).
Analysis of kidney stones formed: This analysis is carried out by conducting a laboratory examination of the kidney stones that are formed, and coming out together with urine when urinating. The results of this analysis are used to determine the causes of kidney stones as well as determine preventive measures going forward.
Symptoms
Small kidney stones can arise without any visible symptoms. Symptoms will arise when the formed kidney stones are trapped in the kidneys, move towards the urinary tract, or cause infection. When one or more of these conditions occurs, several other symptoms will appear, including :
Pain in the back, abdomen, or groin area. In men usually pain will arise in the scrotum (testicles) or testicles.
Pain during urination (dysuria).
The presence of blood in the urine (haematuria).
The urine color tends to be red or tanned.
Increased urinary frequency.
Urinate in smaller amounts.
A feeling of voiding that cannot be resisted.
Nausea and vomiting.
Great fatigue.
Fever and chills if an infection occurs
Pain in the abdomen or during urination is also a symptom of urinary tract infections, sexually transmitted diseases, appendicitis, and ectopic pregnancy. Therefore, if the patient has severe pain in the back or abdomen, you should immediately contact a doctor.
Cause
The occurrence of kidney stones is not only caused by 1 cause. The consumption patterns of foods high in protein, salt, and oxalate, such as chocolate or dark green leafy vegetables, are also risk factors that must be taken into account.
Kidney stones are formed due to changes in the balance of water, salt, and minerals found in urine. Changes in these components cause different types of kidney stones that are formed. Generally, kidney stones are formed when the urine produced contains many crystalline substances, such as calcium, oxalate, and gout.
There are many factors that can trigger changes in urine, ranging from changes in health conditions to differences in consumption of food and drinks. Here are some risk factors that increase the likelihood of kidney stones :
Family history. Patients with a family history of kidney stones or with a history of kidney stones have a greater risk of developing kidney stones.
Dehydration: Lack of water intake every day increases the risk of kidney stones. People who live in climatic climates and sweat more without adequate intake of water are also at higher risk of developing kidney stones.
Diet: The pattern of consuming foods high in protein, salt, and sugar increases the risk of kidney stones. Eating too much salt will increase the workload of the kidneys, thereby increasing the risk of kidney stone formation.
Obesity: People with high BMI, waist circumference, and weight gain have a greater risk of developing kidney stones.
Disease or surgery on the part of the digestion: Gastric bypass surgery, inflammatory bowel disease, or chronic diarrhea can cause changes in the digestive process. This will result in the process of absorption of calcium and water, thereby increasing the possibility of calcium stone formation in the urine.
Other medical conditions: Conditions and some diseases can also increase the risk of kidney stones, such as renal tubular acidosis, cystinuria (high amino acid content in the urine), hyperparathyroid conditions, certain drugs, and urinary tract infections.
Prevention
Prevention of kidney stones can also be differentiated based on the type of kidney stone. If kidney stones are formed is a type of calcium stone, the doctor will recommend reducing salt consumption, which can increase the calcium content in urine. In addition, it is also recommended to avoid foods high in oxalate, such as chocolate, instant coffee, tea, nuts, berries, dark green vegetables, oranges, tofu, and sweet potatoes.
Increasing the consumption of water is also good for preventing the formation of new kidney stones and keeping urine clear. Although kidney stones generally contain calcium, there is no need to avoid foods high in calcium.
Eating foods or drinks high in calcium in sufficient quantities does not directly increase the risk of kidney stones. However, you should avoid using calcium supplements that can increase the calcium content in urine. Consult your doctor first.
In addition, it's a good idea to avoid some conditions that can increase the risk of kidney stones, such as high blood pressure, gout, and urinary tract infections, especially if you have a family history or experience of having kidney stones.
Handling
In general, kidney stones will come out by themselves through the urinary tract within 48 hours if enough fluid intake into the body. If the kidney stones that are formed are small in size, the doctor may recommend giving painkillers and waiting for the kidney stones to come out on their own. At this time, the doctor will recommend to patients to consume sufficient amounts of water (± 8-10 glasses per day) and keep the urine color clear.
Ketorolac injection can be given as a pain reliever. If the lithotripsy method is done, the patient is not recommended to take aspirin and other nonsteroidal anti-inflammatory drugs, because it can increase the risk of bleeding.
There are several factors that affect the ability of kidney stones to pass through the urinary tract. These include the size of the urinary tract, enlarged prostate, pregnancy, and the size of kidney stones that are formed. Generally, the size of 4 mm kidney stones has 80 percent chance of passing through the urinary tract. But the greater the size of the kidney stones that are formed, the less likely it is to pass through the urinary tract.
Several types of drugs can also be used to increase the likelihood of kidney stones being excreted in the urine, including calcium channel blockers (nifedipine) and alpha blockers (tamsulosin). This drug is generally given to patients with kidney stones that have characteristics that are difficult to pass through the urinary tract.
If the kidney stones formed are large, it will be difficult to get out by itself. Therefore, doctors can recommend lithotripsy. This procedure is done to break down large kidney stones into smaller sizes, so they can pass through the urinary tract.
Surgical techniques can also be done using the method of percutaneous nephrolithotomy. This method is done by making a small incision on the skin, as the ureteroscope passes through the urethral and bladder ducts, up to the ureter.