A Kidney stone, also known as renal calculus or nephrolith is a solid mass that forms in the kidney due to the accumulation of minerals found in urine. 200,000 to 3 million cases are reported each year making it a fairly common condition in the United States. Kidney stones can also develop anywhere on the urinary tract including on the urethra, the bladder or the ureter. A kidney stone usually leaves the body stream by passing down the urinary tract.
Kidney stones are differentiated by the mineral type that is contained in them. There are about four different types of kidney stones. These include calcium oxalate kidney stones, uric acid kidney stones, calcium phosphate kidney stones, struvite and cystine kidney stones.
The calcium kidney stones are mainly composed of a compound known as calcium oxalate. This is the most common type of kidney stone occurrence and it accounts for 80% of all kidney stone cases. It is usually formed as a result of high consumption supplemental calcium or high-oxalate foods such as beet, potato chips or spinach. The calcium found in bones and the oxalate produced in the body also play a part in the formation of these kidney stones.
A high acidic concentration in urine may lead to the formation of uric acid kidney stones. This types of kidney stones have a characteristic yellow reddish discoloration. Diets that are rich in uric acid, purine or amino acid include food with a high concentration of animal protein. Foods rich in animal protein include meat, fish and shellfish. High acidity in urine means a low concentration of urinary citrate which promotes the stone formation process.
Calcium phosphate kidney stones occurrence is rare and is reported in 5-10% of the cases. The kidney stone formed by the calcium phosphate mineral tend to be dirty white in color and are formed by alkaline urine. When proteus is present in urine the pH of the urine increases and thus the growing alkalinity leads to formation of calcium phosphate kidney stones.
Struvite kidney stones also known as "infection stones” are usually found in women who have kidney or urinary tract infection. The constituent mineral in a struvite stone is ammonium magnesium phosphate and is a byproduct of the splitting of urea by bacteria.
Kidney stones can also be caused by genetic disorder. Although rare, people who have the genetic disorder known as “cystinuria” produce cytine acid which leaks from the kidney to the urine, thus leading to the formation of cystine kidney stones. Other inborn errors of metabolism such as Fancni syndrome cystinosis can also lead to the formation of cystine acid.
Another extremely rare type of kidney stone characterized by a brick red color is the Xanthine kidney stone. This type of kidney stones normally occur in people who are affected by a condition known as xanthinuria. These is an inherent error in metabolic function and may be passed on from parent to offspring through inheritance of genes.
The process of a kidney stone by passing down the urinary tract is painless and has no symptoms if the kidney stones are small . However if the kidney stone grows to a size larger than 0.12 inches, severe pain is felt in the lower back region and the groin area. This pain known as renal colic is persistent and consistently radiates for 20 to 60 minutes in the affected area. Symptoms accompanying the pain include chills, foul smelling urine, blood and pus in urine, fever, increased frequency of urination, urination of small amounts of urine, nausea and vomiting. The symptoms mentioned above do not occur all at once but are more likely to occur if a person has kidney stones. It is important to note that these symptoms may also occur due to other unrelated conditions. It is important to consult a doctor a soon as possible once these symptoms appear. Failure to consult may result into a more serious condition because the kidney stone buildup continues and the correction of chronic conditions require complicated methods of treatment.
Medical practitioners have devised a number of techniques that correctly diagnose kidney stones. These methods of diagnosis increase if the doctor suspects that a person has a probability of having kidney stones. The diagnosis of kidney stones usually start with a a physical exam where a patient is questioned a bout his diet, his family history of kidney stones and relevant diseases.
Through these questions, a doctor get enough information to help him or her decide whether to proceed with tests such as CT scans, x rays, blood or urine analysis. Urinalysis is basically a test that confirms whether minerals that form kidney stones are present in the urine of the patient. This test may not be conclusive and thus the doctor may order a blood analysis test. The blood analysis tests shed some light on any biochemical problems that can cause the formation of kidney stone.
A somewhat sure way of knowing whether a patient has kidney stone is by conducting an X ray on the abdominal region of his body. The x-ray machine will produce an image of internal structure which may lead to the identification of a kidney stone in the urinary tract of the patient. Needless to say, X rays are fast, painless and a relatively accurate way of diagnosis of kiney stones. However the X ray may provide inconclusive results if the kidney stone is too small to make a positive confirmation on the image provided. This problems calls for the use of a CT scan which produces three dimensional images of the body. The CT scan provides a high resolution and high quality image that can identify where a kidney stone may have formed. It is a highly non-intrusive diagnosis technique requiring only radiologist assistance for a full diagnosis to be performed.
Other methods for testing kidney stones include intravenous pyelogram, magnetic resonance imaging of abdomen and kidney, retrograde pyelogram and kidney ultrasound. This methods are used to rule out obstruction of urinary tract.
The different types of kidney stones are cause by a variety of conditions and thus preventive measures are influenced by kidney stone type. Since the majority of cases of kidney stone formation are due to dietary habits of patients it is prudent to discuss dietary preventative measure at large.
Kidney stones formed by calcium are generally prevented by drinking lots of water or fluids to maintain low calcium levels in urine and thus prevent a gradual buildup of calcium mineral in the kidney. The reduction of calcium levels in urine can also be achieved by medication coupled with diets low in calcium. The purpose of the diet and medicine is to reduce the amount of calcium circulating in the bloodstream. The Kidneys will therefore have a low excretory load of calcium-based minerals and thus no stone buildup will be expected. The diet that enables low calcium levels consists of 2 liters a day of fluid. The most preferred fluid is water and it is important to note that note all fluids promote an optimal diet. An example is cola soft drinks whose acidic content promote formation of kidney stones. Preferred drinks in this diet include water, ginger ale,fruit juice and lime soda. Another food group to avoid is vitamin C in large quantities, sodium , and animal proteins. These food are not to be avoided completely but are to be taken in moderate potions. The guiding principle of the preventative measures is to increase urine volume which is associated with a 40 percent reduced risk of kidney stones.
Another preventative measure is urine alkanization. Oral medications may be used to increase the pH of urine and thus promoting the disintegration of acidic stones. For urine alkanization to be effective a pH of 6.5 must be achieved. It is important not to oversaturate or overly increase pH of urine by taking part in rigorous dietary routines. Measurement of urine pH with a nitrazine paper is required for the optimal balancing of pH. It is important to note that extreme alkanization is dangerous as it may lead to the opposite effect which is the formation of alkaline kidney stones. It is therefore highly advisable to follow strict guidelines when performing alkalinization as a preventive measure.
Treatment method is varied due to different types of kidney stones. For the non severe type of kidney stones, drinking a huge amount of water (six to eight glasses) may alleviate the problem. In severe case narcotic medication is required for pain relieve. Treatment usually involves the use of antibiotic medication. Doctors usually administer sodium bicarbonates, sodium citrate phosphorous solutions or allopurinol for uric acid stones. In more extreme cases sound waves may be used to break up large stones so that they may be able to pass through the urinary tract. This is not the most ideal methods because the broken down prices cause bruising of urinary tract and bleeding of organs.
Surgery is performed if the kidney stones are too large even when broken down by sound waves. There are many situations that may cause the selection of surgery as the method of treatment. These situations include when the kidney stone cause obstruction or when the stone is damaging the kidneys or when the pain becomes too much.
Finally another method for treatment is the use of an instrument is known as ureteroscope. These instrument enters the urethra of the patient and with the doctors guidance via a camera, the kidney stone is captures by a small cage to remove it from the urinary tract. The technique of ureteroscopy has been developed for a long time and has been widely adopted for treatment of kidney stones. Development of uterescopy methods mean that fibers optics are now used to provide an efficient and fast treatment procedure, with no bruises to tissue.
Because kidney stones is a relatively common problem treatment methods are vastly improving to enable the fast detection and easy treatment of these condition. Due to the sheer amount of pain associated with kidney stones patients are more likely to exercise a preventative regimen to prevent multiple occurrence. It is important to note that kidney stones affect a wide range of the age groups and there it is proper to introduce reasonable dietary measures that prevent the buildup o f kidney stones in the body. Treatment can be expensive if kidney stones get huge enough because the larger they get, the more hard it is to extract the from the body. Therefore an important step for patients who are susceptible to the kidney stones problem is to go for regular scanning. Kidney stones in some individuals is a recurring condition. These individuals include the ones with genetic disorder “cystinuria” that cause production cytine acid. Treatment and management of the conditions is relatively easy because they can adopt preventive measures while showing up for regular check ups to prevent unnecessary build up of kidney stones in the urinary tract and kidney. In conclusion, management of kidney stones is simple for the majority of people get them because they do not build up in most cases and are passed out in urine with little or no symptoms experienced. It has been proven than 98 percent of kidney stones are small in size. Usually these means that they re less than 5 Milli meters. These small stones pass spontaneously after four weeks since the beginning of symptoms. For larger stones (defined as stones larger than 0.2 inches in diameter) the rate of quick passing through urination falls to about 53 percent. While these is a serious drop the location where the stone formed plays a huge role in determining whether the stone will pass out of the urinary tract unassisted.
Some individuals are characterized as “repeat stone formers” these by definition have no genetic condition whatsoever and have no infection in their urinary tract but tend to repeated develop kidney stones. A regimen of medicine countered with high fluid intake and the use of preventative measures allow them to go about their normal lives with an occasional checkup with the doctor.
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