Renal Calculi [Kidney Stone]

Understanding Renal Calculi [Kidney Stone]

Renal calculi, commonly known as kidney stones, are hard deposits that form in the kidneys. If not treated properly, these stones can cause severe pain and other complications. This blog will explain the causes, symptoms and treatment options for renal calculi.

What are renal calculi?

Renal calculi are solid masses made of crystals that originate in the kidneys but can develop in any part of the urinary tract. They form when there are more crystal-forming substances in the urine – such as calcium, oxalate and uric acid – than there is fluid in the urine.

Causes of Renal Calculi

Several factors can contribute to the formation of kidney stones:

1. Dehydration: Inadequate water intake can cause concentrated urine, increasing the risk of stone formation.
2. Diet: High intake of salt, sugar, and protein may increase the risk of certain types of kidney stones.
3. Family history: A family history of kidney stones may increase the chance of developing them.
4. Medical conditions: Conditions such as hyperparathyroidism, gout, and urinary tract infections may contribute to stone formation.
5. Medications: Certain medications, including diuretics and calcium-based antacids, may increase the risk.

Symptoms of kidney stones

Kidney stones or renal calculi can cause a variety of symptoms, which vary in intensity depending on the stone’s size, location, and its movement through the urethra. Here are the common symptoms associated with renal calculi:

Severe pain:

• Often described as the most intense pain, kidney stone pain (renal colic) usually begins suddenly and without warning.
• The pain usually begins in the side and back, just below the ribs.
• It may spread to the lower abdomen and groin as the stone passes through the urethra.

Pain while urinating:

• There may be a sharp burning sensation while urinating, especially if the stone is near the junction of the ureter and bladder.

Hematuria:

• Pink, red or brown urine indicates the presence of blood.
• This may be due to the stone irritating the lining of the urinary tract.

Cloudy or smelly urine:

• Indicates a possible infection or the presence of crystals or other substances.

Frequent urination:

• A persistent need to urinate more often than usual, which may also be a sign of a stone near the bladder.

Small amounts of urine:

• Despite the frequent urge to urinate, the amount of urine produced may be small.

Nausea and vomiting:

• Severe pain may trigger nausea and vomiting.

Fever and chills:

• May indicate a urinary tract infection or other complications.
• Requires immediate medical attention.

Discomfort:

• Unable to find a comfortable position due to intense pain.

Difficulty urinating:

If the stone is blocking the urinary tract, it may cause difficulty or inability to urinate.

These symptoms require medical evaluation to confirm the presence of a kidney stone and determine appropriate treatment. If you notice any of these symptoms, especially severe pain, blood in the urine, or signs of infection such as fever and chills, seek medical help immediately.

Types of kidney stones

1. Calcium stones: The most common type, usually formed from calcium oxalate.
2. Struvite stones: Often caused by infection and can grow quickly.
3. Uric acid stones: Can form in people who lose a lot of fluids or consume a high-protein diet.
4. Cystine stones: An inherited disorder causes the kidneys to excrete too much of certain amino acids.

Symptoms of kidney stones

Kidney stones may not cause symptoms until they move inside the kidney or travel into the ureter. Common symptoms include:

• Severe pain under the ribs, in the side and back
• Pain that radiates to the lower abdomen and groin
• Pain that comes in waves and fluctuates in intensity
• Pain when urinating
• Pink, red or brown urine
• Cloudy or smelly urine
• Nausea and vomiting
• Constant urge to urinate
• Urinating more often than usual
• Fever and chills if an infection is present

Diagnosis

Diagnosis usually involves a combination of medical history, physical examination and diagnostic tests, including:

• Imaging tests: CT scans, X-rays and ultrasound can detect kidney stones
• Blood tests: To identify the levels of calcium, uric acid and other substances.
• Urine tests: To detect substances that can form stones and to check for any infection.

Treatment options

Treatment depends on the size, type and location of the stone as well as the severity of symptoms:-

1. Small stones with minimal symptoms: Drinking water: Staying hydrated helps flush out the urinary system. Pain relievers: Over-the-counter medications can help manage pain. Medical therapy: Medications such as alpha-blockers can help relax muscles in the ureter, facilitating the passage of stones.

2. Large stones or stones causing symptoms: Extracorporeal shock wave lithotripsy (ESWL): Uses sound waves to break up stones into smaller pieces that can be passed out in the urine.

• Surgery: Procedures such as percutaneous nephrolithotomy involve removing stones using tiny telescopes and instruments inserted through a small incision in the back.
• Ureteroscopy: This involves passing a thin, flexible telescope through the urethra and bladder to the ureter to break up and remove the stone.
• Parathyroid gland surgery: If the stones are caused by overactive parathyroid glands, removing the gland may prevent future stones.

Prevention

Preventing kidney stones involves making dietary and lifestyle changes, such as:

• drinking plenty of water throughout the day
• reducing sodium intake
• limiting animal protein intake
• avoiding oxalate-rich foods such as spinach, nuts, and tea
• maintaining a healthy weight

Conclusion

Kidney stones can be extremely painful and can lead to serious complications if not properly managed. Understanding the causes, symptoms, and treatment options is important for effective management and prevention. If you suspect you have kidney stones, consult a healthcare provider for a proper diagnosis and treatment plan.