at aki
KIDNEY STONES
Kidney stones are abnormal solid particles found in kidneys. Some are small as a grain of sand, others range in mm or cm. They occurs in a variety of colours from yellow, through brown to black. Kidney stones are made of different chemicals from the urine.
These are not our fault, but we can reduce risk factors. When we do not drink enough water or when we lose an excess of fluid through sweating or diarrhea then urine becomes concentrated. Probably stones form and grow during night as we naturally concentrate urine overnight. Abnormalities in the drainage of the kidney can be the cause of stone formation.
Who is likely to form?
Men are generally at higher risk of developing kidney stones compared to women. Individuals who experience dehydration due to factors like hot weather, strenuous work or illnesses such as diarrhea are also more susceptible. Additionally, those who are overweight, gain weight over time, have a sedentary lifestyle or suffering from diabetes are at an increased risk of developing stones.
Tests for kidney stones:
We typically use a CT scan to detect the presence of kidney stones, as it provides the most accurate imaging. Once stones are identified, we follow-up with abdominal X-rays used for monitoring. Ultrasound is also helpful for detecting kidney obstructions and can reveal stones in some cases. We perform blood tests to assess kidney function and identify any underlying causes of kidney stones.
In some cases, a 24-hour urine test will be conducted to pinpoint the cause of stones. If you manage to pass a stone, it’s helpful to collect it, as we can analyse it to understand the type of stone and its causes.
Kidney stones problems:
While many people with stones are unaware that they have them until they are found on X-ray images or scans, most people are also aware of the potential pain that causes when they move. Smaller stones also give the most pain. Other problems are damage to kidney function, an association with infection and blood in the urine.
The combination of infection and obstruction (called pyonephrosis) is a dangerous condition that needs emergency treatment and drainage in hospital. Symptoms of this are pain in the side of the abdomen and fever.
Treatment:
Once kidney stones are formed, they typically cannot be dissolved. If they are not causing symptoms or harming the kidney, treatment may not be necessary and monitored over time. In some cases urgent surgery is needed for severe pain or complications like pyonephrosis, with treatments such as nephrostomy or ureteric stents to drain the kidney.
For smaller stones, Medical Expulsive Therapy (MET) using alpha blockers like Tamsulosin is common. Ureteroscopy is used for stones that do not pass naturally, where a telescope is inserted through the urethra to break or remove the stone.
For kidney stones, treatment options include ureteroscopy, keyhole surgery (PCNL) and Extracorporeal Shock Wave Lithotripsy (ESWL). ESWL uses sound waves to break smaller stones into pieces that can be passed naturally.