Kidney Stone

Kidney stone, medically termed as nephrolithiasis, are formed from excess minerals in the kidneys where urine is produced. These stones may also develop in the ureter, bladder, or urethra. Stones are a result of an imbalance between water, minerals, and salts processed in the kidneys.

There are different types of kidney stones based on their mineral composition:

• Calcium Stones – The most common type, formed from calcium oxalate, found in foods like tea, chocolate, nuts, and vegetables.
• Uric Acid Stones – Found in animal proteins (meat, fish, shellfish). These increase urine acidity and are more common in men.
• Struvite Stones – Formed due to urinary tract infections, more frequently seen in females.
• Cystine Stones – Rare and genetic in origin (cystinuria), caused by cystine buildup. These often recur and require long-term management.

Symptoms of kidney stones include:

• Severe pain from the side of the back to the abdomen
• Blood in urine
• Nausea and vomiting
• Dark-colored urine
• Fever and chills
• Frequent urination
• Passing small amounts of urine

Treatment for nephrolithiasis includes the following options:

• Medication:
  • Potassium citrate – Makes urine less acidic
  • Diuretics – Increases urination of salt and water
  • Allopurinol – Lowers uric acid levels
  • Antibiotics – Treat urinary infections
  • Calcium channel blockers / Alpha-blockers – Relaxes ureters to help stones pass
• Lithotripsy:
  • Extracorporeal Shock Wave Lithotripsy (ESWL) – Uses shock waves to break stones (ideal for stones <6mm)< /li>
  • Flexible Ureteroscopy and Laser Lithotripsy (FURSL) – Laser used to break stones using a ureteroscope
• Ureteroscopy: A thin scope is inserted into the urinary tract to remove stones using a stone extractor.
• Percutaneous Nephrolithotomy: A minimally invasive procedure using a nephroscope to remove stones through a small incision on the back.
• Open Nephrolithotomy: Traditional open surgery performed to remove large or complicated kidney stones via a flank incision.

RIRS is an endoscopic treatment for kidney stones. An endoscope is passed through the urethra to reach the kidney where the stone is broken using ultrasound or laser. Fragments are then extracted using a stone basket.

• No skin incisions required
• Low risk of complications
• Minimal post-operative pain
• Shorter surgery duration
• Quicker recovery
• Shorter hospital stay

Risk factors for kidney stone formation:

• Genetics
• Male gender
• Dehydration
• High protein, sodium, or sugar diets
• Obesity
• Gastrointestinal diseases or surgeries

Possible complications:

• Ureteral injury during surgery
• Obstruction in the urinary tract
• Recurrent stone formation
• Infection or sepsis post-surgery
• Bleeding
• Severe pain
• Urinary tract infections

Q: How are kidney stones diagnosed?
A: Through physical examination, blood tests, urine tests, and imaging tests such as X-rays, CT scans, and ultrasounds.

Q: How painful are kidney stones?
A: Kidney stone pain, or renal colic, is often described as one of the most intense pains, comparable to childbirth. It occurs when stones obstruct the urinary tract, especially the ureters.

Q: Can kidney stones cause kidney failure?
A: If untreated, kidney stones may lead to infections and bleeding. If both kidneys are affected or a single kidney is obstructed, kidney failure may occur.

Q: What is the treatment for kidney stones?
A: Treatments include medications (citrate, diuretics, allopurinol), lithotripsy (ESWL, laser), ureteroscopy, percutaneous nephrolithotomy, open nephrolithotomy, and retrograde intrarenal surgery.

Q: What is the best surgery to remove kidney stones in India?
A: Effective surgical options include ESWL, RIRS, and percutaneous nephrolithotripsy.

Q: Are kidney stones genetic?
A: Yes, especially cystine stones which are caused by the genetic disorder cystinuria, inherited from parents.