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Formally known as Renal Calculus, kidney stones are formed from the dietary minerals that collect in the kidney and work their way into the ureter or bladder. They are formed aggregately from the following minerals and chemical compounds:

  • Calcium
  • Magnesium
  • Potassium
  • Sodium
  • Zinc
  • Iodine
  • Struvite (phosphate mineral)
  • Uric acid (heterocyclic compound [carbon, nitrogen, oxygen and hydrogen])

Interestingly, kidney stones while being a source of poor health or morbidity in both men and woman, mainly (80% of cases) afflict men in the 30 to 40 year age group; women more commonly develop the malady later in life.

The stones are usually passed thru the urinary tract without causing problems but can cause blockages in the ureter if larger than 3 millimeters in diameter. Once blockage occurs the condition Renal Colic may develop; consisting of swelling, Atrophy (the wasting away of human tissue) and ureter spasms that come in waves of 20 to 60 minutes.

picture of kidney stone
The picture shows the size they can grow to.

Symptoms

Renal colic is one of the severest pain sensations known to distress the human condition. It is described as radiating from the kidney area to the groin and inner thigh. The source of the pain comes from peristaltic contractions from the ureter as it tries to dislodge the stone. This conditions is usually accompanied by:

  • Nausea
  • Vomiting
  • Fever
  • Blood or pus in the urine
  • Painful urination
  • Urinary urgency
  • Restlessness
  • Sweating

Causes

The main cause in developing kidney stones is abnormal dietary intake and low fluid intake. Calcium (supplements) seem to be one of the main culprits in this anomaly; some studies have shown that people taking supplementary calcium tablets have a higher than normal risk of kidney stones development. Higher consumption of dietary calcium does not seem to contribute to kidney stones development and may actually act as a preventive catalyst in the process. Similarly, high dietary intakes of potassium and magnesium promote the increased excretion of citrate in the urine, an inhibitor of crystal formation in the urine. Other electrolytes may influence the formation of kidney stones such as high dietary sodium and fluoride in drinking water. Surplus sulfurous amino acids, uric acid along with other types of acidic metabolites in animal protein acidifies urine, which will promote kidney stones the formationation by drawing calcium from bones. This Supersaturating of urine solution contain more solutes than the solvent can hold, forming seed crystals or the beginning of a kidney stone, but calcium based stones may be more complex. Kidney stones most likely are the result of a combination of factors, rather than one specific cause; however, they may be more common in people who do not consume enough water, have a diet high in animal protein and low in calcium.

Diagnosis

A diagnosis of kidney stones is made on the basis of the location, severity and nature of the pain. (comes and goes in spasmodic waves) The conclusion is based on the following evidence:

  • Health history
  • Physical examination
  • Urinalysis
  • Radiographic studies
  • Ultrasound exams
  • Blood tests

Treatment

The first phase of treatment is usually pain control in hopes a small stone will eventually pass; up to 98% of small stones are expelled within four weeks of the initial symptoms.[1] If this is not successful, stone size and location are the deciding factor in further treatment. Another form of expulsion therapy involves the use of medicinal agents such as tamsulosin and nifedipine.[2] These agents may also be used in conjunction with extracorporeal shock wave lithotripsy,[1] a non-surgical, externally applied treatment that makes use of focused acoustic pulses to break up the stone. More invasive forms of treatment (minimal invasive surgery [local]) may be needed such as cystoscopic procedures (optical fibers and lens [Laser lithotripsy]) that use a laser pulses to break up stone or percutaneous techniques that utilize a needle puncture and catheter to insert a Ureteral stent to bypass the obstruction. Prompt surgery may be require if the patient has only one working kidney, a urinary tract infection or bilateral obstructing stones.

Dietary Preventive Measures & Natural Kidney Stones Treatment

These measures are meant to be suggestive and by no means should be a substitute for your doctor’s advice. If you are displaying any symptoms of this ailment consult your doctor at once. A normalized diet can be both a preventive mechanism and a therapy model for the avoidance of kidney stones. The following recommendations will minimize the risk of the forming of kidney stones:[3]

  • Increase fluid intake in things that are rich in citrate (such as orange juice and lemonade), the aim is to increase the output of urine in excess of two liters a day
  • Limit the daily intake of sodium to 2300 mg or less
  • As best you can, keep up an intake of calcium somewhere around 1000 – 1200 mg daily
  • Limit the daily intake of vitamin C to 1000 mg or less
  • Limit the amount you eat of foods such as  dark chocolate, nuts,  wheat germ,  strawberries, spinach,  brewed tea, rhubarb,  cocoa,  as they are high in oxalate
  • Limit meals of animal protein – 2 or less daily, with a total of less than 6 – 8 ounces (For males, a connection has been found between animal protein and recurring  kidney stones, but this was not found in females.)[4]

 

Footnotes

  1. Miller, NL; Lingeman, JE (2007). “Management of kidney stones”. BMJ 334 (7591): 468–72. doi:10.1136/bmj.39113.480185.80. PMC 1808123. PMID 17332586.
  2. Seitz, C; Liatsikos, E, Porpiglia, F, Tiselius, HG, Zwergel, U (2009 Sep). “Medical therapy to facilitate the passage of stones: what is the evidence?”. European urology 56 (3): 455–71. PMID 19560860.
  3. Paterson, R; Fernandez, A; Razvi, H; Sutton, R (2010). “Evaluation and medical management of the kidney stone patient”. Canadian Urological Association Journal 4 (6): 375–9. PMC 2997825. PMID 21191493.
  4. Taylor, EN; Curhan, GC (2006 Sep). “Diet and fluid prescription in stone disease.”. Kidney international 70 (5): 835-9. PMID 16837923.



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Kidney stones, otherwise known as renal calculus, are a solid mass of crystals formed when the urine contains an excess amount of certain minerals. The cause can be dietary, hereditary, or from a number of other factors.

Causes of Kidney Stones
The exact cause of kidney stones can vary depending upon the type of stone that is present. The most common form are calcium stones which are most often seen in males aged between 20 and 30. The stone is formed when the calcium combines with oxalate, carbonate or phosphate. Spinach for example, is one food where oxalate is found and should be consumed only in moderation by people who are prone to kidney stone development.

Hereditary disorders like cystinuria can result in cystine stones forming. Another type is the struvite stone which are stones that can grow large and result in blockage of the kidney, bladder or ureter. These are most common in women with urinary tract infections.

Men who have gout or who have had chemotherapy are more prone to getting uric acid stones, another form of kidney stone.

One of the major causes and risk factors of kidney stones is low fluid intake as well as a diet high in refined sugars, animal protein, fructose, apple and grapefruit juice and some soda drinks.

Symptoms of Kidney Stones
The signs of kidney stones are often not noticed until the stones have moved down the ureters, which results in the stones blocking the passage of urine from the kidneys to the bladder. This can result in extreme sudden pain in the side of the back or abdomen area, then sometimes becoming groin pain or testicle pain in men.

Kidney stones can cause a variety of other symptoms including vomiting, nausea, abnormal urine colour or blood in urine, and fevers.

Testing for Kidney Stones
Doctors are able to undertake a physical examination if you present with symptoms of kidney stones. Following a physical exam, certain tests may be performed including:

Kidney function tests

  • Blood tests – to check the levels of minerals and electrolytes.
  • Urinalysis
  • CT scans, ultrasounds and x-rays may also be undertaken to confirm the presence of kidney stones.
  • Once kidney stones are diagnosed, the doctor will examine the stone to determine which type it is.

Treatment Options for Kidney Stones
The severity of the symptoms and the type of kidney stones will determine which treatment options your physician will recommend.

Some very small kidney stones will pass through without any assistance. In some cases medication may be prescribed that will help to break the stone down and remove the offending material. The type of medication or product recommended will depend upon which type of stone you have. Antibiotics are often prescribed for struvite stones. For uric acid stones, doctors may recommend Allopurinol. Sodium bicarbonate and water pills are also occasionally used.

In some cases surgery may be required if the stone continues to grow, is too large to pass on its own or to be broken down with substances, or if the stone is resulting in infection of damage to the kidneys.

 

Footnotes:

1) Strategies for preventing calcium oxalate stones. CMAJ. 2006;174(10):1407-1409. Finkielstein VA (PubMed)

2) Preminger GM. Evaluation and medical management of urinary lithiasis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th edition. Philadelphia, Pa: Saunders Elsevier; 2007:chap 43. Pietrow PK.

3) Nephrolithiasis. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 128. Curhan GC.

 



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