As the name suggests, kidney stones are stones found in the kidneys. It is estimated that 10 out of every 100 people will have a kidney stone at least once in their lifetime and 30 out of every 100 patients with kidney stones will have to be admitted to a hospital for at least a few hours to manage the pain, which is often severe, although the stones themselves do not hurt. The pain occurs if the stone causes obstruction to the passage of urine (obstructive lithiasis).
The symptoms are: pain in the back, on one side of the spine and under the ribs (renal colic). The pain may go as far as the groin, it may even hurt on both sides at the same time, although this is very rare. This pain caused by urinary lithiasis (stones) is often accompanied by nausea and vomiting, blood in the urine, a strong desire to urinate or burning when urine passes through the urethra. It is common for the person with urinary stones to have other family members affected with the same problem. To make the diagnosis, the urologist will perform a simple X-ray and an ultrasound. If the stone is uric acid, it will not be seen in the plain X-ray, but it will be seen in the ultrasound or in the scan (computed tomography). The ultrasound will also detect the presence of urinary obstruction (dilatation). If there is obstruction, the urologist will probably perform an intravenous urography (IVU) which consists of the injection of a contrast liquid into a vein in the arm which is eliminated through the kidneys and allows the external ducts of the kidney to be visualized.
When the stone is expelled, it is important to keep it in order to study its composition, which can help to choose the correct treatment to avoid another stone of the same type. It is important to remember that 70 to 80 out of 100 stones are spontaneously eliminated with urine within 48 hours after the onset of pain (colic).
Currently, the vast majority of stones that do not pass on their own can be broken into small pieces with a machine called external shock wave lithotripsy (ESWL) under spinal anesthesia, although some sites do this without anesthesia. Some patients with obstruction will need to have a tube (catheter) placed from the kidney to the bladder to allow urine to pass. In other cases, the stone can be removed with a metallic device called a ureteroscope that is introduced into the ureter, through the urethra and through which a device called a lithotripter is passed to break up the stone. Therefore, in less than 5 out of every 100 cases it is necessary to perform open surgery for the treatment of a urinary stone.
Finally, it should be noted that about half of the patients who have had a stone will develop another one in 5-10 years.
To reduce the possibility of having another stone
1. The most important thing is to drink plenty of fluids (mainly water), between 10 and 12 large glasses each day. This keeps the urine from concentrating and decreases the chance of crystals. To check if you are drinking enough fluid, you should look at the color of your urine, if it is dark yellow, you should drink more.
2. Diet is also important. If you have had calcium oxalate stones or uric acid, you should reduce the amount of protein (meat, sausages, offal, etc.) in your meals.
3. Diuretic medications such as hicrochlorothiazide may help decrease calcium excretion in the urine. Potassium citrate binds calcium in the urine and helps to eliminate it safely. Allopurinol causes the body to produce less uric acid and is useful in patients with gout. In rare cases of cystine stones, penicillamine may be helpful.
In any case, remember that it is very important that you consult with a urologist, he will prescribe and monitor treatment with these products.