Kidney Stone

Overview

Kidney stones (renal lithiasis, nephrolithiasis, renal calculi) are hard deposits made of minerals and salts that form inside the kidneys. Kidney stones have many causes and can affect any part of the urinary tract which is from kidneys to urethra.

Signs and Symptoms

Pain at the lumbar regions, Pain that radiates from loin to groin, Colicky pain, Pain on micturition, Hematuria, Cloudy or foul-smelling urine, Nausea and vomiting, Urinary incontinence, Fever and chills if an infection is present

Common Causes

Dietetic: deficiency of vitamin A causes desquamation of epithelium forms nidus on which stone is formed, Altered urinary solutes and colloids, Decreased urinary citrate, Renal infection: favours the formation of calculi, Inadequate urinary drainage: stones liable to form when urine is static, Prolonged immobilisation, Hyperparathyroidism: leads to hypercalcemia and hypercalciuria,

Risk Factors

Dietetic: deficiency of vitamin A causes desquamation of epithelium forms nidus on which stone is formed, Altered urinary solutes and colloids, Decreased urinary citrate, Renal infection: favours the formation of calculi, Inadequate urinary drainage: stones liable to form when urine is static, Prolonged immobilisation, Hyperparathyroidism: leads to hypercalcemia and hypercalciuria,

Investigation Techniques

Full blood count, Renal function test, Urine analysis(macroscopic and microscopic), X-ray (KUB: kidneys, ureters, bladder), Contrast enhanced CT scan, Excretion urography, Ultrasound

Treatment and Prevention

Small stone with minimal symptoms: drink plenty of water, pain reliever, alpha blocker which relaxes muscles and helps to pass the stones., Large stone and symptomatic: percutaneous nephrolithotomy, extracorporeal shock wave lithotripsy(ESWL), using ureteroscope to remove stone, pylolithotomy, extended pylothitomy, nephrolithotomy (in complex calculus branching), To prevent the recurrence, should be investigated to rule out metabolic factors, urine is screened for infection, moderate amount intake of food containing high in calcium, avoid red meat in patients with hyperuricemia, should drink plenty of water.