Kidney stone disease or Nephrolithiasis is a condition when hard stone-like material forms in the kidneys. The material is derived from residual waste substances in the blood filtered by the kidneys which then settles and crystallizes over time. In most cases, kidney stone disease is experienced by people aged 30-60 years. It is estimated that 10 percent of women and 15 percent of men have experienced this condition during their lifetime. Deposition of stones in the kidneys can be caused by food or other underlying health problems. Based on its type, kidney stones are divided into four, namely calcium stones, uric acid stones, struvit stones, and cystine stones.
Symptoms of kidney stones
Symptoms of kidney stones usually will not be felt by the sufferer if the kidney stone is so small that it can get out of the body naturally through the ureter easily. Ureter is a channel that connects the kidney with the bladder.
Symptoms of a new kidney stone can be felt if the stone is larger than the diameter of the ureter tract. Large stones will rub against the lining of the ureter wall causing irritation and even injury. Therefore, urine can sometimes contain blood. In addition to irritate the ureter, kidney stones can also be caught in the ureter or urethra (end of urinary tract) so that accumulation of bacteria and can cause swelling due to infection. Symptoms of kidney stones that can arise when the stone rubs against the ureter include pain in the waist, lower abdomen or side, and groin that can be accompanied by nausea.
While the symptoms that can be felt if people with kidney stones have kidney infections in which urine looks cloudy and smells unpleasant, body limp, chills, and high fever .
Diagnosis of kidney stones
In diagnosing kidney stones, usually first the doctor will ask the patient about the symptoms that have been experienced. Doctors may also ask whether the patient has had previous kidney stones, has a family history of the same disease, or whether patients often consume food or supplements that can trigger kidney stones.
After the information is collected, the doctor will usually perform a number of tests to strengthen the evidence. The tests may include urine examination, blood tests, and scans (eg ultrasound, X-ray, CT scan, and intravenous urogram / IVU )
Treatment of kidney stones
Treatment of kidney stone disease performed depends on the size of the stone. If kidney stones are still small or medium, and can still pass through the urinary tract without surgery, doctors will usually advise patients to drink only water according to the recommended dosage. With continuous fluid flow, it is expected that kidney stones can be pushed out by itself. If the symptoms are felt by the patient is quite disturbing, usually doctors simply prescribe painkillers, such as acetaminophen , ibuprofen or non-steroidal anti-inflammatory drugs.
Handling of kidney stones with special procedures (eg laser energy, ultrasound, or surgery) is usually applied only if the stone is larger enough to clog the patient's urinary tract.
Prevention of kidney stones
How to prevent kidney stones is actually quite simple. You only need to drink enough water every day and limit the consumption of foods, drinks, or supplements that contain substances that potentially lead to the formation of kidney stones, such as oxalic substances, calcium supplements, and animal protein.
In addition to drinking enough water and limit the intake of certain substances, the prevention of kidney stones can also be done by taking drugs prescribed by a doctor. Usually this step is recommended to prevent relapse for those who previously had suffered from kidney stones.
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Symptoms Of Kidney Stones
Symptoms of kidney stones will not be felt if the stone size is relatively small and can come out of the urinary tract along with the flow of urine smoothly. New symptoms can be felt if the stone stuck in the kidney, the stone is too big through the ureter, or kidney stones cause infection.
Ureter is a channel connecting the kidney with the bladder. This form of organ resembles a tube with a sensitive network structure. When large kidney stones pass through the ureter, the stone will rub against the ureter wall causing irritation and risk of injury. This is why sometimes urine can contain blood. If the stone is large enough, the stone can be caught in the ureter so that interfere with the smooth flow of urine from the kidneys.
The most common symptoms of kidney stones are persistent pain in the side of the abdomen, lower back, waist, groin, or even testes (in men). In addition, other symptoms of kidney stones that may be present are:
- Increased frequency of urination and pain during urination.
- The color of the urine looks cloudy and smells unsightly. Cloudy color like tanned or redness in urine can be caused by the bleeding when the kidney stone passes through the urinary tract.
- Nausea and may be accompanied by vomiting.
- Difficult to rest because it's hard to find the right position to do it.
Causes Of Kidney Stones
Naturally, the kidneys cleanse the blood every day by filtering out the waste substances contained therein for further disposal in the form of urine. Sometimes these substances are too much than the liquid that acts as a solvent so it can not be completely wasted by the body and settles in the kidneys. Another factor is the kidney shortage of material that serves to prevent precipitation of crystals to clot form a stone.
Deposition of stones in the kidneys can be caused by food or other underlying health problems. Based on the ingredients, kidney stones can be divided into four main types, namely calcium stone, uric acid stones, ammonia stone (struvit), and stone cystine.
Calcium stones are caused by high levels of calcium in the urine. This type of kidney stones is the most common. High levels of calcium can be caused due to hyperkalsiuria hereditary disease. This condition causes the sufferer to release a lot of calcium in the urine. High levels of calcium can also be caused by overactive parathyroid glands. The hormones produced by this gland function to regulate the amount of calcium in the blood.
The second is uric acid stones. This rock is formed by high uric acid levels in the urine caused by high purine foods. Examples of foods that trigger high uric acid are shellfish, meat and fish. Patients with Gout disease are also at high risk of forming this type of stone.
The third is struvit stone. This is a type of kidney stones that can form and grow rapidly. The main cause of the formation of struvit stone is a long-lasting urinary tract infection . This type of stone is more commonly found in female patients than in male patients.
The last one is the cystine stone . Kidney stones are formed by too much amino acid cystin issued by the kidney. Stone cystine is a type of kidney stone is very rare. This condition is caused by a disease known as cystinuria. This disease affects the amount of amino acid cystine released in the urine.
In addition to dietary factors and underlying health conditions, there are several other factors that can lead to kidney stone disease, including:
- Drinking less water
- Family health history
- Taking drugs, such as diuretics, aspirin, antibiotics, antacids, as well as some antiepileptic and antiretroviral drugs
- Side effects of surgery on the digestive organs
- Too much protein-containing food and too little fiber consumption.
- Only one kidney is still functioning.
- have experienced several infections associated with the kidney or urinary system.
- Have a family history of kidney stones.
- Ever had surgery on the digestive system.
- Routine supplements containing calcium .
- Taking aspirin medications, certain antibiotics, antacids, diuretics, antiepileptic drugs , and drugs for HIV.
Diagnosis Of Kidney Stones
In diagnosing kidney stones, first the doctor will try to dig up the patient's first information about the symptoms. Usually the doctor will also ask whether the patient has had kidney stones, has a family history of kidney stones, or whether patients often consume food or supplements that are thought to trigger kidney stones.
Once the information is collected, a number of test options will be made to confirm the diagnosis. The test may be a urine examination, a blood test, and a scan (eg ultrasound, X-ray, CT scan, and intravenous urogram / IVU). Urine examination is performed to determine the presence of urinary tract infections associated with kidney stones. In addition, if the urine sample contains kidney stone fragments, this test can help the doctor in recognizing the type of kidney stones that are formed.
As for blood tests, this method is done to help doctors know the levels of certain substances that potentially cause kidney stones, such as calcium levels or uric acid in the blood. In addition, blood tests are also done to ascertain whether the patient's kidney is still functioning properly or has been damaged.
The latter is the examination through the image image with X-ray , CT scan or intravenous urogram (IVU). Examination that can only be done in this hospital actually has the same purpose, namely to ensure the existence and determine the position of kidney stones precisely and accurately.
Appropriate analysis will greatly assist the physician in determining the handling or medication that suits the condition of kidney stone sufferers. To note, the current examination of CT scans are more often used as the primary choice by doctors in diagnosing kidney stone disease because the results are more accurate than other methods of investigation.
Treatment Of Kidney Stones
Treatment of kidney stone disease depends on the size of the stone. If still relatively small, kidney stones can still be out through the urinary tract without surgery. The doctor will usually advise the patient to take the appropriate treatment step precautions, namely by drinking enough water every day. With continuous fluid flow, it is expected that small kidney stones can be pushed out by itself.
If only water is considered insufficient, the doctor may prescribe medication to help expel kidney stones, such as alpha blockers. This drug helps make the ureter muscles relax so that kidney stones can come out without causing pain and within a relatively fast time.
If the patient's symptoms are disturbing enough, doctors usually prescribe painkillers, such as paracetamol , ibuprofen and non-steroidal anti-inflammatory drugs. In addition to painkillers, doctors will also provide antiemetic drugs to treat the symptoms of nausea and vomiting.
Doctors will usually refer patients to the hospital if kidney stone disease has caused severe pain. This is especially necessary if the patient has other conditions (eg being pregnant, vomiting to cause dehydration, aged over 60 years, and having only one kidney). In addition, doctors will also usually refer patients to the hospital if the pain symptoms worsen despite being given pain medication.
Handling of kidney stones with surgery
Handling of kidney stones with new surgery will be applied if the stone is large (approximately 0.6 centimeters in diameter or more) thereby blocking the patient's urinary tract. The type of handling will depend on the location and size of the stone. The procedures for treating large kidney stones are:
- Extracorporeal shock wave lithotripsy (ESWL), a procedure of destruction of kidney stones by using high frequency sound waves (ultrasound). Stone is crushed so that pieces can come out easily.
- Ureteroscopy, the procedure of removing kidney stones using a device called ureteroscope is inserted into the ureter through the urethra and bladder. Urethra is the last channel for urine outflow from the bladder to the outside of the body. Once the location is known, the stone will be destroyed by using other instruments or lasers. Ureteroscopy is usually done to deal with stones that are trapped in the ureter.
- Open surgery. In modern times as it is now, this procedure is actually quite rare and only done to remove the kidney stone is very large. As the name implies, open surgery is done by making an incision on the surface of the skin on the back that serves as an access for the surgeon in removing kidney stones.
- Percutaneous nephrolithotomy or abbreviated PCNL, the procedure of destruction of kidney stones . Small incisions are made on the surface of the skin near the kidneys so that a device called a nephroscope can enter to break and remove the kidney stone fragments. This procedure is usually done if ESWL is not possible to do, eg in obese people.
Kidney Stone Complications
Tibul complications in patients with kidney stones can be caused due to kidney stones themselves or due to treatment of kidney stone treatment.
Kidney Stone Complications
The stones formed in the kidney vary in size, ranging from as big as sand to gravel or larger. Stone surfaces also vary. Some types of kidney stones have smooth surfaces, while others have uneven surfaces. Large stones can irritate the urinary tract when it passes through the kidney stones. Kidney stones can also be caught in the urinary tract and block the flow of urine so that the risk of kidney infection (pyelonephritis) will increase. Infection of the kidneys can result in the spread of bacteria and other microorganisms into the blood. In addition, kidney stones can also cause permanent damage to the kidneys.
Complications Due to Kidney Stone Therapy
The type of therapy as well as the location of kidney stones will affect the types of complications that arise. Some of them are :
- Sepsis. Bacteria and microorganisms found in the kidneys can pass into the bloodstream and cause infection. Symptoms will arise throughout the body.
- Injury to the ureter
- Bleeding due to surgery
Kidney Stone Prevention
How to prevent kidney stones is actually quite simple. The first is to drink enough water every day. In addition to preventing dehydration , drink enough water can also dilute your urine so that the filtered waste substances kidneys from the blood does not easily settle and always wasted smoothly.
The second preventive measure is to limit the consumption of foods, beverages, or supplements that contain substances that potentially lead to the formation of kidney stones. For example, such as oxalate, animal protein, and calcium supplements. In addition, choose foods with low salt content.
Examples of foods or beverages containing oxalate are:
- Nuts, including processed soy products
- Black tea
- Sweet potatoes
Keep consumption of foods that contain calcium, because the body needs calcium to treat bones and teeth. Consult a doctor or nutritionist about nutrition that should be met by the sufferer. Also discuss it first with your doctor, if you want to take an extra calcium supplement.
In addition to drinking enough water and limit the intake of certain nutrients, prevention of kidney stones can also be done by taking drugs prescribed by a doctor. Usually this step is recommended for those who have suffered kidney stones so that the condition does not recur. An example is the administration of allopurinol to lower uric acid levels in the blood in order to prevent the formation of uric acid kidney stones, antibiotics to prevent urinary tract infections as the main trigger of kidney stones struvit, diuretic drugs for patients with hyperkalsiuria disease to prevent calcium kidney stones, and drugs decrease levels of cystine substances to prevent cystine kidney stones.