What is a Kidney stone?
Kidney stone is a mass formed inside the Kidney and is composed of substances from the urine. It is a mixture of crystalline & non – crystalline material.
It could be:-
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Calcium oxalate:- Common ( 60 % )
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Calcium phosphate & mixed ( 20% )
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Uric Acid ( 5 to 10 % )
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Struvitte ( 5 to 10 % )
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Cystine (1 to 3 % )
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Rare 3 %
Who form Kidney stones?
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Those who take low fluid intake.
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Those people who live in hot climates. This is directly related to dehydration & crystallisation in urine.
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Those who excrete high amount of calcium, oxalate, uric acid & low quantities of citrate & magnesium in urine.
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Those who consume high intake of animal protein which increases urinary calcium, oxalate & uric acid excretion.
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Adult men are more prone to form kidney stones (Protective effect of estrogen against stone formation in women).
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Hyperparathyroidism, Renal tubular acidosis, Gout & Cystinuria.
- Miscellaneous.
Do kidney stones reoccur?
- Reccurence rate is 50 % in 10 years
What are the complaints of Kidney stone patients?
- Excruciating pain in the abdomen, back & groin, pain may radiate to the genitalia on the side which bears the stone. Pain is colicky in nature & may be associated with nausea & vomiting.
- Blood in urine
- Difficulty in passing urine
- Kidney stones may be silent
How to diagnose a Kidney stone?
- A non contrast spiral CAT scan is the best test for diagnosing Kidney or ureteral or urinary bladder stone.
- IVU or IVP can also be used for diagnosis of Kidney stones but can miss some stones & has associated risk of administering contrast
What is the treatment of Kidney stones?
- Spontaneous passage (Approx. 80% of stones pass out spontaneously) depending upon the size of stones. Less than 5mm stones have a higher incidence of spontaneous passage. As the size of stone increases the chances of spontaneous passage decrease.
- Non Surgical or expectant treatment for small stones ( Plenty of fluids & medicines which can facilitate spontaneous passage of small stones )
- Surgical Treatment- Kidney Stones Reoccur
What are the different types of surgical treatment available today?
- There are three main procedures available today.
- Extracorporeal Shock Wave Lithotripsy
- Percutaneous Nephrolithotomy
- Flexible & Semirigid Ureteroscopy ( RIRS – Retrograde Intrarenal Surgery )
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