Kidney Stones Treatment Hospital in Punjabi Bagh, Delhi

Understanding Kidney Stones

Kidney stones, also referred to as renal calculi or urinary stones, are hard deposits that form in the kidneys due to the accumulation of minerals and acidic salts. Their size can range from tiny grains to stones as large as a golf ball.

These stones can lead to intense pain, discomfort, and additional symptoms such as blood in urine, nausea, and vomiting.

Kidney stones are a prevalent but excruciating condition caused when substances in urine, such as calcium, oxalate, and uric acid, become excessively concentrated, forming crystals. Over time, these crystals grow and solidify into stones.

Types of Kidney Stones

Each type of kidney stone has a distinct chemical makeup:

• Calcium Stones: The most common type, primarily made of calcium oxalate or calcium phosphate.
• Uric Acid Stones: Form when uric acid concentration in the urine becomes excessively high.
• Struvite Stones: Develop as a result of urinary tract infections (UTIs) and are composed of magnesium, ammonium, and phosphate.
• Cystine Stones: Occur in individuals with a rare genetic disorder that causes the kidneys to excrete excessive amounts of cystine, an amino acid.

Signs and Symptoms of Kidney Stones

Symptoms vary depending on stone size, location, and whether it obstructs the urinary tract or causes infection. Common symptoms include:

• Intense Pain: Sharp, severe pain in the back or flank region, often radiating to the lower abdomen or groin. Pain typically occurs suddenly and in waves.
• Blood in Urine (Hematuria): Urine may appear pink, red, or brown due to the presence of blood.
• Frequent and Urgent Urination: Stones can irritate the urinary tract lining, causing an increased need to urinate.
• Painful Urination: A burning sensation while urinating, caused by inflammation or irritation from the stone.
• Cloudy or Foul-Smelling Urine: Changes in urine appearance or odor may occur.
• Nausea and Vomiting: Often accompanies the severe pain or as the body reacts to the obstruction.

Not all kidney stones cause symptoms. Some may remain unnoticed until identified by imaging tests or routine health checks.

If you experience these signs or suspect a kidney stone, consult a healthcare professional for proper diagnosis and management.

Causes and Risk Factors of Kidney Stones

Several elements increase the risk of developing kidney stones, such as dehydration, dietary habits, lifestyle, and specific medical conditions. Insufficient water intake leads to highly concentrated urine, facilitating the formation of crystals that develop into stones. Experts recommend drinking 2.5 to 3 liters of water daily, especially in hot climates where perspiration leads to greater fluid loss.

Diet plays a significant role as well. High consumption of salt, sugar (particularly fructose), oxalate-rich foods like spinach and dry fruits, and animal proteins can disrupt urine chemistry and promote stone formation.

Obesity also raises the risk, as it alters metabolism, increasing calcium and uric acid excretion.

A family history of kidney stones elevates the likelihood due to genetic predispositions such as hypercalciuria or cystinuria.

Medical conditions that contribute to stone formation include:

• Hyperparathyroidism (excess calcium in blood)
• Gout – associated with high uric acid levels
• Diabetes or Metabolic Syndrome – affecting urine pH and composition

Certain medications may also elevate risk, such as:

• Diuretics (thiazides)
• Calcium-containing antacids
• Drugs like Topiramate

A sedentary lifestyle reduces metabolism, encouraging mineral buildup that forms stones.

Alarmingly, kidney stones are now increasingly reported in children, often due to diets high in salt, sugary beverages, and processed snacks. Promoting proper hydration and balanced nutrition is vital for all ages.

Potential Complications of Kidney Stones

Untreated kidney stones can cause serious health issues, including chronic kidney damage from prolonged blockage and frequent recurrence, with up to a 50% chance of reoccurrence within 5–7 years. Other complications include severe pain, urinary obstruction, and infections that can turn life-threatening. Serious complications include:

1. Urinary Obstruction:

• A stone lodged in the ureter can block urine flow.
• Causes sharp back or abdominal pain (renal colic).
• Long-term obstruction risks permanent kidney damage.

2. Kidney Infection (Pyelonephritis):

• Blockage allows bacteria to multiply in urine.
• Symptoms: fever, chills, painful urination, foul-smelling urine, back pain.
• Untreated infection can cause sepsis.

3. Loss of Kidney Function:

• Prolonged blockages or recurrent infections can impair kidney function.
• May progress to Chronic Kidney Disease (CKD), potentially needing dialysis.

4. Hydronephrosis (Kidney Swelling):

• Blocked urine backs up into the kidney.
• Causes swelling and pressure, damaging kidney tissue.

5. Sepsis (Blood Infection):

• Infection can spread systemically if untreated.
• Sepsis is life-threatening and requires urgent medical care.

6. Urinary Tract Damage:

• Large or sharp stones can injure urinary tract walls.
• Can result in bleeding, infection, or obstructed urine flow.

7. Recurrent Stones:

• Without addressing root causes, stones may recur frequently.
• Repeated stones increase the risk of all the above complications.

How Kidney Stones Are Diagnosed

Diagnosis involves a thorough review of symptoms, medical history, and a physical exam. Diagnostic tests may include:

• Urine Analysis: Detects crystals, blood, and infection indicators, and helps classify stone type.
• Blood Tests: Assess calcium, uric acid levels, and kidney function.
• Imaging Studies:
  
  • CT Scan (Non-Contrast): The gold standard for detecting even the smallest stones and precisely mapping their location.
  • Ultrasound: Safe for pregnant women and frequent stone formers; however, small stones might be missed.
  • X-ray (KUB): Helps detect larger stones, though not as effective for uric acid stones.
• Stone Analysis: Passed stones are collected and analyzed to determine composition and guide prevention strategies.

Treatment and Prevention of Kidney Stones

Once diagnosed, treatment is customized based on stone size, location, and type:

• Hydration and Pain Management: Small stones may pass naturally with increased fluids and pain medication.
• Medications: Certain drugs can help dissolve or prevent stone formation, particularly uric acid or calcium stones.

Minimally invasive procedures for larger or obstructive stones include:

• Retrograde Intrarenal Surgery (RIRS): A laser-based procedure using a flexible scope passed through the urinary tract to treat stones inside the kidney without external incisions.
• Ureteroscopy with Laser: Thin scopes inserted via the urethra fragment stones in the ureter or kidney.
• Percutaneous Nephrolithotomy (PCNL): Small incision in the back allows direct removal of large or complex stones.
• Miniperc (Mini-PCNL): A smaller, less invasive version of PCNL ideal for moderate-sized stones and faster recovery.
• Diet & Lifestyle Adjustments: A personalized plan including dietary recommendations reduces the risk of future stones.

When Is Surgery Necessary for Kidney Stones?

Stone size significantly influences the decision for surgical treatment:

• Stones smaller than 5mm often pass on their own without surgery.
• Stones measuring 5–7mm may require close monitoring; passage can be painful or incomplete.
• Stones larger than 7mm, especially those exceeding 10mm, generally require surgical intervention.

Indications for surgery include:

• Intense pain not relieved by medications.
• Urinary blockage causing hydronephrosis or impaired kidney function.
• Recurrent infections or risk of life-threatening sepsis.

Common surgical options include:

• RIRS (Retrograde Intrarenal Surgery)
• Miniperc (Mini-PCNL)
• PCNL (Percutaneous Nephrolithotomy)
• Ureteroscopy (URS)
• Laser Treatment: Fragments stones into smaller pieces for easier passage.

Recent studies by the American Urological Association (AUA) show evolving trends in stone treatment, patient demographics, and clinical protocols.

Preventing Kidney Stones

• Stay Hydrated: Aim for at least 8–10 glasses of water daily, more when active.
• Reduce Salt Intake: Excess sodium increases calcium in urine. Limit processed foods and add salt. WHO recommends less than 5 grams of salt daily.
• Balanced Diet: Prioritize fruits, vegetables, and whole grains to maintain healthy urine pH.
• Limit High-Oxalate Foods: Such as spinach, beets, and nuts. Monitor calcium intake at 1,000–1,200 mg/day from food sources.
• Moderate Animal Protein: High intake of red meat and eggs raises uric acid levels. Incorporate plant-based proteins.
• Maintain Healthy Weight: Obesity increases the risk of stone formation.
• Citrate-Rich Foods: Lemons and oranges help prevent stone formation.
• Vitamin C Intake: Avoid excessive supplementation as it may increase oxalate levels.

Regular Medical Checkups: Essential if you have a history of kidney stones. Your doctor may recommend medications or specific dietary strategies to prevent recurrence.