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| Kidney stones, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Definition of Kidney Stones
Kidney stone disease or nephrolithiasis is a condition due to the formation of solid deposits in the kidneys from chemicals in the urine. Kidney stones can range in size from as small as a grain of sand to as large as a pea.
Kidney stones can occur along the urinary tract, namely from the kidneys, ureters (tubes that carry urine from the kidneys to the bladder), bladder, and urethra (tubes that carry urine out of the body).
Kidney stones can move and pass through the urinary tract. Kidney stones that move, especially large ones, will be difficult to pass through the urinary tract. If this condition occurs and causes pain, treatment from a doctor needs to be done immediately.
When diagnosed and treated early, this condition generally does not cause permanent damage to kidney function.
Causes and Symptoms of Kidney Stones
Kidney stones are formed due to high levels of chemicals, such as calcium, oxalic acid, and phosphorus in the urine. These substances can form crystals and accumulate in the kidneys. Over time, the crystal will get harder and harder like a rock.
High levels of chemicals in the urine can occur due to consumption of foods high in purines and calcium, lack of fluid intake, as well as side effects of surgery and medications, as well as certain medical conditions.
Generally, small kidney stones do not cause symptoms. However, kidney stones that are large and stuck in the urinary tract can cause severe pain in the waist. The pain makes the sufferer feel uncomfortable even though they have changed body positions.
Kidney Stones Treatment and Prevention
Treatment methods for kidney stones depend on the size and type of kidney stones. If kidney stones are small and cause no symptoms, treatment can be done at home. However, if kidney stones are large and cause symptoms, then treatment should be done by a doctor.
The right way to prevent kidney stone disease is to reduce the risk of kidney stones forming. Efforts that can be made include drinking lots of water, limiting salt consumption, and not eating foods that contain high levels of oxalate.
Causes of Kidney Stones
Kidney stones form when urine contains more chemicals than fluid. These chemicals can form crystals in the kidneys and stick to each other. Some examples of these substances are calcium, oxalic acid, and uric acid.
The formation of kidney stones can also occur when the body lacks substances that can prevent crystals from sticking together so that the formation of kidney stones becomes easier.
Based on the constituent substances, kidney stones can be divided into four types, namely:
1. Calcium Stone
Calcium stones, usually in the form of calcium oxalate stones, are the most common type of kidney stone. These stones occur when the urine contains a lot of calcium (hypercalciuria) and high levels of oxalate in the body.
Oxalates are produced by the liver and obtained from food intake, such as certain vegetables and fruits, nuts, and chocolate.
High levels of calcium or oxalate in the urine can also be caused by the following conditions:
- Eating foods high in calcium oxalate
- Taking high doses of vitamin D supplements
- Experiencing side effects due to bowel surgery
- Taking migraine medications or anti-seizure medications
- Suffering from kidney disease
2. Uric Acid Stones
This type of kidney stone is formed due to high levels of uric acid in the urine. This condition can be caused by the consumption of foods that are high in purine levels, lack of fluids, and a history of gout.
3. Struvite Stones
Struvite stones are formed by a mixture of magnesium, phosphate, and calcium carbonate in the urine. Struvite stones can form and grow rapidly.
The cause of this type of kidney stone is an infection, such as a urinary tract infection.
4. Cystine Stone
Kidney stones are one of the rarest types. Cystine stones form as a result of a genetic disease called cystinuria. This hereditary disease makes the kidneys excrete too many amino acids.
Kidney Stone Risk Factors
Although it can happen to anyone, there are a number of factors that can increase a person's risk of developing kidney stones, namely:
- 35–45 years old
- Male gender
- Not getting enough fluids in the body or being dehydrated
- Eating foods that are high in protein, sodium (salt), or sugar
- Have a family history of kidney stones
- Having indigestion
- Suffering from obesity
- Have you ever had surgery on your digestive system?
- Have certain medical conditions, such as hyperparathyroidism, urinary tract infections, or diabetes
- Taking certain medications or supplements, such as migraine medications, dietary supplements, or vitamin C
Symptoms of Kidney Stones
Kidney stones, especially very small ones, are generally asymptomatic and difficult to detect. Signs of the presence of new kidney stones can be felt if the stone is large and stuck in the kidney, moves to the ureter, or infection occurs.
Some of these conditions can cause symptoms in the form of pain called renal colic. This pain can last for a few minutes or a few hours.
Characteristics of pain that can arise due to kidney stones include:
- Sharp pain in the side of the waist or lower abdomen
- Pain that radiates to the lower abdomen to the groin
- Pain in the testicles and scrotum, if it occurs in men
- Pain or burning when urinating (dysuria)
In addition to pain, kidney stones can also cause other symptoms, namely:
- Frequent urination
- Urinate in small amounts
- Pink, red, or brown urine
- Urine smells bad
- Nausea and vomiting
- Nervous
- Fever or chills
When to go to the doctor
Check with your doctor if you experience the symptoms mentioned above. Early examination is very necessary so that it can be treated early.
See a doctor immediately if you experience the following symptoms:
- Severe pain that doesn't get better with changes in body position
- Fever or chills
- Nausea and vomiting
- Blood in urine
- Difficulty urinating
If you find small stones or grains of sand in your urine, take the stone to a doctor for further examination.
Kidney Stone Diagnosis
To diagnose kidney stones, the doctor will ask questions about the symptoms experienced by the patient, the patient's and family's medical history, as well as the drugs consumed.
Next, the doctor will perform a physical examination, such as examining the waist, lower abdomen, or groin for pain.
To confirm the diagnosis, the doctor will need to perform a series of follow-up tests which include:
- Urine test, to detect deposits, increased epithelial cells, blood content or certain crystals in the urine
- Blood tests, to check how well the kidneys are functioning, as well as check uric acid levels
- Scans, such as X-rays, ultrasound, and CT scans, to find out the exact location of kidney stones
- Analysis of kidney stones that come out, to determine the cause and treatment plan, by analyzing the type of kidney stones that come out with urine
Kidney Stone Treatment
Treatment of kidney stones depends on the size and type of kidney stones experienced by the patient. For small kidney stones, treatment can be done at home, including:
- Drink at least eight glasses of water every day
- Taking pain relievers, such as paracetamol, to relieve pain that occurs due to stone discharge
- Taking alpha-blocking drugs, such as tamsulosin, to relax the muscles in the ureters so that stones can pass faster
Meanwhile, for kidney stones that are large, difficult to pass or cause bleeding, kidney damage, or urinary tract infections, the doctor will recommend the following treatment methods:
Extracorporeal shock wave lithotripsy (ESWL)
ESWL aims to break up stones into smaller pieces that are easier to pass through the urine. In this procedure, the doctor will direct an ESWL device that emits high-frequency sound waves at the location of the kidney stone.
Ureteroscopy
This procedure aims to remove kidney stones or break them into smaller ones so that they can be excreted in the urine. This procedure is performed using a camera tube, which is inserted into the ureter where the stone is located.
Percutaneous nephrolithotomy
This procedure is performed on kidney stones that are more than 2 cm in diameter and cannot be treated by the ESWL method. This method is also used if there is a blockage or infection that damages the kidneys, or severe pain that cannot be treated with medication.
In this procedure, the doctor will insert an instrument called a nephroscope into the kidney through the outer skin. After that, the kidney stone will be pulled out or broken into small pieces with a laser.
Open surgery
Open surgery is a procedure that is rarely performed. This procedure is usually done for kidney stones that are very large or have an abnormal shape, and cannot be treated by other methods.
In addition to open surgery, other surgeries can also be performed to treat the cause of the formation of kidney stones. For example, in kidney stones caused by an overactive parathyroid gland, the doctor will suggest surgical removal of the parathyroid gland.
Complications of Kidney Stones
Complications can arise when the size of the kidney stone is so large that it obstructs the flow of urine. This condition can cause permanent kidney damage, as well as infections of the urinary tract and kidneys.
In addition, treatment for kidney stones, especially large ones, can also cause complications, such as:
- Injury to the ureter
- Blockage in the ureter
- Bleeding
- Infections that spread throughout the body through the blood (bacteremia)
In people who have suffered from kidney stones and recovered, the risk of recurrence of kidney stones is very large. Factors that can increase the risk are:
- Eating too many foods that contain high protein and eating too little fiber
- Have had kidney infections or recurrent urinary tract infections
- Not physically active, for example because of paralysis or bed rest
- Ever suffered from kidney stones when he was under 25 years old
- Have a family with a history of kidney stones
- Have you ever had surgery on your digestive system?
- Taking too many supplements that contain calcium
- Taking aspirin, antacids, diuretics, anticonvulsants, and medicines for HIV
Kidney Stone Prevention
The best way to prevent kidney stones from forming is to lower your risk of developing this condition. Some steps that can be taken are:
- Drink lots of water, which is 2-3 liters every day, especially during hot weather
- Consult a doctor if you have to take calcium or vitamin supplements
- Reduce consumption of foods that cause high uric acid
- Lose weight or maintain ideal body weight
- Do not consume foods high in calcium in excess, such as cheese, cow's milk, and yogurt
- Limit salt intake
However, first consult your doctor before undergoing any diet, so that it is in accordance with your health condition.
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