Kidney stones are a common health condition, affecting approximately 1 in 10 people at some point in their lifetime. The risk of developing kidney stones is higher in men than women, and the condition is most commonly seen in people between the ages of 30 and 60.
Causes of Kidney Stones
There are many different waste products in urine. If these wastes condense in a small amount of liquid, they gradually crystallize, which can lead to the formation of kidney stones. Mostly, these wastes are excreted together with the urine, and stone formation does not occur. However, in the presence of risk factors and in cases where fluid intake is less than necessary, the formation of kidney stones accelerates, and the stones may reach sizes that cannot pass through the urinary tract after a certain point and even block the urinary tract. The chemicals that make up these stones are calcium, oxalate, urea, cystine, xanthine, and phosphate. Many factors, such as diet, metabolic disorders, insufficient fluid intake or fluid loss, and some medications, can cause kidney stones. Among the factors,
- Family health history
- Prolonged administration of high protein diets
- Insufficient fluid intake
- Obesity
- Other kidney diseases or kidney anomalies
- Bowel surgeries
- Stomach surgeries for weight loss
- High salt and sugar consumption
- Heavy use of laxatives
- Some migraine and depression medications
- Metabolic syndromes
- Some supplements (vitamin D, calcium, etc.)
- Gout
- Insufficient physical activity
- Factors such as urinary tract infections are also involved.
How Do You Know You Have Kidney Stones?
Kidney stones generally show symptoms when they enter the urinary tract, that is, the ureter. Growing kidney stones cause pain due to the obstruction they have made in the ureter at the time of removal. However, some small kidney stones can pass through the urine without causing any symptoms. The most common known symptoms of kidney stone disease are:
- Severe chest, abdominal, and low back pain
- Nausea and vomiting
- Seeing blood in the urine
Kidney Stone Diagnosis
Urological doctors are very important when diagnosing kidney stones. Kidney stone symptoms and tests performed by the urological doctor can determine this disease. However, some tests are done to determine the kidney stone disease completely.
1.Blood Test
Blood tests are done to check if the kidneys are working properly. In particular, the rates of substances that may be effective in the formation of kidney stones, such as calcium and uric acid in the blood, are examined.
2. Urine Test
Thanks to this test, the presence of infection and blood in the urine can be detected. Urine tests can provide important details in order to determine the diseases that can accompany kidney stones and clarify their diagnosis. In addition, 1-day urine collection tests can also be applied. With the urine collection test, substances that can cause or prevent stone formation in the urine can be detected.
3. Imaging Methods
Kidney stones can be diagnosed by imaging methods. Different imaging methods can be used to diagnose kidney stones.
Computerized Tomography
The size and location of stones in the urinary tract or kidney, including even small stones, can be determined. The presence of a different disease in the kidney and surrounding organs can be determined by computed tomography.
Ultrasound Method
Ultrasound uses high-frequency sound waves. With this method, detailed information about kidney stones can be obtained. Reliable and fast results can be obtained with ultrasound. Stones that have entered the urinary tract and very small stones can be overlooked in some cases with this method. However, ultrasonography should not be preferred by pregnant women to avoid exposure to radiation.
Kidney Stone Analysis
By taking a stone that has previously been excreted through the urinary tract to the urology doctor, the internal structure of the kidney stone can be tested to determine with which substances it is formed. The stones excreted from the body can be collected by urinating through socks, gauze, or a strainer. It gives the doctor an idea about the application of the treatment that will prevent the formation of stones again by examining the stone in the laboratory environment.
90% of stones smaller than 4 mm will fall out on their own without any intervention. It can be said that half of the stones between 4 and 7 mm and stones larger than 8 mm rarely fall spontaneously.
If the kidney stone has started to move in the urinary tract and is too small to require intervention, patients are advised to consume plenty of water and move around. It is aimed at reducing the problems that may be experienced during the falling of the stone with painkillers. However, it may be necessary to intervene and consult a doctor for stones larger than 5 mm.
The urologist decides on the necessary intervention according to the location and size of the stone, the patient's health status, and his or her age. It can be said that similar treatment methods are used for children and adults.
Medication
In the presence of kidney stones, some painkillers can be given to patients to reduce pain and eliminate discomfort. In some cases, doctors may also prescribe medications to help pass the stone. At the beginning of these drugs are alpha blockers. These drugs, which are given to relax the muscles in the ureter, facilitate the process of removing the stone from the body.
Non-operative Interventions
The ESWL (Extracorporeal Shockwave Lithotripsy) method is the leading method used in the treatment of kidney stones and does not require surgery. In the ESWL method, which can be defined as the process of breaking the stone with shock waves given outside the body, computerized tomography is taken again after the procedure, and it is checked whether the procedure is successful or not.
In cases where all other interventions and procedures are insufficient, in the presence of other diseases or anomalies accompanying the condition of the patients, or if the stones are very large, surgical intervention is used in the treatment of kidney stones.
Surgical Interventions
Percutaneous nephrolithotomy (PNL) is the name given to kidney stone surgery. This surgery is also called closed kidney stone surgery. It is an intervention that allows the removal of kidney stones through a small incision on the back and with the help of telescope-like tools. It is done under general anesthesia. The patient may need to stay in the hospital for several days.
Ureteroscopy is another method used to surgically remove kidney stones from the body. The urethra, or kidney, is reached through a tube called a ureteroscope, which has a lighted camera at the end. This operation is performed under general anesthesia, as in closed kidney surgery. Thanks to this method, the stone can be taken from the place where it is, or it is expected to be removed from the body through urine by breaking the stone.
General Nutrition Recommendations to Prevent Kidney Stone Formation
Protein: normal intake. Excessive intake should be avoided. Plant-based proteins should be preferred.
Calcium: If the intake of calcium from food is low, the amount of oxalate in the body increases. An increase in oxalate increases the likelihood of kidney stones forming.
Oxalate: At the beginning, foods containing medium and high amounts of oxalate should be avoided; they should be restricted in the future if necessary.
Liquid: 2.5 liters or more should be consumed.
Purine: Excessive protein intake should be avoided, and consumption of special foods rich in purines should be avoided.
Vitamin C ≤ 500 mg/day
Vitamin B6: Daily consumption of 40mg or more reduces the risk of kidney stones. No recommendation was made.
It is recommended that sodium intake not exceed 1000 mmol per day.
Obesity: It has been found that there is a relationship between obesity, weight gain, and increased kidney stones. Losing excess weight also contributes to reducing the risk of stone formation.
