A kidney stone or renal calculus is a crystal concentration formed in the kidneys. Nephrolithiasis is formed from the minerals consumed in the diet and is largely composed of calcium. 75% of kidney stones are calcium stones. While Struvite stones are more commonly noticed in women, Uric acid stone can occur in men and women. Typically men are more affected by kidney stones than women. In most cases, the kidney stones are expelled by the body in the urine and no symptoms are noticed. But as the kidney stone grows in size, it can lead to pain and other symptoms. This is because of the obstruction to the ureters. A person suffering kidney stones feels pain in the area between the ribs and hip or lower abdomen and groin. Intermittent pain or renal colic is felt in spasms. It is sometimes accompanied by fever, blood and pus in the urine and pain on urination. There might be nausea and vomiting. There might be abnormal color of the urine.
Some foods that might increase the risk of kidney stone formation are refined sugars, sodium, vast quantities of animal protein and cola. Inadequate consumption of water adds to the risk factors. Those taking calcium supplements might also notice higher incidences of renal stone formation. This does not happen with high consumption of dietary calcium. Sodium, Uric acid and sulfurous amino acids also contribute to the formation of kidney stones. On the other hand, magnesium and potassium reduce urinary crystal formation by excreting citrate. Those with a family history of kidney stones are at higher risk of renal stones. Persons suffering kidney disorders, UTI and cystic kidney disease are also susceptible to kidney stones. Hyperoxaluria is a condition where the body produces too much oxalate. When this quantity is too large to be dissolved in urine, it leads to the formation of renal stones.
Ultrasound is done to confirm the presence of kidney stones. X-rays and IVP (intravenous pyelogram) aid in imaging the renal stone. Kidney function test and blood tests are also done. The size of kidney stones can range from a small grain of sand to a pearl. It can be smooth or jagged. Over time, renal stones can cause irreversible kidney damage. Most small stones in the kidney do not need treatment or removal. But if the kidney stones cause urine blockage, bleeding, infection or keep growing in size, they need to be removed. Some kidney stones, especially those consisting of uric acid or cystine can be treated with medicines. Else endoscopic removal of kidney stones with a uterescope is done. Lithotripsy is often used to break the stone into smaller pieces so that they can be flushed with the urine.
Burst Wave Lithotripsy :
A recent feasibility study published in The Journal of Urology highlights a novel approach that may alleviate the pain associated with the treatment of renal calculus (Kidney stones) . This new technique combines two ultrasound technologies and offers an alternative to the current standard procedure - shock wave lithotripsy, which requires sedation.
This new approach involves the use of a handheld transducer placed on the skin to direct ultrasound waves towards the stone. The ultrasound can then be used in two ways. First, ultrasound propulsion can be utilized to move and reposition the stones, thereby facilitating their passage. Second, burst wave lithotripsy (BWL) can be employed to break up the stone into smaller fragments.
Notably, this technology has the advantage of being minimally invasive and painless, and it does not require anesthesia. This makes it a desirable option for patients who may not be able to tolerate sedation or anesthesia.
Kidney stones can be extremely painful and are known to afflict about 10 % of Americans. While patients with these stones are typically advised to wait for the stones to pass on their own, this can be a lengthy process.
Actually we may owe NASA for this technique to zapping kidney stones, because several years ago, NASA forked out funds for a study primarily intended to break up or move the kidney stones without anesthesia for Astronauts on long space flights where their physical movement will be restricted for longer duration - susceptible to the formation of stones due to factors such as microgravity and fluid shifts. When the study reported that BWL could shift or fracture the stones with ease, it came into general usage.
A kidney biopsy is often recommended for those who notice blood in the urine (hematuria), excess protein in the urine (proteinuria) or progressive kidney failure. Kidney biopsy might reveal the causes for improper functioning or rejection of a transplanted kidney. If urine tests, ultrasound or CT scan reveal possible kidney problems, kidney biopsy can aid in determining the cause.
A patient undergoing kidney biopsy is given sedation through IV. The biopsy needle is inserted through the skin with the aid of ultrasound. A small sample tissue is taken for examination. There is likely to be mild soreness in the muscle and some blood in the urine for the next 24 hours. Serious complications include puncture of a major blood vessel or bleeding into the kidney. Abnormal results of kidney biopsy show signs of scarring or inadequate blood flow or signs of disease such as renal cancer. Patients with blood clotting disorder are not advised to undergo this diagnostic test. Obesity, UTI, hypertension are some factors that can affect the accuracy of kidney biopsy results.
Nephrologists are specialists who specialize in diagnosing and treating diseases related to the kidney. They are trained to mange kidney disorders too. Pediatric nephrologists treat the same conditions in infants, children, and young adults. Nephrologists should complete medical school and then complete three years in internal medicine and further specialize for two years in the field of nephrology. Pediatric nephrologists have to further take special certification to qualify as pediatric Nephrologist. Nephrologists also termed as renal physicians treat diseases related to the kidney, any malfunctioning in the kidney can affect other organs of the body.
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Collection of Pages - Last revised Date: December 2, 2023