Kidney stones

Kidney stones

Definition

Kidney stones are solid accumulations of things that form in the tubal system of the kidney. Kidney stones bring problems when they block the flow of urine through or out of the kidney. When the stones move along the ureter, they cause severe spasm.

Description

Urine is formed by the kidneys. Blood flows into the kidneys, and specialized tubes (nephrons) within the kidneys allow a positive amount of fluid from the blood, and certain substances dissolved surrounded by that fluid, to flow out of the body as urine. Sometimes, a problem causes the dissolved substances to become solid again. Tiny crystals may form in the urine, unite, and cling together to create a larger solid mass called a kidney stone.

Many populace do not ever find out that they have stones within their kidneys. These stones are small enough to allow the kidney to verbs functioning normally, never cause any pain. These are call "silent stones." Kidney stones cause problems when they interfere beside the normal flow of urine. They can block (obstruct) the flow down the tube (the ureter) that carry urine from the kidney to the bladder. The kidney is not accustomed to experiencing any pressure. When pressure builds from backed-up urine, the kidney may swell (hydronephrosis). If the kidney is subjected to this pressure for some time, it may cause plunder to the delicate kidney structures. When the kidney stone is lodged further down the ureter, the backed-up urine may also rationale the ureter to swell (hydroureter). Because the ureters are muscular tubes, the presence of a stone will make these muscular tubes spasm, cause severe pain.

About 10% of adjectives people will own a kidney stone in his or her lifetime. Kidney stones are most adjectives among:

• Caucasians


• Males


• People over the age of 30


• People who have have kidney stones previously


• Relatives of kidney stone patients.

Causes & symptoms

Kidney stones can be composed of a variety of substances. The most adjectives types of kidney stones include:

• Calcium stones. About 80% of all kidney stones go down into this category. These stones are composed of either calcium and phosphate, or calcium and oxalate. People beside calcium stones may have other diseases that make happen them to have increased blood level of calcium. These diseases include primary parathyroidism, sarcoidosis, hyperthyroidism, renal tubular acidosis, multiple myeloma, hyperoxaluria, and some types of cancer. A diet heavy contained by meat, fish, and poultry can cause calcium oxalate stones.


• Struvite stones. About 10% of adjectives kidney stones fall into this category. This type of stone is composed of magnesium ammonium phosphate. These stones take place most often when patients hold had repeated urinary tract infections near certain types of germs. These bacteria produce a substance call urease, which increases the urine pH and makes the urine more alkaline and smaller number acidic. This chemical environment allows struvite to settle out of the urine, forming stones.


• Uric acerbic stones. About 5% of all kidney stones tip out into this category. Uric acid stones materialize when increased amounts of uric acid circulate surrounded by the bloodstream. When the uric acid content become very lofty, it can no longer remain dissolved and solid bits of uric acid settle out of the urine. A kidney stone is formed when these bits of uric bitter begin to cling to respectively other within the kidney, slowly growing into a solid mass. About partly of all patients near this type of stone also have deposits of uric sour elsewhere in their body, commonly surrounded by the joint of the big toe. This bleeding disorder is called gout. Other cause of uric acid stones include chemotherapy for cancer, correct bone marrow disorders where blood cell are over-produced, and an inherited disorder call Lesch-Nyhan syndrome.


• Cystine stones. About 2% of all kidney stones decline into this category. Cystine is a type of amino acid, and family with this type of kidney stone enjoy an abnormality in the passageway their bodies process amino acids in the diet.

Patients who have kidney stones usually do not hold symptoms until the stones pass into the ureter. Prior to this, some individuals may notice blood surrounded by their urine. Once the stone is in the ureter, however, most people will experience bouts of markedly severe pain. The dull pain is crampy and spasmodic, and is referred to as "colic". The pain usually begin in the flank region, the nouns between the lower ribs and the hip bone. As the stone moves closer to the bladder, a patient will recurrently feel the discomfort radiating along the inner thigh. In women, the pain may be feel in the vulva. In men, the distress may be felt surrounded by the testicles. Nausea, vomiting, extremely frequent and painful urination, and conspicuous blood in the urine are adjectives. Fever and chills usually means that the ureter have become obstructed, allowing bacteria to become trapped within the kidney causing a kidney infection (pyelonephritis).

Diagnosis

Diagnosing kidney stones is base on the patient's history of the especially severe, distinctive pain associated near the stones. Diagnosis includes laboratory examination of a urine token and an x-ray examination. During the walkway of a stone, examination of the urine almost other reveals blood. A number of x-ray tests are used to diagnose kidney stones. A plain x sunbeam of the kidneys, ureters, and bladder may or may not reveal the stone. A series of x rays taken after injecting iodine dye into a vein is usually a more reliable channel of seeing a stone. This procedure is called an intravenous pyelogram (IVP). The dye "lights up" the urinary system as it travels. In the overnight case of an obstruction, the dye will be stopped by the stone or will solely be able to return with past the stone at a slow trickle.

When a merciful is passing a kidney stone, it is noteworthy that all of his or her urine is strained through a special sieve. This is to breed sure that the stone is caught. The stone can then be sent to a special laboratory for analysis so that the chemical composition of the stone can be determined. After the kidney stone have been passed, other test will be required in writ to understand the underlying condition that may enjoy caused the stone to form. Collecting urine for 24 hours, followed by wary analysis of its chemical makeup, can often determine several reasons for stone formation.

Treatment

A tolerant with a kidney stone will speak that the most important aspect of treatment is fair pain nouns. Because the pain of endorsement a kidney stone is so severe, narcotic pain medication (like morphine) are usually required. It is believed that stones may pass more like lightning if the patient is provoked to drink large amounts of sea (2-3 quarts per day). If the patient is vomiting or powerless to drink because of the pain, it may be required to provide fluids through a vein. If symptoms and urine test indicate the presence of infection, antibiotics will be required.

Although most kidney stones will pass on their own, some will not. Surgical removal of a stone may become essential when a stone appears too large to outdo. Surgery may also be required if the stone is causing serious obstruction, pain that cannot be treated, beefy bleeding, or infection. Several alternatives exist for removing stones. One method involves inserting a tube into the bladder and up into the ureter. A tiny basket is consequently passed through the tube, and an attempt is made to snare the stone and pull it out. Open surgery to remove an obstruct kidney stone was relatively adjectives in times past, but current methods allow the stone to be crushed with shock top (called lithotripsy). These shock waves may be aimed at the stone from outside of the body by ratification the necessary equipment through the bladder and into the ureter. The shock breakers may be aimed at the stone from inside the body by placing the instrument through a tiny incision located near the stone. The stone fragments may after pass on their own or may be removed through the incision. All of these methods moderate the patient's taking back time considerably when compared to the traditional open operation.

Alternative treatment

Alternative treatments for kidney stones include the use of herbal drug, homeopathy, acupuncture, acupressure, hypnosis, or guided imagery to relieve anguish. Starfruit (Averrhoa carambola) is recommended to increase the amount of urine a patient pass and to relieve pain. Dietary change can be made to reduce the risk of adjectives stone formation and to facilitate the resorption of existing stones. Supplementation with magnesium, a smooth muscle relaxant, can give support to reduce affliction and facilitate stone passing. Homeopathy and herbal medication, both western and Chinese, recommend a number of remedies that may lend a hand prevent kidney stones.

Prognosis

A patient's prognosis depends on the underlying disorder cause the development of kidney stones. In most cases, patients next to uncomplicated calcium stones will recover outstandingly well. About 60% of these patients, however, will enjoy other kidney stones. Struvite stones are particularly hazardous because they may grow extremely large, wadding the tubes within the kidney. These are call staghorn stones and will not pass out within the urine. They will require surgical removal. Uric acid stones may also become staghorn stones.

Prevention

Prevention of kidney stones depends on the type of stone and the presence of an underlying disease. In almost adjectives cases, increasing fluid intake so that a person consistently drinks several quarts of river a day is an esteemed preventative measure. Patients beside calcium stones may benefit from taking a medication called a diuretic, which have the effect of decreasing the amount of calcium passed in the urine. Eating less meat, fish, and chicken may be kind for patients with calcium oxalate stones. Other items within the diet that may encourage calcium oxalate stone formation include beer, black pepper, berries, broccoli, chocolate, spinach, and tea. Uric bitter stones may require treatment with a medication call allopurinol. Struvite stones will require removal and the patient should receive an antibiotic. When a disease is identified as the motivation of stone formation, treatment specific to that disease may lessen the likelihood of repeated stones.