Kidney Stone : Type, Symptom, Risk Factor, Diagnosis, Treatment, Drug, And Prevention

Kidney stone (Renal Calculus or Nephrolith) is a solid piece of material which is formed in the kidneys from minerals in urine.Kidneys are a pair of organs located in the back of the abdomen.Each kidney is about four or five inches long (about the size of a fist).They sit opposite each other on either size of the spine.Kidneys' function are to filter the blood.They remove wastes, control the body's fluid balance, and regulate the balance of electrolytes.Kidney stone typically leave the body in the urine stream and a small stone may pass without causing symptoms.The size of stones at least 3 millimeters can cause the blockage of the ureter.Calcium is the electrolyte that influences the formation of kidney stones.Potassium is an inhibitor of calcium crystal formation that promotes the urinary excretion of citrate.Magnesium inhibits stone formation.Pain is typically the first sign of a kidney stone known as renal colic, the pain usually begins when a stone moves from where it has formed into the urinary tract.

There are four main Types of Kidney Stone

• Stones formed from calcium combined with oxalate or phosphate.

• Struvite stones are caused by a urine infection and are often horn-shaped and quite large.

• Uric acid stones are often softer than other form of kidney stone.

• Cystine stone are rare and hereditary and look more like crystals than stones.

The Classification of Urinary stones based on their location :

• The Kidney (Nephrolithiasis)

• The Ureter (Ureterolithiasis)

• The Bladder (Cystolithiasis)

The symptoms of  Kidney Stone

• Blood in the urine
• Painful urination
• Vomiting
• Nausea
• Fever
• Pus in the urine
• Shivering
• Sweating
• Cloudy or bad smelling of urine

Risk Factors of Kidney Stone

• Dehydration from low fluid intake.
• High dietary intake of animal protein, sodium, refined sugars, fructose, and high fructose corn syrup, oxalate, grapefruit juice, and apple juice.
• Dietary supplement of calcium intake.
• Drinking fluoridated tap water.
• Low urinary citrate excretion (Hypocitraturia).
• Excessive vitamin D supplementation.
• Certain behaviours associated with frequent and binge drinking.
• Soft drinks containing phosphoric acid (Colas)

Diagnosis

Diagnosis of kidney stone is made on the basis of information obtained from the history, physical examination, urinalysis, and radiographic studies.

1. Physical examination is to reveal fever and tenderness at the costrovertebral angel on the affected side.
2. Clinical diagnosis is made on the basis of the location  and severity of the pain, which is typically colicky in nature (comes and goes in spasmodic waves).
3. Laboratory tests include

• Microscopic examination of the urine is to show red blood cells,  bacteria, leukocytes, urinary casts, and crystals.
• Urine culture is to identify any infecting organisms present in the urinary tract and sensitivity to determine the susceptibility of these organisms to specific antibiotics.
• Complete blood count is look for neutrophilia (increased neutrophil granulocyte count) suggestive of  bacterial infection, as seen in the setting of struvite stones.
• Renal function tests are to look for high blood calcium blood levels abnormally.
• 24 hour urine collecttion is to measure total daily urinary volume, magnesium, sodium, uric acid, calcium, citrate, oxalate, and phosphate.
• Chemical analysis of collected stones can establish their composition, which in turn can help to guide future preventive and therapeutic managements.A Simple Tea Strainer or a Stone Screen Kidney Stone collection cup are to collect stones through urinating.
• Ultrasound is a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes.
• Computed Tomography (CT) scan is a procedure that makes a series of detailed pictures of areas inside the body, taken from different angles

Treatments of Kidney Stone

• Extracorporeal Shock Wave Lithotripsy is a procedure that shatter stones into small fragments.It is used for severe cases.
• Surgery is to remove the stone.
• Endoscope Removal is an instrument that is inserted into the urethra, passed into the bladder, then to where the stone is located.It is to remove the stone or break it up.
• Percutaneous Nephrolithotomy is a small incision that is made in the back.It is used to remove kidney stone.

Drugs for Kidney stone

• Allopurinol is the drug to reduce kidney stone recurrences.
• Acetazolamide (Diamox) is a drug to alkalinizes the urine.
• Chlorthalidone and Indapamide are drugs to inhibit the formation of calcium-containing stones by reducing urinary calcium excretion.
• Drug for anti-inflammatory.

Preventation of Kidney Stone

• Increasing total fluid intake to more than two liters per day of urine output.
• Increasing citric acid intake, such as lemon or lime juice.
• Moderating calcium intake.
• Limiting sodium intake.
• Avoidance of large doses of supplemental vitamin C.
• Limiting consumption of soft drinks like cola.
• Limiting animal protein intake to no more than two meals daily.
• Sufficient dietary intake of magnesium and citrate.