Kidney Stones: Causes, Symptoms, Treatment, Prevention

Kidney stones or calculus renalis: a deposit of crystals in the kidney but also in the urinary tract. Waste products from the body are excreted together with water by the kidneys. Kidney stones form when the urine is full of waste products. It can take a very long time before kidney stones lead to complaints, it can take years. It usually occurs in people between the ages of 30 and 50 and is more common in men than women. What are the causes and symptoms of kidney stones and what are the treatment options? Is there a chance of recurrence if you have been treated for a kidney stone? What is a horseshoe kidney?

Article content

  • Kidneys
  • Kidney stones
  • Causes of kidney stones
  • Horseshoe kidney and kidney stones
  • Symptoms of kidney stones
  • Diagnosis kidney stones
  • Treatment of kidney stones
  • Preventing kidney stones
  • Prognosis kidney stones and possible complications

 

Kidneys

A kidney regulates the secretion of metabolic products from the blood. The kidneys are located at the back of the abdomen against the back muscles and behind the intestines and other organs in the abdomen. The adrenal glands are located above the kidneys, which are much smaller. On the inside of the kidney are the renal artery and renal vein, which transport blood to and from the kidney. Inside is the renal pelvis, which discharges urine via the ureter to the bladder. With kidney disease you often see changes in the drainage of urine, such as urinating much more or less. It is also possible that there is blood in the urine. But it may also be that you do not notice anything in the urine, but you do have other complaints such as pain in the abdomen, pain in the back or edema due to fluid retention. You can live very well with one kidney that is functioning well, but if both kidneys no longer work, kidney poisoning occurs. Then hemodialysis or a kidney transplant is required.

Kidney stones

Also called calculus renalis, it is a deposit of crystals that forms in the kidneys. The deposits can be of different sizes. Kidney stones usually occur in people between the ages of thirty and fifty. More in men than in women. Sometimes the condition is hereditary. Risk factors include certain diets, not taking enough fluid and living in a warm climate.

Causes of kidney stones

If there is a large accumulation of dissolved substances in the urine, the risk of kidney stone formation is greatest. If you do not consume enough fluid, the risk is greater. It depends on the waste products that crystallize which type of kidney stones are formed.

  • Most stones consist of calcium . This can be due to food rich in calcium or oxalic acid, but it can also be due to excessive production of parathyroid hormones. The latter causes an accumulation of calcium in the blood.
  • Sometimes kidney stones contain uric acid, which can occur in people with gout. This is a form of arthritis characterized by the formation of crystals of uric acid in the joints.
  • Kidney stones can also develop after infections in the urinary system . They then take on the shape of a coral , which fills the entire renal pelvis (coral stone).
  • Certain medications could cause kidney stones, such as indinavir, which is used to treat a HIF infection.
  • Another possibility is that kidney stones are formed by cystine, but this does not happen often. It is a substance that someone with cystinuria (a hereditary defect) has in large quantities.

 

Horseshoe kidney and kidney stones

A horseshoe kidney occurs when the lower ends of the two kidneys are fused together in the middle of the body. They then form a U-shape (horseshoe). Very occasionally the upper renal poles are fused together. A horseshoe kidney is often located slightly lower in the abdomen than normal kidneys. A horseshoe kidney is more common in men than in women. It is an abnormality that is congenital. Due to the unusual shape, the position of the ureters is abnormal, which can make urine drainage difficult. Someone with a horseshoe kidney is more likely to suffer from urinary tract infections and is more likely to develop kidney stones. However, many people never develop complaints.

Symptoms of kidney stones

You will not notice much of small kidney stones, they are usually excreted in the urine without you noticing. But larger stones or sharp pieces of stones in the ureter can cause cramps that are very painful.
Symptoms:

  • A feeling of nausea and vomiting;
  • Severe pain can occur in attacks, this is also called colic : pain in the back radiates to the abdomen and groin;
  • Frequent urination and it hurts;
  • The urine contains blood;
  • Once the kidney stone is passed out, the pain subsides quickly.
  • If a kidney stone is stuck in a ureter, urine cannot escape and the kidney swells. This is also called hydronephrosis. It does not always hurt, but the risk of infection is increased.

 

Diagnosis kidney stones

If the doctor suspects that there are kidney stones, a urine test will be performed. Blood and crystals will be examined and whether there is any evidence of an infection. Calcium stones can be discovered on an abdominal x-ray. Other stones can be detected with intravenous urography or ultrasound. The stones that have come out naturally with the urine can be examined to see what substances they are composed of.

Treatment of kidney stones

  • For small stones that do not come out spontaneously, medication for the pain can be given. Furthermore, drinking plenty of fluids is important, it can help the stones leave the body together with the urine.
  • Stones that have become stuck can sometimes be removed during a cytoschopy . A viewing instrument is inserted and the stones are removed or broken using tweezers.
  • A stone in the urethra can cause a lot of pain. The pain must be controlled, sometimes even morphine is necessary.
  • Crushing kidney stones is the most commonly used treatment: the shock waves break the stones and the remains can leave the body through the urine.
  • If the kidney stones are very large, surgery may be necessary. It almost never happens, but sometimes the kidney is removed in its entirety.
  • After an attack of kidney stones, the urine will be checked for blood. You will also receive tips to prevent kidney stones in the future.

 

Preventing kidney stones

  • Drink two to three liters of fluid a day.
  • To ensure that urine production continues at night, you must drink fluids before going to sleep.
  • Take more fluids in warm weather, even if you exercise a lot and if you have an elevated body temperature.
  • Do not use antacids that contain calcium (consult your doctor).
  • Your doctor may advise you to use less dairy products.
  • It is better not to eat rhubarb, spinach or asparagus to avoid stones consisting of salts of oxalic acid.

 

Prognosis kidney stones and possible complications

More than half of the people who have been treated for kidney stones often suffer from kidney stones again within seven years. The advice above (section Preventing kidney stones) can reduce the chance that you will suffer from them again. Kidney stones can cause damage to the kidneys that is permanent. If both kidneys are involved, there is a risk of chronic renal insufficiency.

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