Urinary or kidney stones are formed from the minerals and salts in the urine, which clump together when the urine becomes highly concentrated. The term "kidney stones" is often used because the kidneys are the most common site for stone formation.
Usually, these stones are small and pass through the urinary tract without causing problems.
As the kidneys filter the blood impurities, minerals and acid salts can accumulate and harden over time. These solid crystalline deposits are kidney stones and can form in one or both kidneys. The stones can travel down the urinary tract and block urine flow, causing pain and bleeding.
While anyone can develop kidney stones, certain groups of people are more at risk than others. These include
Even if you are at higher risk of developing kidney stones, you can reduce your risk by making lifestyle changes such as drinking more water, eating a healthy diet, and maintaining a healthy weight.
The formation of kidney stones is a complex process that several different factors can cause. Some of the most common causes of the stone disease include
Symptoms of kidney stones can vary depending on the size and location of the stones. Some of the most common symptoms include
Not everyone with kidney stones will experience symptoms, and some small stones may pass out of the body without causing any symptoms. However, even small stones can cause damage to the urinary tract, so it's essential to seek medical attention if you suspect you have kidney stones.
Kidney stones come in many different types, shapes and colours. Based on the composition, the stones are classified into four main types:
These are the most common type of stones (>75%) and are made up of calcium oxalate or calcium phosphate. Calcium stones can form in the kidneys and can also be found in the ureters and bladder. These stones can typically be seen on a plain x-ray.
These stones are formed when the urine is too acidic and can be found in the kidneys and urinary bladder. These stones are more common in people who eat a diet high in purines, which are found in red meat, organ meats, and seafood.
These stones are made of magnesium, ammonium, and phosphate and are most commonly found in women with urinary tract infections. These stones can grow quickly and can cause damage to the kidneys.
They are typically seen on a plain x-ray forming a cast of the kidney's drainage system.
These stones are rare and occur in people with a genetic disorder that causes too much of the amino acid cystine to be excreted in the urine. These stones are only faintly visible on x-ray.
If Dr Wang suspects you are suffering from kidney stones, he will evaluate you appropriately. He may order a few investigations, including
You may also be asked to urinate through a sieve to collect and test the kidney stones that pass in the lab. The results will help your doctor to determine the cause and formulate an appropriate plan for treatment.
Sometimes, the diagnosis is made unexpectedly when the patient is being investigated for an unrelated medical condition. Dr Wang will advise you if your stone needs to be treated.
The options available for treating kidney stones depend on the type of stone present, the severity of the symptoms, and the location of the stone.
Treatment options include
Surgery may be needed to unblock the kidney and remove a stone from the ureter or kidney if:
In case of complex, recurrent stones (in particular cystine stones which often relapse), a lifelong commitment is required with a trusted team of medical specialists, supervised by a urologist and nephrologist.
Long-term management involves close surveillance, ongoing educational support, urinary alkalinisation, oral fluids, and in many instances, lifelong medications.
Dr Wang can discuss the treatment options and help you find the most suitable procedure.
There are medications to help pass a kidney stone causing a blockage, but these are considered only on a case-by-case basis. It remains controversial regarding its effectiveness.
In certain situations, a tablet called tamsulosin (Flomaxtra) may be beneficial in helping relax the ureter to assist the stone in passing. It works best for stones that are lower down in the ureter. Pain-relieving medications may also be required to help during this time.
The type of stone you have will determine your stone management. There is no “one-size-fits-all” prescription for preventing kidney stones.
General measures in kidney stone prevention revolve around being well motivated not to have another stone, maintaining a healthy lifestyle and normal weight range, keeping up fluid intake, reducing animal protein intake and decreasing salt in the diet.
General recommendations for stone prevention include:
In summary, “Eat from each food group daily, animal proteins in moderation; plenty of fruit and vegetables; drink plenty of fluids, and have a diet low in salt”
If kidney stones are left untreated, they can cause a range of complications. Some of the most common complications of untreated kidney stones include
It's essential to seek medical attention if you have symptoms of kidney stones, as early diagnosis and treatment can help prevent complications and recurrences. If you experience severe pain or other symptoms such as blood in the urine, fever, or difficulty urinating, seek medical attention immediately.
Privacy & Copyright | Dr Luke Wang
Content & Design - Quantum Digital