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Introduction Kidney stones are pieces of minerals found in the
kidney. Calcium oxalate, calcium and ammonium
phosphate, uric acid, cystine and other substances in
the urine crystallize to form a hard mineral deposit
called a kidney stone. Kidney stones cause problems
when they block the flow of urine through or out of
the kidney. When the stones move along the ureter,
they cause severe pain.
Causes
The exact cause of kidney
stones is unknown, however, there are a number of
factors that may put a person at risk for kidney stones.
Kidney stones form when small crystals mass
together. These crystals can be made up of a number
of different substances. The most common cause of
kidney stones is the presence of too much calcium in
the urine. The risk factors include:
- age - more common during middle age
- gender - three times more common in men than in women
- diet - eating a diet high in green vegetables, fat,
diary products, salt and brewed tea
- a family hist history of kidney stones
- recurring urinary tract infections
- reduced water intake
- kidney disorders, such as cystic kidney diseases
- metabolic disturbances, such as bowel, endocrine and
kidney problems
- excess intake of vitamins C and D
- blockage of the urinary tract
- alcohol consumption
Symptoms
Kidney stones
can form in some people without causing any
symptoms, however, some stones may cause the
following:
- Severe pain, which usually starts suddenly and
may last from minutes to hours, followed by long
periods of relief.
- Nausea and vomiting
- Burning and the urge to pass urine
- Frequent urination
- Fever
- Chills
- Blood in the urine
- Bloating
- Pus in the urine
Treatment Most small stones move out of the body (pass)
without the need for any treatment other than drinking
extra fluids and taking pain medicine. If the patient
is vomiting or unable to drink because of the pain, it
may be necessary to provide fluids through a vein. If
symptoms and urine tests indicate the presence of
infection, antibiotics will be required.
If you get more kidney stones despite drinking more
fluids and making changes to your diet, your doctor
may give you medicine to help dissolve your stones or
to prevent new ones from forming. You may also receive
prescription medicine if you have a disease that
increases your risk of forming kidney stones.
About 80% of people who have kidney stones have
calcium stones.
Thiazides (such as hydrochlorothiazide, chlorthalidone)
and potassium citrate (Urocit-K) are commonly used to
prevent calcium stones.
Orthophosphate (Neutra-Phos) and cellulose phosphate
are sometimes used. They have more side effects than
thiazides or potassium citrate.
Calcium carbonate or citrate and cholestyramine (Questran)
may be used to prevent calcium stones if you have high
levels of oxalate in your urine.
People rarely need open surgery to treat kidney
stones. In most cases, other less invasive treatments
are successful. Surgical treatment is recommended if
the stones:
- are too large to pass or have grown larger
- have not passed after a reasonable period of time
- are causing constant pain
- are blocking the urine flow
- damage the kidney tissues
You may need open surgery when the kidney stone is
causing severe bleeding that cannot be controlled. In
this case, the surgeon makes a cut in your side or
stomach to reach the kidneys, and he or she removes
the stone.
Another type of surgery, percutaneous nephrolithotomy
or nephrolithotripsy, is sometimes used. The surgeon
puts a narrow telescope into your kidney through small
cuts in your back. He or she then removesor breaks up and removes (lithotripsy) the stone. This
surgery may be used if other procedures do not work or
if you have a very large stone.
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