Kidney stones

Urolithiasis is a condition that is marked by the formation of crystals or stones in the urinary tract which comprises the kidneys, ureters, bladder and urethra. Renal calculi, or kidney stones as they are more commonly known, result from the crystallization of certain minerals present in urine. The process is gradual. Stones begin to form when a few particles adhere to the walls of the tubes in the urinary system and form a mass. The flow of urine continues to bring new particles that stick to the others until the stream of urine causes the stone to detach. Since the tubes that connect the urinary system are quite narrow, the stone irritates the walls as it travels through the tract, thereby causing pain. The stone eventually makes its way into the bladder. Once in the bladder, one of two things will happen:

  1. The stone quickly finds its way towards the urethra opening and is expelled with the urine.
  2. The stone remains in the bladder where it continues to grow. It then becomes too large to pass through the urethra and is no longer able to leave the body on its own. Medical intervention is then necessary.

A stone can be the result of three factors: an increase in urine concentration, an obstruction in the urinary tract (which causes a blockage) or an acid imbalance in the urine. In most cases, stones are made of calcium.

Causes

Urolithiasis affects approximately twice as many men and is more common in those between 30 and 50 years of age. The exact causes of kidney stone formation are not completely known. Dehydration and inadequate fluid ingestion however, are widely associated with a higher mineral concentration in urine which is one of the leading causes behind stone formation. Several risk factors may also predispose certain individuals to developing urolithiasis, including:

  • High-protein and/or high-salt diet
  • Family history
  • Benign prostatic hypertrophy
  • Recurrent urinary tract infections
  • Lack of physical exercise
  • Excessive intake of vitamin D supplements

Those who have suffered from urolithiasis in the past must take appropriate measures to prevent kidney stones from reforming since they are more likely to reoccur in people with a prior history (in close to 50% of cases).

Symptoms

Symptoms vary in intensity based on the size of the stone. It is indeed possible to have several stones at once, which disperses the pain. The most common symptoms are:

  • darker coloured urine
  • severe pain in the small of the back and/or flank that may radiate to the abdomen
  • nausea and vomiting
  • pain during urination and the urge to urinate frequently
  • blood in the urine

If the urine becomes cloudy, foul-smelling or if other symptoms such as fever or chills occur, an infection may be present. It then becomes important to consult (or revisit) your physician so proper treatment can be initiated.

If you are no longer able to urinate, it is imperative that you get to a hospital and seek immediate medical attention. This means that the stone is completely obstructing the urethra which could permanently damage your kidneys.

Diagnosis

Kidney stones are diagnosed by a physician during a complete physical examination. The physician will examine the state of the bladder and kidney tenderness. Blood and urine tests may also be requested. To locate the stone, an abdominal x-ray or ultrasound may also be scheduled since certain types of stones are not visible on x-rays.

Treatment

Unfortunately, there is no treatment available to hasten the passing of a stone. Analgesics (pain medication) of various strengths can be taken and purchased without a prescription at your local pharmacy. Otherwise, copious amounts of water must be drunk to help the stone pass. It may take up to 6 weeks for the stone to be expelled from the body.

If the pain becomes unbearable or if the stone is not showing any signs of passing, it must be removed. Several methods are used to dissolve the stone so that it may pass. Otherwise, it can be surgically removed.

Prevention

You can take a few simple steps to better your chances of not developing urolithiasis:

Adopt a healthy diet
 Eat fruits, vegetables and high fibre foods and avoid high-protein and high-salt foods and avoid putting too much salt on your food.
Drink plenty of water
 It is recommended that we drink at least 2 litres of water a day which is equal to between 8 and 12 glasses. It is important to drink even more when physically active in hot weather. Use the colour of your urine as a gauge. It should be clear.
Do not take vitamin and mineral supplements lightly
 Taking supplements is not always necessary. Speak to your physician or pharmacist to assess your needs.

For more information or for support :

The Kidney Foundation of Canada

www.kidney.ca

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