FAQ-


How does kidney stone form?
Scientists do not always know what makes stones form. While certain foods may promote stones in susceptible people, researchers do not believe that eating a specific item will cause stones in people who are not vulnerable. Yet they are confident that factors - such as a family or personal history of kidney stones and other urinary infections or diseases - have a definite connection to this problem. Climate and water intake may also play a role in stone formation.

Stones can also form because of obstruction to urinary passage like in prostate enlargement or stricture disease. Stone formation has also been linked to hyperparathyroidism, an endocrine disorder that results in more calcium in your urine. Susceptibility can also be raised if you are among the 70 percent of people with rare hereditary disorders such as cystinuria or primary hyperoxaluria who develop kidney stones because of excesses of the amino acid, cystine or the oxalate in your urine.

Another condition that can cause stones to form is absorptive hypercalciuria, a surplus of calcium in the urine that occurs when the body absorbs too much from food. The high levels result in calcium oxalate or phosphate crystals forming in the kidneys or urinary tract. Similarly, hyperuricosuria, excess uric acid tied to gout or the excessive consumption of meat products, may also trigger kidney stones.

Consumption of calcium pills by a person who is at risk to form stones, certain diuretics or calcium-based antacids may increase the risk of forming stones by increasing the amount of calcium in the urine. Calcium oxalate stones may also form in people who have chronic inflammation of the bowel or who have had an intestinal bypass operation or ostomy. This is because of loss of more water from the body as well as absorption of oxalate from the intestine.





How to prevent it?
Unfortunately we don't have any means to find out the high risk group of stone formers. So a normal individual if he maintains urine out put of 2 1/2 liters of urine it is sufficient.

To prevent recurrence of stone formation the patient has to follow strict intake of sufficient fluids in the form of tender coconut, butter milk, water and fruit juice etc. and the patient has to very clearly understand that drinking plenty of fluids is different from taking fluids in sufficient intervals to keep a regular urine flow (i.e.) the patient has to take 200 ml of fluids every one hour so that the newly formed sand like particles in the kidney will be washed out in the free flow of urine. But most of the patients mistake plenty of oral fluids and take 11/2 - 2 liters of fluid each time and don't take fluids in between and allow the small sand particles to aggregate and form a big stone.

Restriction of red meat (beef, pork, and mutton), spinach, tea, Coffey, and intake of salt, may benefit by reducing recurrence.

If you are at risk for developing stones, your doctor may perform certain blood and urine tests to determine which factors can best be altered to reduce the risk. Some people will need medicines to prevent stones from forming.





Will my children get stones because I have them?
Any person with a family history of stones may be at higher risk. Stone disease in a first degree relative, such as a parent or sibling, can dramatically increase the probability for you. In addition, more than 70 percent of people with certain rare hereditary disorders are prone to the problem. Those conditions include cystinuria, an excess of the amino acid, cystine, that does not dissolve in urine and instead forms stones of cystine; and primary hyperoxaluria, an excess production of the compound oxalate, which also does not dissolve in urine, forming stones of oxalate and calcium.





Is it related to intake of bore well water?
No, many people have a wrong idea that bore well water has lots of salt in it. Which, is the culprit of stone formation but, the truth is that this salt is different which does not have any effect on kidney stone formation.





Which food to avoid?
Even though all the stones have calcium, it is the oxalate which is the culprit and most common type of stone is calcium oxalate so prevention of food rich in oxalate is important, like {red meat (beef, pork, and mutton), spinach, tea, coffee etc } Salt restriction and plenty of oral fluids as mentioned before.

People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. However, recent studies have shown that foods high in calcium, including dairy foods, help prevent calcium stones. Taking calcium in pill form, however, may increase the risk of developing stones. Women taking vitamin D and calcium pills in the post-menopausal period to prevent osteoporosis, especially with family history of stones, need to be careful..





After kidney stone removal will I get a stone again?
Yes, the probability of stone recurrence is as follows
  • Next one year ---- 10 %
  • Next 10 years --- 50 %




How long can we wait once a Ureteric stone is diagnosed?
In general with a ureteric stone conservative treatment can be done for 14 days after which there will be subtle damages to the renal function. But, if there is associated problems like

a. Infection
b. Solitary kidney.
c. Bilateral Ureteric stone.
d. Raised renal parameters. Etc

The intervention should be immediate.





Which is the best treatment for kidney /Ureteric stone?
The selection of type of treatment depends on the stone size, location, duration and associated problems.

Laser treatment, also called as Retrograde Intra Renal Surgery (RIRS) has revolutionized the treatment of kidney stones up to 3 cms

The advantage of laser treatment is that the patient's hospital stay is only 1 day and he can resume his normal duties with in 4 days.




What are the symptoms of kidney/Ureteric stones?
Calculus of the Kidneys:
There is a dull pain in the loin of the affected side, when the stones are in the kidney pain radiates along the ureter to the lower abdomen and the perineal region which may be associated with hematuria. If the case turns into a complicated infection, the patient may have fever and pus cells in the urine.

Ureteral Calculus:
In the lumbar region there is an acute pain which may be associated with hematuria. When the stones happen to be in the upper 1/3 part of the ureter, the pain will be in the costovertebral angle region and radiate to the part above iliac crest and external side of the abdomen. When the stones descend, the region of pain will also come down with the pain radiating to the thigh, testicle or vulva region

Vesical Calculus:
There is a pain in urination and the pain is often severest at the end of urination. This pain mainly occurs in the lower abdomen and may radiate to the perineum and tip of penis. Other symptoms are often difficulty and interruption in micturation and hematuria at the end of urination, urgent and frequent micturation.

Urethral Calculus:
Pain in urination, thready urination, dribbling urination, or even retention of urine may appear.





What is the role of IV fluids therapy (Forced diuresis)?
I V fluid therapy is not the standard treatment for patients with stone disease. It is mainly a supportive treatment to hydrate patient due to severe vomiting. Forced diuresis may cause extravasation of urine in case of tight obstruction of ureteric stone.





Are gallstones and ureteral stones related?
No, there is no known link. They are formed in different areas of the body. Also, if you have a gallstone, you are not necessarily more likely to develop kidney stones.


0 comments:

Post a Comment

Subscribe to: Posts (Atom)