March 23, 2012
World Kidney Day is celebrated worldwide every year on the second Thursday of March. This year, it was celebrated on March 8, 2012.
What is kidney stone?
Kidney stones, known medically as renal calculi, are hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones can be extremely painful and cause many people to visit the doctor for treatment.
Who is at risk?
Anyone may develop a kidney stone, but certain people are more susceptible to it. Stones are more common in men than in women and commonly develop in the age group of 20-49 years. In India, kidney stones are common in Maharashtra, Gujarat, Punjab and Rajasthan. In Karnataka, it is common in Coastal and Northern districts because of the hot weather.
What causes kidney stones?
Kidney stones form when there is a decrease in urine volume due to reduced fluid intake or an excess of stone forming minerals in the urine. Dehydration and reduced fluid intake, increases the precipitation of these minerals within the urinary system and increases the risk of formation of kidney stones. Climate may be a risk factor for kidney stone development, since residents of hot and dry areas are more likely to become dehydrated and susceptible to stone formation.
Obstruction of urine flow, infections, metabolic abnormalities, medical conditions like gout, hyperparathyroidism and some medications including some diuretics, calcium-containing antacids etc also predispose to stone formation.
Dietary practices may increase the risk of stone formation in susceptible individuals. These include high intake of animal protein, a high-salt diet, excessive vitamin D supplementation and excessive intake of oxalate-containing foods such as tomatoes and spinach.
What are the symptoms?
People who have kidney stones experience sudden onset of severe spasmodic pain in their back which often radiates to the groin. Those affected cannot lie down comfortably, and many writhe in pain. The pain has been described by many ladies as being as worse as the pain of childbirth. It is often accompanied by nausea and vomiting. It may also cause blood in the urine, discomfort in passing urine and fever with chills, if infection sets in. Some kidney stones may not produce symptoms, and may be incidentally detected during an ultrasound examination.
How are kidney stones diagnosed?
An ultrasound of the abdomen will help in diagnosing stones in most of the patients. Blood and urine tests and in certain cases, a CT scan may be required.
What is the treatment for kidney stones?
There are several factors which influence the spontaneous passage of a stone. These include the size and position of the stone. Any congenital or acquired abnormalities of the urinary system may hamper the passage of stones. Hence, treatment of kidney stones has to be individualized.
Treatment with analgesics may give symptomatic relief from pain. The patient is generally instructed to maintain a high fluid intake of 2 to 3 litres/day to help pass the stone. Other causes which predispose to stone formation require to be treated.
Current treatment options are ESWL (Lithotripsy) and endoscopic procedures like Ureteroscopy (URS), Retrograde IntraRenal Surgery (RIRS) and Percutaneous Nephrolithotomy (PCNL).
How to prevent kidney stones?
Increase of fluid intake to 2-3 litres/day, especially during summer and increased intake of citrus fruits like lemon and orange is recommended. Dietary changes include salt restriction and eating less of meat, fish and poultry.
Avoiding large portions of spinach, beet, tomatoes, nuts and chocolates is advisable. Hence, with these lifestyle changes, it would be possible to avoid kidney stones in the first place, rather than having to undergo treatment for it.
Dr Nischith can be contacted at ‘KIDNEY CLINIC’, Don Bosco Hall Cross Road, Falnir, Mangalore. Ph: 08242422166, 9945087949. E mail: nish25@gmail.com.