Kidney stones: Doctor shares 5 facts one should know before the pain strikes

Kidney stones may sound like one of those “it won’t happen to me” problems… until it does. And trust us, anyone who’s had one will tell you it’s an experience you never forget. These tiny, stubborn crystals can cause big-time pain, mess with your daily routine, and even send you to the ER if you’re not careful. The surprising part? Many people don’t even know what triggers them—or that some cases can actually be prevented. Before you brush it off as just another health issue, here are five things you really should know about kidney stones.
(Dr. Prashant C Dheerendra, Senior Consultant Kidney Specialist, Apollo hospitals, Bannerghatta Road, Bangalore)

The pain of kidney stones is severe. It starts in the flank and radiates to the private parts. The pain is especially severe when they come into the urine tubes (“ureters”). It can come in waves(‘colic”) with pain free periods in between. Sometimes, the nausea and vomiting that can accompany the pain can be bad enough to require admission in the hospital and intravenous medications. Fever, decreased urine output are warning signs that need immediate attention. Other symptoms include passage of blood in the urine and pain while urinating. In some patients, even large stones may not cause any symptoms. Stones on one side can cause silent damage to the kidneys. An ultrasound scan must be a part of all health checks to detect silent stones.

One specific cause of kidney stone formation can be found in only a small minority of patients. . Generally, these are genetic diseases like oxalosis, cystinuria, etc.Stones are made of calcium, uric acid, and oxalate. Very low fluid intake, dietary indiscretion (high salt, high animal protein, high sugar) and indiscriminate use of calcium supplements contribute to stone formation. People with already formed kidney stones should drink three liters of water a day. Uric acid stones are derived from a diet high in red meat, sea food and alcohol.

Men are more prone to kidney stones.One in six human beings will develop kidney stones. Stones are difficult to manage when they occur during vulnerable times like infancy, very old age, pregnancy, etc. Recurrent attacks are common. Hot climate favours stone formation. All parts of India have a high stone burden but the western part is particularly affected.

Many people fall victim to quacks when it comes to kidney stones. A common claim of quacks is that kidney stones can be cured by avoiding fruit seeds which has no scientific basis. . Calcium containing foods like dairy products, nuts, green leafy vegetables are advised to be avoided but calcium is an important requirement for health. The cause of stone formation is imbalance between calcium, oxalate and water. Medications that can "melt" stones are enticing but without proof. Some “magic” potions claim to cure all sorts of kidney diseases like stones, infections and kidney failure. These might contain molecules that can actually cause kidney damage. Be careful!

Diagnosis of an acutely painful stone is generally confirmed by a CT scan. A small stone stuck low in the ureter will generally get out through the urine. Larger stones in the ureter generally need minimally invasive surgery ("ureteroscopy") for pain relief.Extracorporeal shockwave lithotripsy ("ESWL") breaks the stones which are then passed in the urine is also an option. Percutaneous nephrolithotomy("PCNL"), is a major surgery which involves entering the kidney from the back and fragmenting the stones. Retrograde intrarenal surgery ("RIRS") in which stones are removed through the urinary route is a newer option Bleeding and infection are the complications of these procedures but they are usually self-limiting.



In case, one develops kidney stones, then one must avoid quackery and get treated scientifically.