All You Need To Know About Kidney Stones

Despite a considerable improvement in life expectancy, kidney diseases are on the rise in worldwide. World Kidney Day 2021 theme- 'Living well with Kidney Disease' aims at encouraging one towards the ultimate goal of life participation. Education is key to effective symptom management and patient empowerment. The idea is to empower CKD patients and their family members who have struggled through the pandemic.

World Kidney Day 2021: Everything about kidney stones

Kidney stones are one of the most common kidney diseases. Any disease can be best dealt with if diagnosed at an early stage. Kidney stones can be both symptomatic and asymptomatic. Sometimes even larger stones can be relatively asymptomatic if they do not block the passage of urine. Patients may exhibit symptoms like:

• Pain due to the stone lodged in the kidney. This pain is usually severe and is on one side of the body.
• Pain due to the stone lodged in the tube (ureter) draining urine from the kidney is called renal colic. It can last from a few minutes to a few hours and comes in spasms.
• Blood in the urine: Due to the stone rubbing the inside of the ureter
• Urine infections: High fever, painful urination and increased frequency of urination

Also read: World Kidney Day 2021: Top Tips To Live An Active Life With Kidney Disease

You are more likely to develop kidney stones if you have:

1. Recurrent Urinary tract infections (UTIs)

2. Repeated Renal (kidney) infections

3. Kidney abnormalities like a cyst or scarring

4. Family history of kidney stones in a close relative

5. Certain medications

6. Rarely, an underlying condition is leading to high levels of calcium, oxalate, uric acid and cysteine in the body.

Doctors prescribe diagnostic tests to investigate the size and location of the stones. Several diagnostic methods help in finding the presence of kidney stones; the most commonly used processes are:

1. Urine tests: Doctors conduct two urine tests over 24 hours to ascertain whether the patient is excreting too many stone-forming minerals or whether he is excreting negligible stone-preventing substances. Urine tests are also done to rule out a urinary tract infection(UTI)

2. Blood tests: To check whether the kidneys are functioning correctly. Also, excessive calcium or uric acid in the blood can be a cause of kidney stones. Blood tests are a primary diagnostic method used to monitor internal organs' general health, and the kidney is not an exception to this general rule.

3. Imaging tests: Three types of imaging tests can ascertain kidney stones. The purpose of imaging is to check the presence of a stone, its location and whether it is blocking urine passage.

• X-rays or KUB (Kidney ureter bladder) X-ray: the oldest type of imaging tests conducted for investigative procedures is X-ray. It can help identify certain types of stones (calcium), but other types(uric acid) are not detected since they are radiolucent. (Allow X-ray to pass through)
• CT scan: This is the imaging modality of choice. Doctors world over prefer high-speed, or dual-energy Computerised Tomography (CT) scans as the images generated are more detailed and accurate. Further, doctors have the option of administering contrast agents to patients for better visibility. CT scans are readily available in most hospitals and can be performed and read in just a few minutes. Also, the density of the stone on CT can predict response to lithotripsy (Using sound waves to break the stone)
• Ultra-sound: It is another non-invasive technique used by doctors to investigate the possibilities of kidney stones. In pregnant women, ultrasound is also the preferred diagnostic modality. The 2018 EAU guideline recommends ultrasound for initial assessment when there is a concern for an acute symptomatic stone, followed by non-contrast-enhanced computed tomography to confirm a stone diagnosis.

4. Analysis of passed stones: Patients pass urine through a strainer to retain the stones passed through it. Labs analysis establishes the stone ingredients, which helps the doctor form a prognosis and decide the treatment process.

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Some lifestyle changes can help us avoid the chances of kidney stone formation. Patients suffering from lifestyle diseases like hypertension and diabetes must opt for these steps-

Water intake: Doctors advise patients to drink enough water to pass 2.1 quarts (2 .5litres) of urine every 24 hours. Regulating fluid intake is the most important step to curb the chances of kidney stones. People living in dry and hot areas need to increase water intake to maintain this balance.

Reduce high oxalate food intake: Rhubarb, black pepper, spinach, sweet potatoes, okra, nuts, tea, and chocolate and soy product intake must be regulated to check the occurrence of calcium oxalate stones. Patients with calcium stones and relatively low urinary citrate should increase their intake of fruits and vegetables.

Low salt and animal protein diet: People must reduce their salt and animal protein intake. Salt substitutes can be tried to safeguard from this disease.

Avoiding Vitamin C supplements: A 2013 study found out that Vitamin C supplements can aggravate kidney stones' chances. Hence, it is recommended that people with kidney stone ailment history avoid them.

Cautious approach with calcium substitutes: While eating calcium-rich food is not prohibited, people must not use calcium substitutes. Calcium substitutes must be taken in consultation with doctors to reduce the chances of stone formation.

Also read: Exercise Could Benefit Patients With Kidney Disease: Study

Patients who have a stone at a young age (i.e., < 30 years), multiple occurrences of kidney stones, a solitary functioning kidney, or a history of prior kidney stone surgery should obtain a 24-hour urine collection for stone prevention analysis

Avoiding kidney ailments is possible with precaution and prevention. Different dietary and physical fitness regimes can help individuals dodge this lifestyle disease. Regular consultation with doctors is necessary for people who have ailments like hypertension and diabetes, as many research reports indicate that they are at a higher risk for kidney stones.

(Dr. Ajay Phadke - Head SRL Diagnostics-Dr Avinash Phadke Labs)

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