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1. What is a kidney stone?

Kidney stone, also called as renal colic, is a solid crystalline mass found within the kidney or the urinary tract. Tiny crystals pass out of the body through urine stream. Large stones require surgical or non-surgical treatment.

2. What causes kidney stones?
The primary causes of urinary stone disease can be attributed to low fluid intake with subsequent low volume of urine productions which results in formation of crystals in the urine.
3. What are the types of kidney stones and how do they occur?

The types of kidney stones are:

  • Calcium Stones: Caused due to increased gut absorption of calcium.
  • Struvite stones:Recurrent occurrences of chronic urinary tract infection (UTI) can cause struvite stones.
  • Uric acid stones:These stones results from high purine intake (eg, organ meats, legumes, fish, meat extracts, gravies), or malignancy (ie, rapid cell turnover).
  • Cystine stones:This is a hereditary condition which arises due to intrinsic metabolic defect resulting in failure of renal tubular reabsorption of cystine, ornithine, lysine, and arginine.
4. Is kidney stone hereditary?

People with a family history of stones tend to develop kidney stones.

5. What are the symptoms of kidney stone?
Symptoms of urinary stone disease may include pain, infection, or hematuria. Small nonobstructive stones in the kidney may only cause occasional pain and can be easily controlled. The passage of stones into the ureter with acute obstruction causes pain.
6. What is the first step in prevention of kidney stone formation?
Drinking plenty of fluids, especially water can reduce the incidence of stone formation. An increase in the fluid intake increases the volume of urine output. Patients with recurrent stone disease are instructed to drink 8 glasses of fluid daily to maintain adequate hydration and decrease chance of urinary stone-forming salts. The goal is a total urine volume in 24 hours in excess of 2 liters.
7. Does Urinary tract Infection (UTI) cause stone formation?

Recurrent occurrences of chronic urinary tract infection (UTI) can cause stones.

8. What are the main features that help in analysis of urinary stone disease?
  • Duration, characteristics, and location of pain
  • History of urinary calculi
  • Prior complications related to stone manipulation
  • Urinary tract infections
  • Loss of renal function
  • Family history of calculi
  • Solitary or transplanted kidney
  • Chemical composition of previously passed stones
9. What are the complications associated with kidney stone?

Serious complications of urinary tract stone disease include the following:

  • Abscess formation
  • Serious infection of the kidney that diminishes renal function
  • Urinary fistula formation
  • Ureteral scarring and stenosis
  • Ureteral perforation
  • Extravasation
  • Urosepsis
  • Renal loss due to long-standing obstruction
10. What are the diagnosis procedures involved in kidney stone?
  • Urinalysis : Urinary crystals of calcium oxalate, uric acid, or cystine may occasionally be found upon urinalysis. Presence of these crystals gives a clue about the nature and type of obstructing calculus.
  • Blood Studies : To assess a patient’s current renal health and to diagnose metabolic risk of future stone formation, measurements of serum electrolyte, creatinine, calcium, uric acid, parathyroid hormone (PTH), and phosphorus are essential.
  • 24-Hour Urine Profile : A 24-hour urine profile with appropriate serum tests of renal function, uric acid, and calcium can identify any associated urinary stone disease. The test can identify the exact nature of the chemical problem that caused stone formation.
  • Plain (KUB) Radiography : Plain abdominal radiography (also referred to as KUB radiography) is useful for assessing total stone burden, as well as the size, shape, composition, and location of urinary calculi in some patients.
  • Ultrasonography : Renal ultrasonography can be used to determine the presence of a renal stone.
  • Intravenous Pyelography (Urography) : IVP is helpful in identifying the specific problematic stone among numerous pelvic calcifications, as well as in demonstrating renal function and establishing that the other kidney is functional.
  • Computed Tomography Scanning : CT scan is used in the assessment of urinary tract stone disease, especially in case of acute renal colic. CT scans are readily available in most hospitals and can be performed and read in just a few minutes.
  • Retrograde Pyelography : Retrograde Pyelography is the most precise imaging method for determining the anatomy of the ureter and renal pelvis for making a definitive diagnosis of any ureteral calculus.
  • Nuclear Renal Scanning : A nuclear renal scan can be used to measure differential renal function, especially in a dilated system for which the degree of obstruction is in question. This is also a reasonable study in pregnant patients, in whom radiation exposure must be limited.
  • Magnetic Resonance Imaging : MRIs are generally more expensive than other studies, such as CT scans, which reveal stones much better. MRI scanning is used in selected cases in which other technologies are too toxic or potentially dangerous.
11. What is the basic treatment involved in urinary stone disease?
The focus of the treatment is in correcting dehydration, treating urinary infections and reducing risk of acute renal failure. Intravenous (IV) hydration can be provided to control nausea and vomiting. Small stones with relatively mild hydronephrosis can be treated with observation and acetaminophen. Serious patients may require drainage.
12. When should a person require hospitalization for kidney stones?

Patients can be hospitalized in case:

  • Oral analgesics becomes insufficient to manage pain
  • Ureteral obstruction from a stone occurs in a solitary or transplanted kidney.
  • Ureteral obstruction from a stone occurs in the presence of a urinary tract infection (UTI), fever, sepsis, or pyonephrosis.
  • Comorbid conditions like diabetes, dehydration, renal failure or any immunocompromised state.
13. What kind of life style changes can prevent incidence of kidney stones?
  • Drinking plenty of water to increase urine output.
  • In case the patient tends to form calcium oxalate stones, restricting foods rich in oxalate like spinach, beet etc can help.
  • A low salt, low animal protein diet may reduce the chances of kidney stone formation.
  • It is advisable to eat calcium rich food rather than calcium supplements unless your doctor advises otherwise. Always consult your doctor before taking calcium supplements.

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