Kidney stones are hard deposits consisting of minerals and salts like Calcium.

Oxalate, Uric acid, Phosphate, and some rare types of Cystine, and Xanthine.

that develop inside your kidneys. They are also known as renal calculi, nephrolithiasis, or urolithiasis. The size of a kidney stone can be anywhere from a grain of sand to something as enormous as a golf ball. Some people might not even be aware that they have a kidney stone (or stones), depending on the size.

Kidney stones can exist for years without one being aware of them. You may not feel anything as long as these stones are lodged in your kidney. It usually causes discomfort when it moves out of place or travels out of the Kidney. A stone can form quickly, in just a few months.  To determine how quickly stones form in your body, doctors may request a 24-hour urine test.

How does a kidney stone form?

Several factors may raise your risk of developing kidney stones, but there is frequently no one specific explanation or cause.

Kidney stones develop when your urine contains more crystal-forming components than the fluid in your urine can dissolve, such as calcium, oxalate, and uric acid. Some of these risk factors include:

• an obstruction in the urinary system.
• not consuming enough water 
• Diet, a high intake of meals that are high in ingredients that help build stones for example diets high in salt or animal protein which contain sodium and phosphate.
• Family history.
• Also, Pre-existing health conditions such as hypercalciuria (high calcium levels in your urine), high blood pressure, diabetes, obesity, osteoporosis, cystic fibrosis, and kidney cysts.
•  Supplements and medications, such as vitamin C, dietary supplements, laxatives (when used excessively), and calcium-based antacids, can increase your risk of kidney stones.

Types of kidney stones

Calcium crystals: Calcium stones are the most common type, typically in the form of calcium oxalate, and make up the majority of kidney stones. Your liver produces oxalate every day, and you can also get it from food. The oxalate level of some fruits, vegetables, and nuts.

Calcium phosphate stones are another type of calcium stone that can develop. This kind of stone occurs more frequently in metabolic disorders such as renal tubular acidosis. It might also be connected to several drugs used to treat migraines or seizures, like topiramate (Topamax, Trokendi XR, Qudexy XR).

Uric acid crystals: This type of stone occurs as a result of dehydration.  People with chronic diarrhoea or malabsorption, those who consume little amounts of water or a high protein diet, and those who have diabetes or metabolic syndrome, can all develop uric acid stones. Your risk of uric acid stones may also be increased by specific genetic factors, or tubular acidosis.

Stones caused by uric acid are also fairly common.

Struvite stones: Urinary tract infections can cause the formation of struvite stones. Frequently with very few symptoms or little warning, these stones have the potential to grow swiftly and become extremely huge. 

Cystine stone: People who have a hereditary condition called cystinuria, in which the kidneys produce an excessive amount of certain amino acids, develop these stones.

Symptoms of kidney stones

Kidney stone symptoms include:

• Pain in the side and back, below the ribs that radiates to the lower abdomen and groin, comes in waves and fluctuates in intensity.
• A severe colic pain in children.
• Having trouble urinating or having a greater urge to urinate.
• Burning sensation while urinating.
• Traces of blood in urine.
• Fever or chills
• Nausea or vomiting.
• Foul-smelling urine etc.

How can kidney stones be prevented?

The risk of kidney stones can be reduced in a number of ways, which may include a combination of lifestyle changes and medications.

Drink water. Every day, your kidney needs at least 2.5 liters to balance the concentration of your urine, drink more water if and when you sweat more. Your increased frequency of urination helps to effectively eliminate the accumulation of the compounds that lead to kidney stones, so staying hydrated is beneficial. 

Eat an adequate diet, consume less salt, and do moderate exercise at least 3 days weekily.

If you have formed kidney stones in the past, some drugs that aid in the prevention of kidney stones may be prescribed by your doctor. Depending on the sort of stones you develop, the medicine may vary.

Diagnosis and Treatment

Your doctor may order some diagnostic tests and treatments after speaking with you and going over your medical history, such as:

Blood analysis: Blood tests may suggest that you have an excess of uric acid or calcium. The results of a blood test allow your doctor to look for additional medical issues while also monitoring the condition of your kidneys. A blood test will show how your kidneys are functioning, and screen for biochemical problems that may lead to kidney stones.

Urine analysis: In addition to checking the levels of stone-forming chemicals and indications of infection that cause kidney stones, the excretion of too many stone-forming minerals or insufficient amounts of stone-preventing chemicals may be detected by the 24-hour urine collection test. 

Image analysis: A kidney stone’s size, shape, location, and number can be determined by using imaging tests like an X-ray, CT scan, and ultrasound of the urinary system. These tests assist your doctor in determining the best course of treatment for you. Computerized tomography (CT) with high-speed or dual energy may be able to detect even tiny stones. Simple abdominal X-rays are less often used since they have a higher chance of missing tiny kidney stones.

Analysis of passed stones: This information is used by your doctor to identify the cause of your kidney stones and to develop a plan to stop further stone formation.

The two treatment options are medication or surgery. Your doctor will determine the type of treatment most suitable if necessary because some tiny kidney stones might pass from your body. This may cause severe discomfort. 

Medication: Drugs could be recommended to help the ureter relax so the stone can pass easily, also to reduce the discomfort and in some cases control nausea and over-the-counter drug like ibuprofen or an IV painkiller may be suggested by your healthcare professional.

Control nausea and vomiting. To help the stones pass, relax your ureter. Tamsulosin (Flomax®) and nifedipine (Adamant® or Procardia®) are two drugs that are frequently recommended.

Surgery: Minimally invasive treatments like Shockwave lithotripsy, Percutaneous Nephrolithotripsy, and Ureteroscopy are commonly used to break and extract kidney stones. Open stone surgery compared to minimally invasive procedures, is now very rarely performed globally because of its invasive nature. However, open stone surgery is still an option in developing countries like Nigeria.

Conclusion

If you are experiencing kidney stone symptoms, don’t wait to contact your doctor. Although kidney stones by themselves cannot result in mortality, however, severe damage may result, if they remain in the body for an extended period of time.

References

https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759

https://my.clevelandclinic.org/health/diseases/15604-kidney-stones