Kidney Stones Causes, Symptoms, and Globally Used Treatment Methods
History
Kidney stones are an important part of urological practice. In 4800 BC, specifically in Egypt, kidney and bladder stones discovered in mummies are among the earliest reported examples.
In ancient Rome, Greece, China, Egypt, and Mesopotamia, standards for diagnosing stones were established using the color, smell, and quantity of urine.
What is Urolithiasis?
Urolithiasis is a condition characterized by the formation of stones in the urinary tract, including the kidneys, ureters, bladder, and urethra.
These stones are composed of accumulated minerals and salts that crystallize and form hard masses within the urinary tract.
Causes of Urolithiasis
Several factors contribute to the formation of urinary stones, including:
- Dehydration: Insufficient fluid intake increases the concentration of substances that form stones in the urine.
- Diet: High intake of protein, sodium, or oxalate-rich foods can increase the risk of stone formation.
- Genetics: There may be a genetic predisposition to stone formation within families.
- Diseases: Certain medical conditions such as chronic bowel inflammation, chronic urinary infections, and gout can increase the likelihood of stone formation.
- Medications: Some drugs can increase the risk of stone formation.
Epidemiology
- Prevalence: 2-3%
- Demographics: Two-thirds of patients are males aged 30-50 years.
- Lifetime Risk of Urolithiasis: 8-20%
- Recurrence Rates:
Within one year: 10%
Within five years: 35%
Within ten years: 50%
Why Do Kidney Stones Occur?
The exact factors and mechanisms leading to kidney stones are not fully understood.
Insoluble materials in the urine, such as calcium, oxalate, and uric acid, can aggregate at high concentrations to form stones.
Chemical Composition of Stones (Types)
- Calcium Oxalate Stones: 80%
- Struvite Stones (Ammonium Magnesium Phosphate): 10%
- Uric Acid Stones: 5-10%
- Cystine Stones: 1%
Knowing the types of kidney stones is important for treatment.
Diseases Causing Stone Formation
- Cushing’s Syndrome
- Chronic Diarrhea
- Paralysis
- Intestinal Resection
- Paget’s Disease
- Inflammatory Bowel Disease
- Hyperparathyroidism
- Gout
Medications Causing Stone Formation
- Crystallogenic Drugs: Amoxicillin/Ampicillin, Ascorbic Acid, Ceftriaxone, Calcium, Ciprofloxacin, Laxatives, Indinavir, Vitamin D
- Drugs Affecting Urine Production: Affecting the balance and formation of urine
Symptoms of Kidney Stones
Most people with kidney stones do not experience any symptoms, and the stones may pass unnoticed. However, severe pain can occur when stones grow or move within the kidney or get stuck in the urinary tract, causing:
- Severe Pain
- Blood in Urine
- Urinary Tract Obstruction
- Painful Urination
- Nausea and Vomiting
- Fever and Chills
- Reduced Urine Output
Which Clinic Should Kidney Stone Patients Visit?
Patients experiencing severe pain, blood in urine, reduced urine output, nausea, vomiting, fever, sweating, or irregular heartbeat should consult a urology clinic.
Diagnostic Methods for Kidney Stones
- Medical History
- Blood Tests: Urea, creatinine, sodium, potassium, calcium
- Ultrasound (USG)
- Radiography of the Urinary System
- Urine Analysis
- CT Scan of the Urinary System
Treatment Options for Kidney Stones
Treatment may vary depending on the stone’s size, shape, location, and type within the urinary tract. Stones smaller than 5 mm often pass spontaneously, while stones 7 mm or larger typically require intervention. Treatment options include:
- Medical Treatment
- Lithotripsy (Shock Wave Lithotripsy – ESWL)
- Ureteroscopy
- Percutaneous Nephrolithotomy
- Laparoscopic Surgery
- Flexible Ureterorenoscopy (Endoscopic Kidney Stone Surgery)
Recommendations for Patients with Kidney Stones
Making lifestyle changes can reduce the risk of stone recurrence and improve overall health. Recommendations include:
- Increase Fluid Intake
- Drink Plenty of Water
- Regular Exercise
- Balanced Diet
Factors Increasing the Risk of Kidney Stones
- Inadequate Fluid Intake
- Genetic Factors: Family history of stones
- Age, Gender, and Race: Predominantly affects individuals aged 30-50
- Inactivity
- Dietary Factors
Complications of Kidney Stones
- Kidney Enlargement and Loss of Function
- Infections and Sepsis (20% mortality rate)
- Squamous Cell Carcinoma
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