Kidney stones (nephrolithiasis) is a disease of the urinary tract or kidneys, in which small to larger crystalline stones form over the course of the disease, which can only be excreted with great pain. Typical first signs are severe pain in the groin area or lower abdomen. At the beginning of kidney stone disease, however, those affected do not feel any symptoms, since the kidney stones are usually still small.
What are kidney stones?
Kidney stones are solid structures that form in kidney stone disease (nephrolithiasis) in the kidneys and in the urinary tract (urinary bladder, ureter). Most kidney stones are composed of calcium salts, but they can also be composed of uric acid, cystine or magnesium ammonium phosphate. See etaizhou for What does Clitoral Hypertrophy Mean.
The peak incidence is in adults aged 30 to 60 years. It affects men about twice as often as women. The size of the kidney stones formed can vary greatly. It ranges from a few millimeters (about the size of a grain of rice) to many centimeters (so-called renal pelvis stones, which can completely fill the renal pelvis). In about 80% of the cases, these deposits occur on one side.
Kidney stones form due to an increased concentration of certain substances in the urine. There are many causes for this, ranging from nutritional factors and insufficient fluid intake to a lack of exercise to certain metabolic diseases and genetic factors. For the majority of those affected by kidney stones, the causes remain unexplained.
The substances that contribute to the formation of kidney stones are components of the urine, which are normally dissolved and excreted through the kidneys. These substances include calcium, phosphate, uric acid, cystine and oxalate. When they are so abundant in the urine and can no longer dissolve, they crystallize out. With a corresponding concentration of urine, new layers of material accumulate on the crystals that have formed, so that ever-growing onion-skin-like kidney stones form.
Symptoms, Ailments & Signs
Kidney stones are a disease of the kidneys, which is associated with typical and fairly clear symptoms. In the early stages, no pain or signs are noticeable because the kidney stones are simply too small. However, if they increase in size and weight, then the first pain in the groin area can be expected.
There are also occasional cramps in the lower abdomen. Another symptom that can occur is pain and a burning sensation when urinating. This symptom occurs in both men and women. Another and at the same time very typical symptom associated with kidney stones is severe nausea. At the same time, the nausea triggers a general feeling of discomfort and loss of appetite, so that those affected are significantly restricted in their everyday life.
Anyone who leaves existing kidney stones without any treatment must expect a significant worsening of the symptoms that occur. Rapid recovery and healing can only be achieved if the affected person consults a doctor immediately. Otherwise, especially the pain when urinating will increase.
course of the disease
If kidney stones are treated nowadays, a favorable course can almost always be expected. Depending on the treatment method, the affected person is usually relieved of the symptoms after a short time. Nevertheless, complications can also arise if, for example, the kidney stones block the urinary tract and the urine cannot be excreted. As a result, bacteria can more easily penetrate the renal pelvis and cause inflammation.
If the kidney stones are not treated at all, the typical pain when urinating becomes worse and worse. Other symptoms such as severe back pain, fever and chills can also occur. In rare cases it can even lead to a complete failure of the kidneys. The resulting blood poisoning can then lead to life-threatening symptoms.
Due to a favorable course, complications from kidney stones rarely occur. More than 80 percent of stones are excreted from the body with the urine. How long this process takes depends on the extent of the kidney stones. Nevertheless, consequences are possible if the drainage of the urine is impeded by the stones.
One of the most unpleasant complications of kidney stones is renal colic. It becomes noticeable through the sudden onset of severe pain, which manifests itself as seizures and spasms. They are localized in the kidney area, but they can also radiate to the groin, thighs or genitals. Many sufferers also experience restlessness, anxiety, nausea and vomiting.
Renal colic can last from a few minutes to several hours. Medical therapy is required to prevent permanent damage to the kidneys and urinary tract. If the urinary tract is blocked by kidney stones, pathogens such as bacteria can penetrate the organism more easily and cause urinary tract infections such as urocystitis.
It is not uncommon for the kidneys to be affected by interstitial nephritis. The affected people suffer from urinary problems, fever, chills and severe back pain in the kidney region. A feared complication of kidney stones is urosepsis. It occurs when bacteria are washed into the bloodstream. It can sometimes take on life-threatening proportions.
Treatment & Therapy
Appropriate pain therapy and the elimination of any urinary obstruction are particularly helpful against acute renal colic and kidney stones. Most kidney stones pass by themselves with the urine. The person affected can probably support such a spontaneous passage of the stones themselves by drinking plenty of fluids, taking antispasmodic medication and moving around a lot. If the spontaneous passage is not the case, the kidney stone can be removed in different ways.
In extracorporeal shock wave lithotripsy (ESWL), the doctor breaks up the kidney stones from the outside using shock wave therapy under ultrasound or X-ray control. The resulting quarry pieces then usually go away on their own in the urine over the next 3 months.
Percutaneous nephrolitholapaxy (PCNL) is used primarily for larger stones. An endoscope is inserted through a tiny incision in the skin, through which the stone is then broken up and removed.
The snare extraction is only used for kidney stones located in the lower third of the ureter. The doctor uses a cystoscopy to insert a special snare into the ureter, which is used to pull out the kidney stone.
Nowadays, kidney stones are only removed surgically (through a laparoscopy or open surgery) in less than 5% of those affected.
Some kidney stones (uric acid and cystine stones) can possibly be dissolved by drug therapy (so-called chemolitholysis). In addition, the uric acid level can be lowered with the help of the drug allopurinol.
Outlook & Forecast
Kidney stones offer a variable prognosis. Four-fifths of all kidney stones pass by themselves in the urine without any further action being taken. After the kidney stones have passed, the patients are usually symptom-free and do not require any further medical examination or treatment.
However, kidney stones can also cause serious complications. As a result of kidney stones, for example, blood poisoning in the area of the urinary tract, narrowing of the urinary tract or severe inflammation of the renal pelvis can develop. In the worst case, the kidney stones trigger acute kidney failure. In about 50 percent of cases, kidney stones reappear after successful treatment. Comprehensive preventive care reduces the relapse rate and thereby improves the prospect of a symptom-free life. The specialist provides the prognosis for kidney stones.
The size and number of kidney stones must be taken into account. In addition, any concomitant diseases and the general state of health of the patient are part of the prognosis. The doctor evaluates the course of the disease in terms of kidney health and the preventive measures that the patient is taking. As a rule, the prognosis is adjusted as part of the regular check-ups that have to be carried out after a disease with kidney stones.
One of the most important preventive measures against kidney stones is first and foremost adequate fluid intake (about 3 liters a day). This dilutes the urine and prevents it from being oversaturated with stone-forming substances. Drinking should be evenly distributed throughout the day, because the concentration of stone-forming substances can also be increased at night.
The risk of kidney stones can also be reduced by regular exercise, preventing obesity or by shedding excess pounds. The positive effects are supported thanks to a balanced and high-fiber diet.
Since new kidney stones often form again, this cycle must be analyzed individually and, above all, broken. To prevent stones from forming again, the risk should be significantly reduced, primarily by changing your drinking and eating habits. The amount of fluid the affected person drinks should allow the body to produce at least two liters of urine.
In addition, a balanced diet, reducing excess weight, moderate physical exercise and, above all, drinking enough and regularly is recommended. Affected people should prefer fruit and vegetables in their diet, citrus fruits in particular are considered helpful. Patients should also avoid oxalate-rich foods such as spinach, rhubarb, coffee, black tea, chocolate, cola, and nuts.
Adequate calcium intake should also be ensured. Whereas the amount of salt in the diet should be significantly reduced. The consumption of animal proteins should also be reduced. A qualitative urinary stone analysis is recommended as a diagnostic measure after the removal of the kidney stones.
Patients are recommended to drink an increased amount of four to six liters per day and night. The goal is a light urine color. In addition, supplemental medication is usually necessary.
When should you go to the doctor?
Kidney stones may be the cause if you notice kidney pain, reddish urine or reduced urinary flow. A doctor should be consulted if the symptoms persist for a long period of time or are associated with serious symptoms. If you have blood in your urine or urinary retention, seek medical advice. Severe pain that impairs well-being also requires clarification by a doctor. If the disease is not treated, it can lead to serious complications, such as urethral injuries or infections. Therefore, an appointment with the family doctor should be made at the latest when stabbing pain occurs. People who already suffer from chronic kidney disease are best advised to speak to the responsible personinternists.
Patients at risk, such as people who lead an unhealthy lifestyle and eat a particularly high-fat diet, should speak to a nutritionist in addition to symptomatic treatment. If the symptoms do not improve despite taking medication and other remedies, it is best to see a urologist. Then a special colic medication can be prescribed, which dissolves the kidney stones. In addition to the urologist, a nephrologist or a gastroenterologist can be consulted. Women consult a gynecologist if they suspect kidney stones. Children should first see a pediatrician if they have the symptoms mentionedbe gone who can clarify the symptoms and initiate treatment.
You can do that yourself
If the diagnosis is “kidney stones”, the size and location of the stones are important in terms of healing. If it is small stones or kidney gravel, herbal preparations can be helpful. A lot of water, bladder and kidney teas or teas from herbal preparations such as dandelion or restharrow root with a diuretic effect in connection with a lot of exercise can already cause the stones or kidney gravel to pass. At rest, heat is helpful. The doctor will prescribe medication if necessary.
To check the success, urination through a fine sieve is recommended. The result can be shown to the treating doctor at the next visit. If a kidney stone does not dissolve, the urinary tract is blocked and an infection develops, the doctor will decide how the kidney stone is to be removed. In 90 percent of cases, kidney stones are shattered and pass out of the urinary tract with the urine. In stubborn cases, the stone is removed with a small operation.
In order to counteract the formation of new kidney stones, it is still important to drink a lot, i.e. at least 2.5 to 3 liters per day. Lots of exercise and a healthy diet definitely help. The doctor or a nutritionist will know which foods should be avoided to avoid recurrence of the disease.