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Kidney Stone Disease

Kidney Stones

There are a variety of types of kidney stone, and are far more common than most people would think. It’s estimated that nearly one in ten people in the UAE will have a kidney stone at some stage in their life.

What causes kidney stones?
Urine contains a variety of minerals including calcium, oxalate and uric acid. If your urine contains more of these substances than your urine can dilute, stones can form. When the stones are less than 0.1 inch (3mm), they can generally be passed in the urine, and there are no symptoms.

Types of kidney stones

The most common kidney stones are calcium stones. Generally, they are calcium oxalate, but can also be calcium phosphate. Oxalate is formed in the liver, and is present in fruits, nuts and chocolate. A range of factors can increase your body’s concentration of oxalate, providing conditions for stones to form.
Uric acid stones can form when you don’t drink enough fluids; have high protein diets, suffer from gout, or possibly from genetic causes.
Strusive stones can form and grow quickly, with little warning, and can form following infections (e.g. urinary tract infections).
There are some other, rare stones such as cystine stones, which are caused by genetic factors (where people excrete too much cystinuria, a form of amino acid).

Signs and Symptoms

Kidney stones can be incredibly painful. Renal colic is caused by the stone blocking the ureter. Pain radiates from the groin to the lower back, and comes in waves that can last between 20 and 60 minutes.
There will also be pain when urinating. Urine may be discolored (brown, pink or red) or cloudy, and smell bad. Some people experience a persistent need to urinate, urinate more frequently than usual, and only pass small amounts of urine. For some, nausea and vomiting are also symptoms.

Diagnosis and Investigation
Doctors will organize tests if they suspect kidney stones. Tests include blood (to measure calcium or uric acid); urine (where tests will identify low levels of stone-forming minerals); X-rays (after a dye is injected), CT imaging; and testing of any small stones that you pass.

Treatment Options
For many kidney stones, treatment can be simple as drinking lots and lots of water to help flush out the urinary system. If you’re likely to pass a small stone, we recommend taking pain relief such as ibuprofen or acetaminophen.

When the stone is a little larger, he noted that doctors will prescribe a medication that helps relax the muscles in your ureter, helping the stone to pass more quickly and with less pain.
If the stone can’t be passed, Treatment depends on the type of stone and the severity of your symptoms:

  • Using sound waves to break up stones.
  • Medical therapy
  • Surgery to remove very large stones in the kidney
  • Using a scope to remove stones.
  • Parathyroid gland surgery.

A sound-wave treatment will help create shock waves through your kidney to break up the stone. The treatment is called extracorporeal shock wave lithotripsy (ESWL). This is a little painful so you may need sedation or light anesthesia. Where stones are larger, or where ESWL is not successful, we’ll organize surgery to remove the stone via. This can be through a scope inserted through your ureter, or through keyhole surgery through your back.
For some patients, removing the stone is only part of the issue. People who suffer from overactive parathyroid glands may require the removal of the gland to stop the recurrence of stones.