Forbes India 30 Under 30 2023

Kidney stones

Dr. Ratan Jha, DM, DNB, MD, DTCD (Gold Medalist), FISN, Sr. Consultant Nephrologist & Renal Transplant Physician, Specialist in Dialysis and Hypertension Care Hospital, Banjarahills, Hyderabad, Telangana, India

BRAND CONNECT
Published: Nov 11, 2022 10:41:46 AM IST
Updated: Nov 22, 2022 11:08:32 AM IST

Kidney stones
A kidney stone is a solid, pebble-like piece of material that can form in one or both of your kidneys when high levels of certain minerals are in your urine. Researchers have concluded that about one in ten people will get a kidney stone during their lifetime. Kidney stones in children are far less common than in adults but they occur for the same reasons. They’re four times more likely to occur in children with asthma than in children who don’t have asthma. Kidney stones rarely cause permanent damage if treated by a healthcare professional.

Causes
Kidney stones often have no definite, single cause, although several factors may increase your risk. Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate, and uric acid — than the fluid in your urine can dilute. At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.

Symptoms
Pain in your back or side, blood in your urine, and nausea/vomiting alongside the pain are symptoms of a kidney stone or stones.  You can have a stone in your kidney for years and not know it’s there. But, when it starts to move or becomes very large, you may have symptoms.


Symptoms of a kidney stone include:

  • Feeling pain in your lower back or side of your body. This pain can start as a dull ache that may come and go. It can also become severe and result in a trip to the emergency room.
  • Having nausea and/or vomiting with the pain.
  • Seeing blood in your urine.
  • Feeling pain when urinating.
  • Being unable to urinate.
  • Feeling the need to urinate more often.
  • Fever or chills.
  • Having urine that smells bad or looks cloudy.

Risk Factors

  • There are several risk factors for developing kidney stones. These include:
  • Not drinking enough liquids.
  • Having a diet that includes the substances that form the stones (phosphate, for example, is in meat, fish, beans, and other protein-rich foods).
  • Having a family history of kidney stones.
  • Having a blockage in your urinary tract.

Certain foods can also place you at risk of a kidney stone. These foods include:

  • Meats and poultry (animal proteins).
  • Sodium (diets high in salt).
  • Sugars (fructose, sucrose and corn syrup).

Diagnosis
Your healthcare provider will discuss your medical history and possibly order some tests. These tests include:

  • Imaging tests: An X-ray, CT scan and ultrasound will help your healthcare provider see the size, shape, location and number of your kidney stones. These tests help your provider decide what treatment you need.
  • Blood test: A blood test will reveal how well your kidneys are functioning, check for infection and look for biochemical problems that may lead to kidney stones.
  • Urine test: This test also looks for signs of infection and examines the levels of the substances that form kidney stones.

Prevention
Once diagnosed, your healthcare provider will first determine if you even need treatment. Some smaller kidney stones may leave your system when you urinate. This can be very painful. If your provider decides that you do need treatment, your options include medications and surgery.


Medications: Medications may be prescribed to:

  • Decrease pain: Your healthcare provider may recommend that you take an over-the-counter medication like ibuprofen.
  • Manage nausea/vomiting
  • Relax your ureter so that the stones pass: Commonly prescribed medicines include Tamsulosin and Nifedipine.

Surgery: There are four types of surgeries used to treat kidney stones.

  • Ureteroscopy: To perform this procedure, a small instrument called an ureteroscope is inserted in your urethra, through your bladder and into a ureter. This instrument shows the kidney stones and then retrieves them in a surgical “basket,” or breaks them apart using a laser.
  • Shockwave lithotripsy: In this procedure, you’re placed on a special type of surgical table or tub. High-energy shockwaves are sent through water to the stone(s). The shockwaves break apart the stones, which are then more easily able to exit your body.
  • Percutaneous nephrolithotomy: When kidney stones can’t be treated by the other procedures — either because there are too many stones, the stones is too large or heavy or because of their location — percutaneous nephrolithotomy is considered. In this procedure, a tube is inserted directly into your kidney through a small incision in your back. Stones are then disintegrated by an ultrasound probe and suctioned out so that you don’t have to pass any fragments. A urethral stent is placed after the procedure (an internal tube from the kidney to the bladder which is removed one week later).
  • Open stone surgery: A longer cut is used during this surgery. Compared to minimally invasive procedures, it’s rarely performed (0.3% to 0.7% of cases).

There are several ways to decrease your risk of kidney stones, including:

  • Drink water. Drink at least six to eight 8-ounce glasses every day (about 64 ounces). Staying hydrated helps you urinate more often, which helps “flush away” the buildup of the substances that cause kidney stones. If you sweat a lot, be sure to drink even more.
  • Limit salt: Eat less sodium. You may want to connect with a dietician for help with planning what foods you eat.

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