Kidney stones: causes, symptoms, and treatments

We are talking about a painful condition marked by the formation of small stones that obstruct the urinary system. Popularly known as a kidney stone, this hardened formation can arise in the kidneys and block another part of the urinary tract. Since the ureter, the channel that carries urine to the bladder, is very narrow, the particle ends up stuck. As a result of the attempt of expulsion, intense pain appears.

The kidneys function as two large blood filters. Besides water to form urine, they retain various elements, such as calcium, uric acid, and oxalate. When these molecules appear in large quantities and there is little liquid to dissolve them, crystals or aggregates appear, which swell up and become stones. Their size varies greatly.

There is also a fourth and rarer type of stone, the struvite. Unlike the others, this one affects mainly women. Its origin is associated with an infection caused by the bacteria Proteus mirabillis, which alters the pH of the urine, facilitating the aggregation of magnesium, phosphate, and ammonia particles.

The formation can reach up to 11 centimeters, occupying the entire space of the kidney. As it is softer, the pee can pass through it and thus there is no pain. This is a danger, because the problem goes unnoticed and is prolonged – and the kidney can end up seriously affected.

Signs and symptoms

  • Cramps that start in the lower back and migrate to other areas
  • Lower abdominal pain
  • Blood in the urine
  • Nausea and vomiting
  • Constant urge to pee

Risk factors

  • Abuse of salt in food
  • Excessive intake of foods rich in calcium and proteins
  • Too little liquid in the diet
  • High temperatures (too much perspiration and lack of adequate hydration make urine more concentrated, increasing the agglomeration of particles)
  • Obesity
  • Hypertension
  • Genetic predisposition

Diet is a preponderant factor in controlling the problem. To avoid salt crystallization, the body needs water, so one of the first rules is to drink plenty of liquids. One way to check if the amount is sufficient is to pay attention to the color of the pee, which should be clear – if it is yellowish, it means that it is too concentrated and may lead to the formation of stones.

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Cut back on salt, sausages (such as sausage, salami, and salami), canned food, and instant noodles is another measure that is recommended. Foods with a high oxalate content (spinach, nuts, pepper, and black tea, for example) also require moderation when there is already a propensity to have stones of this type. People with a high concentration of uric acid in their blood should also reduce their intake of beer, red meat, and seafood, since they further increase the rates.

Some experts also recommend caution with calcium supplements. The mineral is important for the body, but supplementation can only be done with a doctor’s recommendation. Otherwise, the overload can result in kidney problems.

The diagnosis
The intense pain caused by stones in general is the starting point for detecting the problem. Very thick, dark urine or with dots of blood is another warning sign. Laboratory tests of the pee analyze the acidity and presence of crystals or infection.

To investigate the type of stone and where it is located, the doctor orders a CT scan. X-ray and ultrasound are other options. Because they are transparent, the stones formed by uric acid do not appear in these exams. The helical tomography is a resource to catch this type of mass. More invasive procedures, excretory urography and intravenous urography are done with an injection of dye to map the area and detect smaller stones and other important alterations in the urinary tract.

The treatment
When it is small, the stone is usually expelled naturally. It is enough to increase the amount of liquid ingested or, if the doctor thinks it is necessary, injected into the vein.

Depending on the size, procedures come into play to fragment the stone and make its elimination possible. One of the options is extracorporeal lithotripsy, the least aggressive to the body. In this procedure, electromagnetic waves destroy the solid material.

In the traditional percutaneous technique, an incision is made in the patient’s back and a device penetrates the skin until it reaches the kidney to remove the calculus. The procedure requires up to five days of hospitalization for recovery.

Today a simpler technique, called flexible uretero-nephrolithotripsy, detonates the hard formations with the laser of a device introduced through the urethra. With this method, however, sometimes one attempt is insufficient. Then it is necessary to repeat it every two weeks, for up to four sessions, always under general anesthesia. The post-operative period is worthwhile, because the person is discharged on the same day.

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