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Kidney Stones गुर्दे  की  पथरी 

- By Dr Vikas Singh,
M.B.B.S., M.S., M.Ch.
Urologist, Genito Uro Oncologist and Kidney Transplant Surgeon,
Kokilaben Dhirubhai Ambani Hospital, Indore.

"Kidney stones are a reminder that even the strongest of us can be brought down by something small and sharp."



  Renal stones, also known as kidney stones, are a common medical condition affecting millions of people worldwide. The condition is characterized by the formation of solid masses or crystals within the kidney, bladder, or urinary tract. Kidney stones can cause severe pain and discomfort, and may even lead to complications such as kidney damage or infection. Understanding the causes of renal stones is crucial for prevention and treatment. In this article, we'll answer some common questions about the causes of renal stones.

 

What are renal stones, and how are they formed?

  Renal stones are hard, crystalline deposits that form in the kidneys or urinary tract. They can vary in size and shape and can cause severe pain when they pass through the urinary tract. Renal stones are formed when certain substances, such as calcium, oxalate, or uric acid, become concentrated in the urine and crystallize.

 

What are the common causes of renal stones?

  There are several factors that can increase the risk of developing renal stones. These include:

Dehydration: Not drinking enough water can cause urine to become concentrated, leading to the formation of stones.

Diet: A diet high in sodium, sugar, and animal protein can increase the risk of developing renal stones. Foods high in oxalate, such as spinach and chocolate, can also contribute to the formation of stones.

Family history: People with a family history of renal stones are more likely to develop the condition.

Medical conditions: Certain medical conditions, such as hyperparathyroidism, cystinuria, and renal tubular acidosis, can increase the risk of developing renal stones.

Medications: Some medications, such as diuretics and antacids containing calcium, can increase the risk of developing renal stones.

Structural abnormalities: Blockages or abnormalities in the urinary tract can prevent the normal flow of urine, leading to an increased risk of kidney stones.

 It's important to note that kidney stones can have multiple causes, and often, a combination of factors can contribute to their formation.

 

How does dehydration contribute to the formation of renal stones?

  Dehydration is a significant risk factor for renal stone formation. When there isn't enough water in the body, urine becomes concentrated and minerals and other substances in the urine can crystallize, leading to the formation of stones. Drinking plenty of water can help dilute urine and reduce the risk of stone formation.

 

How does diet contribute to the formation of renal stones?

  A diet high in sodium, sugar, and animal protein can increase the risk of developing renal stones. Sodium can increase calcium excretion in the urine, while animal protein can increase uric acid excretion, both of which can contribute to stone formation. Foods high in oxalate, such as spinach and chocolate, can also contribute to the formation of stones.

 

What medical conditions can increase the risk of developing renal stones?

  Several medical conditions can increase the risk of developing renal stones. These include:

Hyperparathyroidism: This condition causes the parathyroid glands to produce too much parathyroid hormone, leading to an increase in calcium in the blood and urine.

Cystinuria: This genetic disorder causes the kidneys to excrete too much cystine, an amino acid that can form crystals in the urine.

Renal tubular acidosis: This condition causes the kidneys to excrete too much acid, leading to the formation of stones.

Gout: This condition causes an excess of uric acid in the blood, which can lead to the formation of uric acid stones

 

How can medications contribute to the formation of renal stones?

  Some medications can increase the risk of developing renal stones. For example, diuretics can cause dehydration, which can lead to the formation of stones. Antacids containing calcium can increase the amount of calcium in the urine, which can contribute to stone formation.

 

How can renal stones be prevented?

Fortunately, there are several ways to prevent the formation of kidney stones.

Drinking plenty of water is one of the most effective ways to prevent kidney stones. Staying hydrated helps to dilute the urine, which reduces the concentration of minerals that can form stones.

Reducing your intake of salt and animal protein can also help prevent kidney stones. These foods increase the levels of calcium and uric acid in the urine, which can lead to stone formation.

Eating a diet rich in fruits and vegetables can also be beneficial in preventing kidney stones. These foods contain potassium, magnesium, and other essential nutrients that help to keep the urinary system healthy.

In summary, preventing kidney stones requires a combination of lifestyle changes, including drinking plenty of water, reducing salt and animal protein intake, and eating a healthy diet rich in fruits and vegetables

 

What are the surgical treatment options for kidney stones?

While small kidney stones may pass on their own, larger ones may require surgical intervention to remove them. In this article, we will explore the various surgical treatment options available for kidney stones.

 

RIRS (Retrograde IntraRenal Surgery)

RIRS laser surgery, also known as Retrograde IntraRenal Surgery, is a minimally invasive procedure used to treat kidney stones. This procedure uses a small laser fiber to break up the stones inside the kidney, which are then removed through a small tube inserted through the urethra. Compared to traditional surgery, RIRS laser surgery has many advantages, including a shorter recovery time and fewer complications.

One of the key benefits of RIRS laser surgery is its minimally invasive nature. Because the procedure is performed through the natural openings of the body, there are no incisions or cuts, which means less pain and scarring. Additionally, because the procedure is performed under anesthesia, patients are able to return home the same day and resume normal activities within a few days.

Another advantage of RIRS laser surgery is its high success rate. The laser fiber used in the procedure is able to break up even the hardest kidney stones, allowing for their removal without causing damage to surrounding tissues. This means that patients can expect to experience fewer complications and a lower risk of recurrence.

If you are experiencing kidney stones, RIRS laser surgery may be an excellent option for you. This minimally invasive procedure offers a safe and effective way to remove kidney stones while minimizing pain and discomfort. To learn more about RIRS laser surgery, speak with your healthcare provider today.

 

Ureteroscopy

Ureteroscopy is a minimally invasive procedure that involves inserting a thin, flexible instrument called a ureteroscope into the ureter to locate and remove the kidney stones. The procedure is performed under general anesthesia or local anesthesia with sedation and is often done on an outpatient basis.

During the procedure, the ureteroscope is passed through the urethra and into the bladder and ureter. The surgeon then uses small instruments to break up and remove the stones. Ureteroscopy is most effective for stones that are located in the ureter or near the bladder.

 

Percutaneous Nephrolithotomy (PCNL)

PCNL is a minimally invasive surgical procedure that involves making a small incision in the back to access the kidney and remove the stones. The procedure is performed under general anesthesia and is most effective for larger stones that cannot be treated with ESWL or ureteroscopy.

During the procedure, a thin tube called a nephroscope is inserted through the incision and into the kidney. The surgeon then uses small instruments to break up and remove the stones. PCNL may require a short hospital stay and recovery time, and patients may experience some discomfort after the procedure.

 

Open Surgery

Open surgery is a traditional surgical procedure that involves making a large incision in the abdomen or back to access the kidney and remove the stones. The procedure is performed under general anesthesia and is often reserved for complex cases where other surgical treatments have failed.

Open surgery is more invasive than other surgical procedures and may require a longer hospital stay and recovery time. Patients may also experience more discomfort after the procedure.

 

Extracorporeal Shock Wave Lithotripsy (ESWL)

ESWL is a non-invasive procedure that uses shock waves to break up kidney stones into smaller pieces, making them easier to pass through the urinary tract. The procedure is performed under anesthesia and involves placing a specialized machine over the patient's kidney area. The machine generates shock waves that pass through the skin and break up the stones.

ESWL is most effective for stones that are less than 2cm in size and located in the kidney or upper ureter. However, it may not be suitable for patients who are pregnant, have bleeding disorders, or are taking blood-thinning medications.

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