Kidney Stones: Everything You Need to Know About Early Symptoms and Formation

Kidney stones are small, hard deposits that form in the kidneys when urine contains a high concentration of minerals and substances like calcium, oxalate, and uric acid. These crystals come together to create stones, potentially causing significant pain and discomfort. This comprehensive guide will delve into the reasons behind kidney stone formation, the different types, signs and symptoms of kidney stones, and what actions to take if you suspect you have kidney stones.

Why are Kidney Stones Formed?

Kidney stones form when urine includes a high concentration of minerals such as calcium, oxalate, and uric acid. Eventually, these substances combine to create crystals that adhere together and become stones. The factors that lead to the production of stones are inadequate fluid intake and a deficiency of other chemicals in the urine that inhibit crystal formation. Some stones are so small that they will go unnoticed, but larger ones can block the urine's passage and cause terrible pain that some have comparable to childbirth.

Several factors contribute to an increased probability of developing kidney stones, including:

• Family or Personal History: The likelihood of developing kidney stones rises if there is a familial history of these formations. Additionally, individuals with a previous history of kidney stones face an elevated risk of recurrence.
• Dehydration: A substantial risk factor for kidney stones is inadequate daily water intake. Those living in warm, dry climates and individuals prone to excessive sweating are especially vulnerable.
• Dietary Patterns: Notably, an excessive intake of sodium amplifies the filtration of calcium by the kidneys, significantly increasing the risk of stone formation.
• Digestive Diseases and Surgery: Conditions such as gastric bypass surgery, inflammatory bowel disease, or chronic diarrhoea can disrupt digestive processes, influencing the absorption of calcium and water. This disruption leads to an elevated presence of substances conducive to stone formation in urine.
• Supplements and Medications: Specific supplements such as vitamin C, dietary supplements, laxatives (when excessively used), calcium-based antacids, and certain medications employed in the treatment of migraines or depression can also contribute to an increased risk of kidney stones.

Types of Kidney Stones

Understanding the type of kidney stone is crucial for determining its cause and implementing preventive measures. The primary types of kidney stones are:

Calcium Stones:

• Calcium Oxalate Stones: Formed when oxalate, a substance produced by the liver and found in certain foods, combines with calcium. High oxalate foods include fruits, vegetables, nuts, and chocolate.
• Calcium Phosphate Stones: More prevalent in individuals with metabolic conditions or those taking medications for migraines or seizures.

Struvite Stones: Develop as a result of urinary tract infections (UTIs) where bacteria produce ammonia, leading to stone formation. Struvite stones can multiply.

Uric Acid Stones: Form in individuals experiencing chronic fluid loss due to conditions like diarrhoea or malabsorption, those with a high-purine diet, or individuals with diabetes or metabolic syndrome. Genetic factors may also contribute to uric acid stone formation.

Cystine Stones: A rare type resulting from an excess leakage of the amino acid cysteine into the urine. This condition is associated with a genetic disorder called cystinuria.

Early Signs and Symptoms of Kidney Stones

Recognising the symptoms of kidney stones is crucial for timely intervention. Here are signs to be aware of:

• Pain in the Back, Belly, or Side: Kidney stone pain, known as renal colic, is excruciating and often compared to childbirth or being stabbed with a knife. The pain typically initiates when the stone moves into the narrow ureter, causing a blockage and building pressure in the kidney. Pain is felt along the side and back, below the ribs, and may radiate to the belly and groin as the stone progresses through the urinary tract.
• Pain or Burning During Urination: These occur when the stone reaches the junction between the ureter and bladder. This symptom, known as dysuria, can be sharp and might be mistaken for a urinary tract infection (UTI).
• Urgent Need to Urinate: The stone moving into the lower urinary tract can lead to a sudden and frequent urge to urinate. This urgency may mimic UTI symptoms, compelling individuals to run to the bathroom frequently.
• Blood in the Urine: Hematuria, or blood in the urine, is a common symptom of kidney stones. The colour of blood can range from red to brown, and even microscopic hematuria can be detected through urine testing.
• Cloudy or Smelly Urine: Cloudy or foul-smelling urine may indicate an infection in the kidneys or urinary tract. Research suggests a correlation between acute kidney stones and urinary tract infections.
• Going a Small Amount at a Time: Large kidney stones can obstruct the ureter, leading to reduced urine flow. In severe cases, urination might stop entirely, requiring immediate medical attention.
• Nausea and Vomiting: These are common symptoms, often triggered by the shared nerve connections between the kidneys and the gastrointestinal tract.

What to Do If You Have Symptoms of Kidney Stones?

If you experience signs and symptoms of kidney stones, it is imperative to seek medical attention promptly. Contact your doctor if you:

• Experience severe pain that disrupts your comfort.
• Have symptoms like nausea, vomiting, fever, chills, or blood in your urine.
• Encounter difficulty in urination.

If your doctor suspects kidney stones, various diagnostic kidney stone tests and procedures may be recommended, including:

• Blood Testing: Blood tests can reveal abnormal levels of calcium or uric acid, providing insights into kidney health and potential underlying conditions.
• Urine Testing: A 24-hour urine collection test can identify imbalances in stone-forming minerals or stone-preventing substances.
• Imaging: Imaging tests such as CT scans or ultrasounds can visualise kidney stones in the urinary tract.
• Analysis of Passed Stones: Urinating through a filter can help collect passed stones for lab analysis, aiding in understanding the composition and cause of kidney stones.

Kidney stone treatment varies based on the stone type and its underlying cause.

Small Stones with Minimal Symptoms:

• Drinking ample water helps keep urine dilute, preventing stone formation.
• Pain relievers like ibuprofen or naproxen sodium may be recommended as a cure for kidney stone symptoms.
• Medical therapy with alpha-blockers can facilitate the passage of kidney stones.

Large Stones or Those Causing Symptoms:

• Extracorporeal shock wave lithotripsy (ESWL) uses sound waves to break up stones.
• Percutaneous nephrolithotomy involves surgically removing large stones.
• Ureteroscopy may be used to remove smaller stones in the ureter or kidney.

Parathyroid Gland Surgery:

• In cases of calcium phosphate stones due to overactive parathyroid glands, surgery may be recommended to remove the growth-causing hormone imbalance.

Preventing kidney stones involves lifestyle changes and medications.

• Lifestyle Changes: Adequate fluid intake, measured by clear or nearly clear urine. Restricting oxalate-rich foods and maintaining a low-salt, low-animal protein diet.
• Medications: Thiazide diuretics or phosphate-containing preparations may be prescribed medicine to break up kidney stones. Allopurinol can lower uric acid levels for those prone to uric acid stones.

Conclusion

Understanding the early signs and symptoms of kidney stones is crucial for prompt diagnosis and effective management. If you suspect kidney stones, seek medical attention promptly to undergo a diagnostic kidney stone test and receive appropriate treatment. Lifestyle changes and medications can be pivotal in preventing recurrent kidney stones and enhancing overall kidney health and well-being.