Kidney Stones (renal calculi)

Kidney stones are masses of solid material, the vast majority of which form and enlarge within the kidney pelvis, while about two percent develop within the tubules of the kidneys. The common stones are composed of calcium oxalate ,uric acid, and cystine-precipitates of chemicals normally held in solution. They occur more frequently in some families and in certain geographic areas.

Certain factors appear to trigger stones formation, including infections of the kidney; obstructions to the flow of urine due to acquired or inherited defects; metabolic/ disorders such as gout (increase in uric acid), hyperthyroidism  (increase in blood calcium levels), and excessive absorption of oxalate;dietary imbalances (diets high in protein increase excretion of calcium, phosphorous, and uric acid); and not drinking enough water.
 Some stones remain in the kidney for long periods without causing symptoms. Usually, however, discomfort ranges from a dull ache in the lower back to extremely severe  colicky pain,which comes and goes in waves. Spasm of the ureter muscles causes the pain. As the stones moves down toward the bladder, the pain shifts to the flank, lower abdomen, and then the groin. As the stone passes into the bladder, the pain is relieved. Injury from the stone may cause blood in the urine.

 The presence and the location of the stone can be determined by means of an X-rays or by X-rays using a dye which is infected into the blood and excreted in the urine (intravenous pyelogram).

What you can do. You should be under the care of your physician. However, you can do a number of things yourself. Drink large quantities of water (enough to produce 4 quarts or four liters of urine per twenty four hours).This may help to flush out a stone, keep it for enlarging, and help prevent the formation of the new stones. A low salt intake, and a diet with 30 to 40 grams of protein per day will not only reduce the workload of the kidneys, but also decrease the excretion of wastes which tend to form stones.

What your physician can do. By periodic examinations he can advice as to whether stones are growing or forming. Should you have high levels of uric acid, he may prescribe medications, together with a chance of diet, to help correct this situation. The problem of a stone which fails to pass or which blocks urine flow require treatment.
 A stone low down in the ureter can be removed through the bladder.

Stones higher up can now be reached using a tube inserted in the side. If not removed the stone can be electrically fragmented and then extracted. Direct surgical removal may be necessary. However, some institutions have an ultrasonic shock wave machine (lithotriptor) which can shatter the stone by directing the shock waves from outside the body.