KIDNEY STONE DISEASE

What is it?

Kidney stones are a common disease affecting 1 in 10 Australian men and 1 in 35 women over their lifetime. 

The composition of stones vary as do their shapes and sizes. Most stones are formed from Calcium compounds and can be related to diet or fluid intake. Others, such as uric acid stones can occur in people who also suffer from gout or high protein diets. Some genetic disorders can also produce stones such as cystinuria.

Unfortunately, once a person forms a kidney stone, they are twice as likely to form another one in the next 5 years.

CAUSES

Kidney stones result from crystallisation of saturated mineral compounds in urine. These start out no larger than a grain of sand and grow over time to sometimes occupying the entire kidney collecting system.

Risk factors for developing kidney stones include:

  • Dehydration

  • Dietary imbalances

  • Genetic disorders

  • Electrolyte disorders

  • Previous surgery

  • Diabetes

  • Obesity

  • Gout

SYMPTOMS

Uncomplicated stones can reside in the kidney without any symptoms or signs.

However, if a stone migrates into the ureter and causes obstruction, even the smallest stone can cause extreme pain (Renal Colic). This is often a medical emergency and requires urgent care. If there is also an infection of urine at the time of obstruction, it can evolve into a life threatening condition if not treated. Your doctor should be notified of any fevers, sweats, shakes, nausea, vomiting or blood in the urine (haematuria).

TREATMENT

Small stones can often pass out with time. Pain killers may be needed along with medication to relax the ureters.

Other cases may require ureteroscopy, fragmentation and extraction of the stone. This involves the insertion of a fine camera into the ureter and using a laser to vaporise the stone into dust or breaking it down into smaller pieces for removal with a specialised basket. This surgery is performed under general anaesthetic and does not involve any incisions to the skin. Most patients can go home the same day.

Extracorporeal Shock Wave Lithotripsy (ESWL) uses shock waves to break up the stone into pieces small enough for self passage. This is a non invasive procedure which has excellent outcomes in certain stones.

Percutaneous Nephrolithtomy (PCNL) involves direct access into the kidney via a puncture in the skin. A telescope is then inserted into the kidney to break up and extract the stone(s). While it is a more "invasive" technique, it allows for the clearance of larger stone burden in a single procedure. 

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