Doctor's Notes on Kidney Stones In Children an Adults
When crystals form in the urinary tract, they begin as very tiny objects smaller than a grain of sand, but over time, they can become quite large (a 5-millimeter stone can block urine flow) as they accumulate layers of crystals within the kidney, pelvis, and/or ureters. These large crystals are termed kidney stones and produce symptoms and signs when they begin to obstruct the lumen that passes urine and begins at the kidney and continues down to the bladder with the ureters. Many people have kidney stones but have no realization they do until the kidney stone begins to block urine flow from the kidneys to the bladder. The main symptom of kidney stones is pain that can often be severe. Urine flow can be diminished or stopped by the kidney stone. This causes the urine to put pressure on the kidney, which may swell and cause back and/or flank pain, usually on the right or left side of the body. The pain may radiate to the groin. Waves of pain can occur as the body tries to dislodge the obstructing kidney stones. These waves cause intense pain and are termed renal colic; the waves may wax and wane, but there remains a background level of pain until the stone is passed into the bladder or is destroyed surgically. The patient cannot be comfortable until the obstructing stone is treated or the body is successful in pushing it into the bladder.
Other signs and symptoms that may accompany renal colic pain from kidney stones are
Currently, there is no medical agreement as to what causes kidney stones. Theories range from genetics, heredity, and dehydration to diets high in protein, salt, vitamins, and calcium. Medications and certain diseases may increase the risk of kidney stone formation, but there is no compelling information about a true cause for stone formation.
What Are the Treatments for Kidney Stones?
Treatment of kidney stones varies with the cause and type of stone:
- Minimal symptoms caused by small (less than about 4-5 mm) stones
- More severe symptoms due to large kidney stones (greater than about 5-10 mm)
unable to be passed (about a 50% chance to pass)
- Lithotripsy: sound waves break up large stones
- Nephrolithotomy: surgical removal of stone by instruments inserted into the kidney
- Ureteroscope: mechanical removal of stones with scope from kidney or ureters
- Parathyroid surgery: sometimes done to reduce or stop calcium phosphate stones from forming
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.