Kidney Stones

What are Kidney Stones?

Kidney stones are one of the most common disorders of the urinary tract, developed from crystals that separate from the urine and build up on the inner surfaces of the kidney.

If the crystals remain small enough, they travel through the urinary tract and pass out unnoticed. However, if the crystals accumulate and form a large stone, they can impair the function of your kidney, obstruct the flow of urine, and cause pain and discomfort as they travel through the urinary tract.

Generally, There are 4 Types of Kidney Stones

• Calcium: The most common type of kidney stone contains calcium in combination with either oxalate or phosphate. These stones are caused by a high oxalate diet, an inflammatory bowel disease, a calcium disorder like hyperparathyroidism, or various other reasons
• Uric Acid: As a result of high levels of uric acid in the urine, these stones are more likely to form if you’re suffering from conditions like gout or those who consume diets rich in purines.
• Struvite: This type of kidney stones is commonly associated with urinary tract infections (UTIs). Struvite stones can grow rapidly and become quite large, composed of magnesium, ammonium, and phosphate.
• Cystine: While cystine stones are rare, they can be hereditary. Their formation is typically due to an excess of cystine (an amino acid) in the urine, and those who have cystinuria are more prone to developing these types of stones. 

Knowing the type of kidney stones, you have can greatly help you and your doctor determine the best treatment plan for you. By identifying its precise type, you can create accurate kidney stone removal strategies in trusted Philippine facilities.

Who Are at Risk of Kidney Stones?

Several factors contribute to the formation of kidney stones, and these stones are more likely to accumulate and grow if you:

• Regularly consume high amounts of oxalate-rich foods, sodium, and animal proteins.
• Lack water intake—which can lead to concentrated urine that fosters stone development.
• Are constantly exposed to the sun.
• Experience excessive sweating.
• Have a genetic predisposition for kidney stones in your family history.

Kidney stones commonly happen to those in the 30 to 50-year-old age group and are more prevalent in men. And since two of its risk factors are exposure to the heat of the sun and high amounts of sweating, it is more likely to occur during the summer months.

Symptoms of Kidney Stones

Recognizing the symptoms of kidney stones is crucial for prompt intervention and treatment. You should consult a doctor when you have:

• Fever and chills
• Blood in your urine
• Nausea and vomiting
• Urine that smells bad or looks cloudy
• A burning feeling when you urinate or general pain whenever you pee
• Extreme pain on your back or side radiating downward toward the groin

Usually, management options for kidney stones depend on its characteristics. This is determined by several diagnostic procedures such as:

• Urinalysis: Examining a urine sample helps identify the presence of minerals, crystals, or abnormal substances that may contribute to stone formation.
• Complete Blood Count (CBC): This blood test assesses the number of red and white blood cells, providing information about potential infections or conditions affecting blood composition related to kidney stones.
• Ultrasound: This test is often used as an initial screening tool to detect the presence of kidney stones, assess their size and location, and identify any associated blockages.
• X-ray (KUB-IVP): X-rays are used to visualize the urinary tract after injecting a contrast dye into a vein. The contrast dye helps highlight the structures of the urinary system, making it effective in identifying the presence of kidney stones. It's particularly useful for tracking the passage of contrast through the kidneys, ureters, and bladder.
• CT Stonogram: A CT scan provides detailed cross-sectional images of the kidneys and surrounding structures. It’s highly effective in detecting even small kidney stones, offering precise information about their precise location and characteristics. It is particularly useful when other imaging methods do not provide sufficient details.
• Cystoscopy: This procedure involves the insertion of a thin telescope into the bladder through the urethra. While it’s not primarily used for detecting kidney stones, cystoscopy allows direct visualization of the bladder interior. It may be used to identify stones lodged in the bladder or to investigate other urinary tract issues.
• Retrograde Pyelogram: This test is a specialized procedure that allows doctors to see inside the ureters. It involves injecting a contrast dye directly into the ureters to visualize its interiors, helping identify the presence and location of stones. It provides detailed information that can guide surgical or interventional procedures.

These diagnostic tests are selected based on the specific clinical scenario, the suspected presence of kidney stones, and the information needed for accurate diagnosis and treatment planning. The choice of tests depends on factors such as the size of the stones, their location, and the overall health of the urinary system.

If you suspect kidney stones or experience symptoms, consult with a healthcare professional who can recommend the most appropriate diagnostic approach for your specific situation.

Treatments for Kidney Stones in the Philippines

Addressing kidney stones involves a multifaceted approach, depending on their characteristics and the severity of your symptoms. Some of the more common procedures are:

⦁ Expectant Therapy

This treatment involves monitoring and waiting for the stones to pass on their own by drinking plenty of water. This is usually an option if the stone is very small and unlikely to cause complications or discomfort.

⦁ Medications

Certain medicines for kidney stones available in the Philippines can be prescribed by your doctors to manage the specific type of stone or to address underlying conditions contributing to its formation. For instance, your doctor can prescribe alpha-blockers to help relax the muscles of your ureters, potassium citrate to help prevent your kidney stones from growing, or thiazide diuretics to lessen the amount of calcium released in your urine.

⦁ Non-invasive Procedures

These techniques are generally those that don’t require incisions or penetration of your skin. These include methods like extracorporeal shock wave lithotripsy (ESWL), which breaks kidney stones into smaller fragments, making them easier to pass through the urinary tract

⦁ Invasive Procedures

This treatment plan involves direct access to the urinary tract through incisions or instruments and is used for larger or more complex stones. Invasive procedures such as surgery can include:

• Percutaneous Nephrolithotomy: A minimally invasive procedure where a small incision is made in the back, and a nephoscope is inserted directly into the kidney to remove or break up stones.
• Ureteroscopy: Involves the use of a thin, flexible tube with a camera to visualize and remove stones in the ureter or kidney. It is often performed through the urethra.
• Open Surgery: A traditional surgery where doctors make a larger incision to directly access and remove kidney stones. Once the stone is adequately treated and you are feeling well again, a follow-up treatment is still very important. The rationale for your follow-up treatment is based on the high recurrence rate of stones.

What Should You Do If You Have Kidney Stones?

If you’re experiencing kidney stones, it’s important to take proactive steps when you start feeling the symptoms. A few measures you should keep in mind are:

• Seek Medical Attention: Consult with a healthcare professional for an accurate diagnosis and tailored treatment plan.
• Stay Hydrated: Adequate fluid intake is essential for promoting the natural passage of your kidney stones.
• Follow the Treatment Plan: Adhere to your doctor-prescribed medications and dietary recommendations for optimal health results.
• Monitor the Symptoms: Stay vigilant for changes in your symptoms and seek prompt medical attention if there's worsening pain or new concerns.

While kidney stones can be a challenging and painful condition, understanding their types, risk factors, symptoms, and treatment options empowers you to take control of your health. By staying informed and proactive, you can work towards preventing its recurrence for a healthier and more comfortable life.