Kidney Stone Treatment 2023

Kidney stone treatment: Stones are an important kidney disease seen in patients. Stones can cause excruciating pain, urinary tract infections, and kidney damage. So it is necessary to know about stone and its prevention measures, and the native medicine of stone.

Table of Contents

In some patients, stones can lead to urinary tract infection and kidney damage if not treated on time. Once a stone is formed, repeated stones are very common.

How many types of kidney stones are there?

There are four types of kidney stones.

calcium stones
struvite stones
Uric acid stones
cystine stones

1. Calcium stones:- This type of stone is seen in most (about 70-80%) stone patients. The cause of calcium stones is calcium oxalate in more patients and calcium phosphate in fewer patients.

2. Struvite stones: – Struvite (magnesium ammonium phosphate) stones are found in approximately 10-15% of stone patients. These types of stones cause urinary and kidney infections. These gallstones are more common in women.

3. Stones of uric acid (uric acid stones). Uric acid stones are seen in very few (about 5-10%) stone patients. There is a risk of developing this type of stone when the amount of uric acid in the urine is high and the urine is consistently acidic. – Gout (gout), non-vegetarian food, low amount of fluid in the body, and some drugs for cancer (chemotherapy) increase the risk of this type of stone. Uric acid stones are transparent and cannot be seen on X-ray examination.

4. Cystine stones: – This type of stone is found in very small quantities and only in some hereditary cystinuria patients. An excess of cystine in the urine is called cystinuria.

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What is Staghorn (Staghorn Stone)?

This type of stone is a very large struvite type stone. Which is scattered throughout the kidney. Since this stone looks like a deer horn, the name of this stone is stag (stag = deer) horn (horn = stag horn). In most patients, the diagnosis of this type of stone is very late because the pain in this type of stone is very painful. Reduces or does not dissolve. Since the size of this type of stone is large but painless, it can cause serious damage to the kidneys.

What is the stone?

Calcium oxalate or salt particles (Crystals) in the urine combine with each other and form a hard substance in the urinary tract in the long term, which is known as a stone.

How is the stone? What does it look like? Where is it found in the urethra?

Urinary stones come in different sizes, from as small as a grain of sand to as large as a ball. Some stones are round or oval and smooth on the outside. This type of stone is less painful and can easily pass naturally through urine.

Stones are the main cause of red urine with abdominal pain.
Some stones are rough, can be excruciatingly painful, and do not pass easily in the urine.
Stones are mainly found in the kidney, ureter, or bladder and sometimes in the urethra.
Why are stones more common in certain individuals? What are the main causes of stone formation?
In most people, special chemicals in the urine prevent the salt particles from clumping together, so stones don’t form. Some people are more likely to develop stones due to the following reasons:

A habit of drinking less water
Implications for hereditary stones
Diet: Carnivorous (high protein) diet, high in salt and oxalates and low in fruits and potassium in the diet.
The risk of developing stones is much higher in men than in women. 75% of patients with kidney stones and 95% of patients with bladder stones are men.
Prolonged bed rest
People who live in very hot or humid environments
Frequent urinary tract infections
Urethral obstruction
A very high amount of vitamin C or calcium in food
Hyperparathyroidism disorder
Painless stones increase the risk of kidney damage.

Characteristics of stones:

Stone pain depends on where, how big, and what type of stone it is.

- The stone disease usually occurs between the ages of 30 and 40 and is three to four times more common in men than in women.
- Stones are often diagnosed incidentally. The stone which does not have any marks is called Silent Stone.
- Constant pain in the back and stomach.
- Vomiting and nausea.
- Blood in the urine.
- Pain or burning while urinating
- If the stone gets stuck in the ureter, the flow of urine stops suddenly.
- Urinary stones.
- In some patients, stones can cause moderate to severe kidney damage due to recurrent urinary tract infections and urinary obstruction.
- Urinary irritation.
- Frequent urinary infections

Characteristics of stone pain:

The intensity of pain and type of pain varies from person to person. It is a myth that bigger stones cause more pain. Stone pain depends on where, how big, and what type of stone it is.

Stone pain starts suddenly. These pains are hard and excruciating like stars on a sunny day.
Small but rough stones cause more severe pain than large and smooth stones.
Stones are usually found in the kidneys and ureters.
Kidney stone pain starts from the waist and moves down to the pelvis.
Bladder stone pain occurs in the pelvis and urinary tract.
These pains usually last for hours and then subside.
Most of the time, the pain is so severe that the patient rushes to the doctor and needs medicine or an injection to relieve the pain.

Can kidney stones deteriorate?

Yes. Some patients develop obstruction due to large stones in the ureter (kidney or ureter), due to which the urine produced in the kidney cannot flow easily to the bladder, and the kidney swells.

If these stones are not treated properly in time, over a long period of time the swollen kidney gradually weakens and eventually stops working altogether. In this way, even if the bed is removed after the kidney deteriorates, there is no chance of the kidney functioning again.

Diagnosis of Urinary Tract Stones: The aim of various investigations in stone patients is to diagnose the stones and the problems caused by them and also to diagnose the reason responsible for stone formation.

Radiological tests:- Sonography:- This is very simple, less expensive, and easily available in small and large places. With the help of sonography, stones in the urinary tract and their obstruction can be diagnosed.

The main investigations for the diagnosis of stones are sonography and X-ray.

X-ray KUB ( x-ray KUB):- Through this examination accurate information of stone size, shape and location can be done by X-ray of kidney-ureter-bladder (x-ray KUB). For this, X-ray KUB before and after stone treatment. Very helpful.

CT Scan:- ( CT scan):- CT scan is the most useful test for the diagnosis of stone, its size and very accurate information of obstruction in the ureter.

I.V.P. Examination of Intravenous Pyelography: Usually this examination is done before definitive diagnosis and treatment given by operation or endoscopy.

Apart from accurate information about the size, shape, and location of the stone, this test also provides information about the condition of the kidney, its function, and how much it is swollen.

Urine and blood tests provide information about urinary tract infections and their severity and kidney function.

Laboratory tests:- Urine test:- Urine infection and pH of urine are measured through general urinalysis. Calcium, Phosphorus, Uric Acid, Magnesium, Oxalate, Citrate, Sodium, and Creatinine are measured in urine collected for 24 hours.

Blood tests:- Complete blood count (CBC), creatinine, electrolytes, and blood sugar are commonly done in stone patients. Apart from this, special blood tests – calcium, phosphorus, uric acid, and parathyroid hormone, etc. – are done as needed to diagnose the causes of stone formation.

It is important to reduce the amount of salt in food to prevent calcium stones.

Stone analysis (stone analysis):-

Urethral stones that pass naturally or through treatment are saved for examination. By the chemical analysis of this stone, what substance is the stone made of? It is diagnosed. Based on this diagnosis, appropriate treatment is planned to prevent the recurrence of stones or to prevent the size of stones that have not yet passed. Stone medicine.

Measures to prevent stones in the urinary tract:- Once a stone is formed, there is a possibility of recurrence. Stones recur in approximately 50-70% of patients. But the chances of stone recurrence can be reduced with proper diet and proper treatment. And only about 10% of patients are at risk of stone recurrence. Hence every stone patient should take proper care, diet, and treatment.

Stone patients who want to avoid stone recurrence should always strictly follow the following instructions.

Drink more fluids

Always drink plenty of fluids (more than 3 liters or 12 to 14 glasses).
This remedy plays the most important role in preventing stone formation.
The amount of water consumed is more important than the type of water to prevent stone formation.
How much water do you drink to prevent stones? Even more important than that is how much urine is produced. It is necessary to drink more than two liters of water per day.
Small stones may pass naturally with more fluids.
If the urine comes out as clear as water throughout the day, it means that enough fluids have been consumed. Yellow (dark) urine indicates low fluid intake.
It is advisable to drink more fluids during summer because more water is lost through sweat during the heat.

What type of fluid should be taken to prevent stone formation?

Consuming plenty of fluids such as coconut water, barley water, thin whey, plain cold drinks (like unsweetened soda, lemon), pineapple juice, etc., reduces the chances of stone formation. But it is necessary to take 50% of the total liquid intake as plain water.

Which type of liquid should not be taken by a person suffering from stones? Do not drink grape juice, apple juice, strong tea, coffee, chocolate, or cold drinks with high sugar content like Coca-Cola, all types of alcohol, beer, etc.

Taking less salt ( salt restriction) Taking too much salt (salt-sodium) in food increases the risk of calcium stones. Therefore, it is important for every person with stones to take salt in their food in less quantity.

Non-vegetarian food:- Avoid non-vegetarian food like mutton, chicken, fish, eggs, etc. Due to the high amount of uric acid in these non-vegetarian foods, there is a possibility of uric acid stones and calcium stones.

Drinking plenty of water is very important to treat and prevent stones from recurring.

Balanced diet:- Eat a balanced diet with a high proportion of green vegetables and fresh fruits. Fruits include bananas, mangoes, cherries, pineapples, and vegetables include carrots, bitter gourds, Shimla peppers, etc.

Avoid eating white bread, pasta, and high-sugar foods as foods with high sugar content contribute to the formation of kidney stones.

Other instructions:- Do not take vitamin C in excess. Do not eat heavy food at night, and keep weight under control by eating a balanced diet as the risk of stones is higher in obese persons.

Care required according to the type of stone:-

Care for calcium stones:-

Food:- It is a misconception that stone patients should consume less calcium-rich foods. Including milk, milk dishes, etc. containing calcium in the daily diet can prevent the formation of stones. Calcium mixes with dietary oxalates to reduce its absorption from the stomach. And thus prevents the formation of stones. When the diet is low in calcium, increased absorption of oxalate from the stomach contributes to stone formation.
Avoid eating foods that are high or low in calcium as both increases the risk of stone formation.
Medicines:- Medicines called thiazide help to prevent calcium stones from forming.
Other suggestions:- Lose weight.

Diet for Oxalate Stones: Home remedies for stones

Avoid the following foods high in oxalates:

Vegetables: Tomato, okra, brinjal, spinach, saffron, cucumber.
Fruits: Strawberries, raspberries, Chiku, amla, custard apple, cashew.
Beverages: Strongly brewed tea, Grape juice, Cadbury, Cocoa, Chocolate, Thums-Up, Pepsi, Coca-Cola.
Stones can recur in up to 80% of patients, so regular follow-up and follow-up is essential.

Instructions for patients with uric acid stones:

Drink a lot of water.
Exercise daily and lose weight.
Avoid pulses and non-veg food.
Eat more vegetables like bitter gourd, lemon, and carrot.
Do not take vegetables like cauliflower, spinach, tomato, soybean, or asparagus.
Do not consume alcoholic beverages.
Avoid fatty foods like salad dressing, ice cream, and fried foods.
Do not take cold drinks and sugary cold drinks.
Do not take tea/coffee more than twice a day.

Treatment of urinary tract stones:

The treatment required for a stone is determined by the size of the stone, the location of the stone, and the discomfort and risks it causes. There are two main types of this treatment:

Conservative Medical Treatment
Special types of treatment (operation, endoscopy, lithotripsy, etc.) to remove stones from the urinary tract

1. Treatment by drugs:

In more than 50% of patients, the stones are small and pass naturally in the urine within three to six weeks. During this time, this treatment is given to the patient to relieve the pain and help the stone to pass quickly.

Medicines and injections: Timely, all-day analgesic pills or injections are used to reduce or cure excruciating stone pain.

2. Through binoculars

Stones in the middle and lower part of the ureter have been successfully removed endoscopically without surgery.

Excess fluid:

After the pain subsides, stone patients are advised to drink more fluids – water. Drinking more fluids increases the volume of urine and thus helps to pass stones in the urine.

When it is not possible to drink fluids due to vomiting, fluids are given by bottle. It is a misconception that drinking beer is a cure for gallstones. It is not certain when a stone will come out in the urine, so urinating in a bowl is the easiest and best way to get the stone.

Treatment of urinary tract infection:

Many stone patients have urinary tract infections, which are properly treated with antibiotics.

Other suggestions::- Calcium channel blockers and alpha-blockers drugs help the stones pass naturally.

Many stone patients suffer from urinary tract infections. Which needs proper treatment.

Many stone patients suffer from urinary tract infections. Which requires proper treatment. Stone medicine.

Special Treatment for Urinary Tract Stones: Home remedies for stones

Surgical Treatment:- Despite adequate treatment with more fluids, diet, and appropriate medication for a long time, many patients’ stones do not pass naturally. There are many different surgical options for treating such stones. The most commonly used methods are lithotripsy (ESWL), percutaneous nephrolithotripsy (PCNL), and ureteroscopy. When surgery (open surgery) stone removal is required in very few patients.

There are many different options for removing bedsores that do not naturally come out. The urologist or surgeon decides which method is best for the patient based on the size, location and type of stone. Stone medicine

Ensuring adequate fluid intake means clear water-like urine throughout the day.

Does every stone need to be removed immediately?

No, if the stone is not obstructing the ureter, the kidney is not deteriorating, there is no pain, there is no infection or blood in the urine, then there is no need to remove the stone immediately. The doctor advises when and by what method it is necessary to remove the stone by careful monitoring of the stone.

Stones that block the ureter,
If there is frequent blood or urine in the urine or kidney damage, it is necessary to remove it immediately.
A very large stone that cannot pass naturally.

Stones that block the ureter, which can cause the kidneys to swell and deteriorate.

Lithotripsy (ESWL – Extracorporeal shock wave lothotripsy):

This is a very modern and effective method of removing kidney and upper ureteral stones.

In this method, with the help of powerful waves (Shock Waves) generated from a special type of Lothitripter machine, the stone is crushed like sand, which is gradually passed out with urine over a few days. After lithotripsy, the patient is asked to drink a lot of fluids so that the crushed stones pass easily in the urine.

When lithotripsy is performed for large stones, the stone is crushed in large quantities, which may lead to ureteral obstruction. To prevent this risk, a soft plastic tube connecting the kidney and bladder is placed. Which is called a stent.

This method is very safe for treating stones. Some of the potential risks or complications after lithotripsy include blood in the urine, urinary tract infection, having to have more than one treatment to remove the stone, blockage of the ureter due to stone fragments, and increased blood pressure leading to kidney damage. To happen etc.

Lothitripsy is a modern and effective method of stone removal without surgery.

Advantages:

Hospitalization is usually not required.
Stones can be removed without surgery, without binoculars, without anesthesia.
Pain is minimal or non-existent. And is best for patients of all ages.

Disadvantages:

This method is not effective for all types and large stones.
Often this treatment needs to be given more than once to remove the stone.
Pain along with passing of stones or sometimes urinary tract infection may occur.
For the treatment of large stones, a special type of tube (DJ Stent) needs to be placed between the kidney and the bladder with the help of a telescope.
After doing lithotripsy, it is very important to see the doctor regularly, get the necessary check-ups done at times and take all care and diet to prevent stones from reoccurring.

Peripheral Kidney Stone Treatment (PCNL – Per Cutaneous Nephro Lithotripsy):

Kidney stones when one cm. This is an indestructible and excellent method of removal when larger than PCNL is the best method when stones cannot be removed by ureparoscopy or lithotripsy.

In this method, a small incision is made in the side, above the kidney area, a passage is made to the kidney, and a tube is placed until the stone is in the kidney.

Nephroscope is a special type of instrument with the help of which stones can be seen. A stone can be seen from this tube. Small stones are crushed and removed by the shock wave.

Laparoscopic treatment of stones can avoid the need for surgery.

P.C.N.L. is generally a safe method. But like any other operation, bleeding, infection, injury to other organs can also cause problems in this operation.

Stone surgery, which is usually performed by opening the abdomen, involves about 12 to 15 cm on the back and abdomen. As long as the cut has to be made but in this modern method only 1 cm. A small incision is placed above the waist so that the patient can resume daily activities shortly after the operation.

Ureteroscopy (URS) Endoscopic treatment of bladder and ureteral stones:

This is the most effective and best method to successfully remove stones located in the middle and lower part of the urinary tract. A light, thin and easily bendable tube with a camera at the front called a ureteroscopy is used. In this method, stones are reached with the help of a special telescope through the urinary tract without surgery or drilling.

In this method, stones are reached through the urinary tract with the help of a special type of telescope (Cystoscope or Ureteroscope) and the stones are crushed and removed by a ‘shock wave probe’.

The major advantage of this method is that the patient can go home immediately and lead a normal life in two to three days. This method is also safe in pregnancy, in obese patients, and in patients with blood clotting disorders. Possible risks of this treatment include bleeding in the urine, infection or injury to the urinary tract

Be careful! Lack of calcium in food increases the risk of stone formation.

Operation (Open Surgery):

In this method, the stone is removed by making an incision in the stomach, reaching up to the kidney. Post-major surgery pain and longer hospital stay are major disadvantages of this treatment. Due to the availability of new modern methods, the need to operate by placing checks is very few patients. The main advantage of this operation is that more and larger stones can be removed at once through a single operation.