Renal lithiasis or stones/stones in the kidney: symptoms, treatments and prevention

It is estimated that approximately 12% of the world's population suffers from kidney stones at some point in their lives. This figure may be higher in certain geographic areas, such as the “stone belt” in the southeastern United States, where prevalence may be as high as 20%.

It is important to note that the incidence of kidney stones has been increasing in recent decades, possibly due to changes in diet and lifestyle. Additionally, kidney stones can affect people of all ages, although they are more common in young adults.

What is kidney stones?

Kidney stones, also known as kidney stones or kidney stones, are solid formations that develop in the kidneys from substances present in the urine. These substances may include calcium, oxalate, uric acid, phosphate, and other compounds.

When the concentration of these substances in the urine is high, they can crystallize and form small solid deposits in the kidneys. Over time, these deposits can grow and become larger kidney stones. These stones can range in size from grains of sand to larger golf ball-sized stones.

Kidney stones can cause severe pain and other symptoms when they travel from the kidneys to the ureters, the tubes that connect the kidneys to the bladder. Depending on the size and location of the stones, they can cause partial or complete obstruction of urine flow, resulting in symptoms such as lower back or abdominal pain, blood in the urine, frequent and painful urination, nausea and vomiting.

Kidney stone treatment can vary depending on the size and location of the stones. In some cases, small stones can pass on their own with the help of hydration and pain control medications. For larger stones or stones that cannot be passed naturally, additional treatments may be necessary, such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, or open surgery.

Causes of kidney stones. Risk factors for suffering from kidney stones

The formation of kidney stones, or renal lithiasis, can be caused by various factors. The chemical composition of stones can vary, which influences the underlying causes. Here are some of the most common causes:

  1. Imbalances in the concentration of substances in the urine: Kidney stones can form when there are imbalances in the concentration of certain substances in the urine, such as calcium, oxalate, uric acid or phosphate. If these substances are at high levels, they can crystallize and form kidney stones.
  2. Dietary factors: Diet plays an important role in the formation of kidney stones. Excessive consumption of foods high in oxalate, such as spinach, beets, chocolate, nuts, and some fruits, may increase the risk of developing calcium oxalate stones. Additionally, a diet high in sodium and low in fluids can contribute to stone formation.
  3. Genetic factors: There is evidence that genetic predisposition may increase the likelihood of developing kidney stones. Some people may inherit a greater tendency to produce substances that crystallize and form kidney stones.
  4. Underlying medical conditions: Some medical conditions can increase the risk of developing kidney stones. These include hyperparathyroidism, chronic kidney disease, obesity, gout, inflammatory bowel diseases, and certain urinary tract diseases that interfere with the normal flow of urine.
  5. Environmental factors and lifestyle: Chronic dehydration, hot weather, and lack of adequate fluid intake can contribute to kidney stone formation. Additionally, certain medications, such as diuretics and antiretrovirals, may increase the risk of developing kidney stones in some people.

It is important to note that each case of kidney stones can be unique and influenced by a combination of factors.

Symptoms of kidney stones or kidney stones

The symptoms of kidney stones can vary in intensity and presentation, depending on the size and location of the stones, as well as the individual response of each person. Some of the most common symptoms include:

  1. Severe pain in the back or side: The most characteristic symptom of kidney stones is the sharp, stabbing pain experienced in the back or side, in the area where the kidneys are located. This pain, known as renal colic, can be very intense and fluctuate in intensity. It may radiate to the abdomen or groin.
  2. Changes in urination: Kidney stones can cause changes in urination, such as increased urinary frequency or an urgent need to urinate. Additionally, there may be blood in the urine (hematuria), which can give it a pink, reddish or brown color.
  3. General discomfort: Some people with kidney stones may experience general malaise, nausea or vomiting.
  4. Difficulty finding a comfortable position: Severe pain caused by kidney stones can make it difficult to find a comfortable position. Some people may feel the need to move constantly to relieve pain.

It is important to note that not all people experience obvious symptoms. Some smaller stones can go unnoticed and be removed without causing significant symptoms. If fever or chills appear, there may be an associated infection, so it is vitally important to contact your urologist immediately or go to the emergency room since there is a risk of taking the patient to a serious clinical situation.

It should be noted that the symptoms of kidney stones can be similar to those of other medical conditions, such as urinary infections or appendicitis, so the evaluation of a specialist is essential to reach a correct diagnosis.

How is lithiasis diagnosed?

Diagnosis of kidney stones is usually made through a combination of clinical evaluation, imaging tests, and laboratory tests. The most common methods used to diagnose kidney stones are:

  1. Medical history and physical examination: The doctor will collect information about your symptoms, medical and family history, as well as perform a physical examination.
  2. Urine analysis: A urinalysis can help identify the presence of blood in the urine (hematuria) and signs of a urinary tract infection.
  3. Imaging tests:
    • Simple abdominal x-ray: X-rays can detect the presence of dense kidney stones in the kidney area. However, some stones may not be visible on a plain x-ray, especially those composed of uric acid.
    • Kidney ultrasound: Ultrasound evaluates the kidneys, bladder, and urinary tract. It can help identify the presence of kidney stones, although its ability to detect smaller or mid-ureteral stones is limited.
    • Computed Tomography (CT): CT is a more precise and commonly used imaging technique to diagnose kidney stones. It allows you to view kidney stones in detail, determine their size, location, possible composition and quantity, as well as evaluate possible associated complications.
  1. Chemical analysis of the stones: If a kidney stone is removed, a chemical analysis may be performed to determine its chemical composition. This can help guide treatment and prevent future recurrences.

Treatments for lithiasis (Those performed at Ramírez Urology)

Treatment of kidney stones depends on several factors, such as the size and location of the stones, the severity of symptoms, the presence of complications, and the individual characteristics of the patient. Common treatments used for kidney stones are:

  1. Observation and conservative management: If the kidney stones are small and do not cause serious symptoms, it is possible to opt for a strategy of observation and conservative management. This involves drinking plenty of water to promote the spontaneous passage of stones through urine. Changes in diet and medication intake may be recommended to relieve symptoms and prevent new stones from forming.
  2. Medicines: Some medications may be prescribed to help treat kidney stones. For example, alpha-blocking medications can relax the muscles of the urinary tract and facilitate the passage of stones, or some drugs help change the pH of urine, favoring the dissolution of some types of stones.
  3. Extracorporeal shock wave lithotripsy (ESWL): This non-invasive procedure uses high-energy shock waves to break kidney stones into smaller fragments, which can then be passed naturally through urine. ESWL is usually performed under sedation and is primarily used for small to medium-sized stones.
  4. Both rigid and flexible ureteroscopy: It consists of accessing the stone both at the level of the kidney and the ureter, through the natural urinary orifices, using an instrument called a ureteroscope that can be rigid or flexible. Subsequently, the stone is extracted or fragmented with a laser.
  5. Endoscopic percutaneous nephrolithotomy: By creating a path from the skin to the kidney, a nephroscope is introduced that allows us to fragment the stone with a laser and extract the stone fragments.
  6. Surgery: In more complex cases or when other treatments are not viable, surgical intervention may be necessary. Open surgery for kidney stones is less common today, but may still be necessary in certain cases.

How to prevent kidney stones?

To prevent the formation of kidney stones, you can take steps and adopt healthy habits. Here are some general recommendations for preventing kidney stones:

  1. Drink enough water: Maintaining adequate hydration is essential to dilute the concentration of substances in the urine and prevent stone formation. It is recommended to drink at least 2-3 liters of water per day, unless there is a medical contraindication.
  2. Modify the diet: Some dietary changes may help prevent kidney stone formation, especially if the specific chemical composition of the stones has been identified. These recommendations may vary depending on the type of calculation, but in general it is suggested:
    • Limit consumption of foods rich in oxalate, such as spinach, beets, chocolate, nuts and some fruits.
    • Moderate your intake of salt and processed foods that contain sodium.
    • Consume adequate amounts of calcium, preferably through food sources.
    • Limit the consumption of animal proteins, especially high-purine animal proteins, which can increase the level of uric acid in the urine.
  3. keep a healthy weight: Obesity is associated with an increased risk of developing kidney stones. Maintaining a healthy weight through a balanced diet and regular exercise can reduce your risk.
  4. Manage underlying medical conditions: If you have medical conditions such as hyperparathyroidism, chronic kidney disease or gout, it is important to follow the instructions and treatments recommended by the specialist to adequately control these conditions and reduce the risk of stone formation.

Urology center specialized in kidney stones

Our service specializes in the comprehensive treatment of kidney stones, providing a complete and personalized approach to help patients prevent the formation of kidney stones, as well as diagnose, treat and effectively manage this condition when it occurs.

Our team of professionals highly trained and specialized in urology and nephrology has the experience and resources necessary to offer advanced, evidence-based treatment options, ranging from lifestyle changes and dietary modifications to the use of innovative technologies, such as ureteroscopy both flexible and rigid.

Our goal is to improve our patients' quality of life, relieve symptoms associated with kidney stones, prevent recurrences, and promote long-term kidney health.