Diff: Kidney stones
Comparing revision #1 (2023-12-30 15:13:19) with revision #2 (2026-06-22 11:27:25).
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'''Kidney stones''', also known as renal calculi, are solid masses composed of crystals that form in the kidneys. They can vary in size, from tiny particles to larger stones, and may cause significant pain and discomfort as they pass through the urinary tract. Kidney stones are a common urological condition, and their formation is influenced by factors such as diet, fluid intake, and underlying medical conditions. |
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==Overview== |
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Formation and Composition: |
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Crystal Aggregation: Kidney stones form when certain substances in urine, such as calcium, oxalate, and uric acid, aggregate to form crystals. |
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Composition Variability: Stones can have different compositions, including calcium oxalate, calcium phosphate, uric acid, and struvite. |
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Types of Kidney Stones: |
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Calcium Stones: The most common type, comprising calcium oxalate or calcium phosphate. |
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Uric Acid Stones: Formed when there is an excess of uric acid in the urine. |
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Struvite Stones: Associated with urinary tract infections. |
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Cystine Stones: Rare and caused by a hereditary disorder leading to increased cystine in urine. |
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==Symptoms== |
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Renal Colic: |
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Severe Pain: The hallmark symptom is sudden, severe pain, often referred to as renal colic, as the stone moves through the urinary tract. |
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Flank Pain: Pain typically originates in the back or side, radiating to the lower abdomen and groin. |
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Haematuria: |
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Blood in Urine: The presence of blood in urine (haematuria) is common and may be visible or detected through laboratory tests. |
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Other Symptoms: |
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Nausea and Vomiting: Some individuals may experience nausea and vomiting. |
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Frequent Urination: Urgency and frequency of urination may increase. |
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==Causes and Risk Factors== |
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Dehydration: |
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Low Fluid Intake: Inadequate fluid intake can lead to concentrated urine, increasing the risk of stone formation. |
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Diet: |
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High Oxalate Foods: Consuming foods high in oxalate, such as beets, chocolate, and nuts, may contribute to oxalate stone formation. |
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High Sodium Intake: A diet high in sodium can increase calcium excretion in urine, potentially leading to calcium stone formation. |
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Medical Conditions: |
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Hyperparathyroidism: Overactivity of the parathyroid glands can lead to increased calcium levels in urine. |
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Cystinuria: A hereditary disorder causing excess cystine in urine. |
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Family History: |
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Genetic Predisposition: A family history of kidney stones may increase the risk. |
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==Diagnosis== |
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Imaging: |
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CT Scan: Computed tomography (CT) scans are often used to visualize the size and location of kidney stones. |
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Ultrasound: An ultrasound may be used to detect stones, especially in pregnant individuals. |
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Urinalysis: |
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Detecting Blood and Crystals: Urinalysis helps identify the presence of blood and crystals in urine. |
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==Treatment and Prevention== |
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Pain Management: |
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Analgesics: Pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are used to manage pain. |
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Fluid Intake: |
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Hydration: Adequate fluid intake helps prevent stone formation by diluting urine. |
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Medications: |
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Alpha Blockers: Medications like tamsulosin may help relax muscles in the ureter, facilitating stone passage. |
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'''Kidney stones''' are hard deposits that form inside the kidneys from substances in urine. They can be tiny and pass without being noticed, or large enough to block part of the urinary tract and cause severe pain. |
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Thiazide Diuretics: Useful in certain cases to reduce calcium excretion. |
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Kidney stones are also called renal calculi. They are common in urology and can recur. NHS information estimates that up to half of people who have had kidney stones will have them again within five years. |
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Dietary Changes: |
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== Formation == |
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Stones form when waste products in urine crystallise and collect in the kidney. This is more likely when urine is concentrated, when a person does not drink enough fluid, when some medicines are being used, or when a medical condition raises levels of stone-forming substances in urine. |
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Calcium and Oxalate Control: Modifying the intake of foods rich in calcium and oxalate may be recommended. |
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Common types include calcium oxalate stones, calcium phosphate stones, uric acid stones, struvite stones linked to infection, and cystine stones linked to cystinuria. |
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Sodium Restriction: Lowering sodium intake can reduce calcium excretion. |
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== Symptoms == |
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Small stones may cause no symptoms and pass in urine. Larger stones can cause renal colic, which is often severe pain in the side or back that may move towards the lower abdomen or groin. |
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Surgical Intervention: |
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Other symptoms can include blood in the urine, nausea, vomiting, needing to pass urine more often, pain when passing urine, cloudy or foul-smelling urine, fever or chills if infection is present, and difficulty passing urine if there is obstruction. |
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Extracorporeal Shock Wave Lithotripsy (ESWL): Shock waves break stones into smaller fragments. |
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Fever, uncontrolled pain, vomiting, pregnancy, a single functioning kidney, reduced urine output or signs of infection with a suspected stone need urgent medical assessment. |
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Ureteroscopy: A thin tube is used to remove or break up stones in the ureter. |
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== Diagnosis == |
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Diagnosis is based on symptoms, examination, urine testing, blood tests and imaging. CT is commonly used in adults when the diagnosis is uncertain or complications are suspected. Ultrasound may be used in some situations, including pregnancy and follow-up. |
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Prevention Strategies: |
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If a stone is passed or removed, analysis can help identify its type and guide prevention. |
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Hydration: Maintaining adequate fluid intake is key to preventing stone formation. |
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== Treatment == |
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Many small stones pass naturally. Treatment may include pain relief, anti-sickness medicine, fluids and observation. Some people are given medicines such as an alpha blocker to help a stone pass, depending on the stone and clinical circumstances. |
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Dietary Modifications: Adjusting the intake of specific foods based on stone composition. |
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Stones that are large, infected, stuck, causing ongoing obstruction, or unlikely to pass may need a procedure. Options include shock wave lithotripsy, ureteroscopy with laser fragmentation, percutaneous nephrolithotomy, or, rarely, open surgery. |
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Regular Monitoring: Individuals with a history of kidney stones may undergo regular monitoring and preventive measures. |
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==Complications== |
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Obstruction: |
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== Prevention == |
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Prevention depends on the type of stone and the person's risk factors. General measures include drinking enough water to keep urine pale, reducing dehydration risk, moderating salt intake and following tailored dietary advice. |
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Urinary Tract Obstruction: Larger stones can obstruct the urinary tract, leading to complications such as hydronephrosis. |
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People with recurrent stones may need metabolic testing, medicine, specialist urology follow-up or dietetic advice. Advice differs by stone type, so broad restrictions without knowing the stone type can be unhelpful. |
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Infection: |
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== Complications == |
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Possible complications include urinary tract infection, kidney infection, hydronephrosis, kidney damage, sepsis in infected obstruction, and recurrent stones. Prompt treatment is important where a stone is blocking urine flow and infection is suspected. |
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Urinary Tract Infections: Stones, especially struvite stones, can be associated with urinary tract infections. |
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== See Also == |
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* [[Kidney]] |
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* [[Urinary_Tract_Infection]] |
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* [[Urology]] |
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* [[Hydronephrosis]] |
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Recurrence: |
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== References == |
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* [https://www.nhs.uk/conditions/kidney-stones/ NHS: Kidney stones] |
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* [https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/kidney-stones/ NHS inform: Kidney stones] |
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* [https://www.baus.org.uk/patients/conditions/6/kidney_stones/ British Association of Urological Surgeons: Kidney stones] |
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* [https://www.guysandstthomas.nhs.uk/health-information/lithotripsy-treatment-kidney-stones Guy's and St Thomas' NHS Foundation Trust: Lithotripsy treatment for kidney stones] |
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High Recurrence Risk: Individuals with a history of kidney stones have an increased risk of recurrence. |
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[[Category:Medicine]] |
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[[Category:Urology]] |