The kidneys fall into group of organs in which stones can develop. Kidney stones usually begin to develop from tiny particles of solid material that is deposited in the kidney, i.e. where the urine accumulates before passing into the erethra. An additional solid material is usually collected with the particle, and it gradually becomes rigid. The process can be occur in one kidney or both, and in a few years a stone, 25 mm in diameter or more, stone can be formed. Since most kidney stones contain calcium, the formation of stones is probably due to excessive amounts of calcium in the urine.
A stone with a diameter greater than 5 mm will likely stay in the kidney because it will not be able to pass into the ureter. Such stones should not cause any problems, unless their number is greater. Very small stones rarely cause problems because they are easily transmitted and excreted by urine. However, the stone with a size somewhere between these two extremes can cause pain and other problems if (and when) it enters the ureter and begins to move towards the urinary bladder.
If the stones are too large and therefore cannot move from the kidneys to the ureter, the symptoms usually do not exist or only a mild pains occur when the part of the stone ”breaks” and enters the ureter. The most common symptom of problematic kidney stones is the stabbing pain (renal colic) which usually occurs in the waves, often within a few minutes. This can be the result of a problem or a disorder in various parts of the body, and the patient usually feels a strong, almost unbearable pain. This type of pain, which occurs when the stone passes from kidney to ureter, will go away when the stone stops moving or when it is excreted with the urine. The pains almost always occur on one side of the body although, of course, the next attack may manifest on the other side if you have stones in both kidneys.
At first, renal colic and be felt in the back, just below the ribs on one or the other side of the spine. During several hours or days, the pains “track” the passage of the stone through the ureter toward the front of the body and fall to the groin. The patient can feel nausea, and traces of blood may appear in the urine. When the stone arrives in the bladder, the passage of the stone through the rest of the urinary tract is usually painless or almost painless.
In Croatia, most commonly, there are kidney stones in Dalmatia, which is rarer in the continental part. Since the passage of stone often causes very severe pain, patients with kidney stones are often received into the hospital. Nonetheless, the frequency of kidney stones in developed countries decreases, partly (perhaps) due to changes in diet and lifestyle, though the exact causes of this decline are not known, as it is not known why some are people particularly prone to kidney stones.
It is known, however, that the disease is hereditary and prevalent in tropical countries, probably because of excessive calcium concentration in the urine. Namely, people in hot climatic conditions lose so much body fluids (water) by sweating that they typically excrete less urine. Interestingly, during World War II, soldiers who fought in the desert areas suffered from kidney stones more than soldiers who fought in areas with temperate climate.
Disease affects men more than women, as well as people over the age of 30. In rare cases, a certain types of kidney stones caused by chemical disorders in the blood can develop in children.
Although most kidney stones remain in the kidney (causing no problems) or are eventually excreted with the urine, the stone can sometimes ”stuck” in the ureter and clog the normal flow of urine on one side. In this case, an operating procedure is required. In addition, kidney stones increase the likelihood of urinary tract infections and, consequently, the likelihood of of acute pyelonephritis attacks. Repeated infections and (sometimes) scars (caused by large stones) can cause chronic renal insufficiency if the problems with the kidney stones are long lasting, although such cases are rare.
What to do?
If you have kidney stones, go to your doctor for examinations every six months to check if there is a permanent damage on your kidneys. If you get kidney stones, your doctor will probably refer you to a blood and urine tests, an intravenous pyelogram (IVP) and (perhaps) a cystoscopy. Such diagnostic tests will reveal locations of the kidney stones in the urinary tract (if there are any), and with the obtained data the physician will determine whether the therapy is necessary or not.
Self-help: if you get kidney stones, you should contact your doctor as oon as possible. However, it would be wise to drink large amounts of water (at least five liters a day); with this, you will easily “drive” the stone down the urinary tract. Use a mild analgesic for a pain relief, e.g. aspirin or paracetamol.
Professional help: there is no satisfactory medical treatment to deal with this problem if the kidney stones do not come out of the body by themself. However, if you are particularly prone to kidney stones development, your doctor may prescribe a medicine that may prevent kidney stone formation (in some cases). If the stone clogs the lower part of the urinary tract, it can sometimes be removed by cystoscopy (under general anesthesia).
If this procedure can not be performed, you may need a larger surgery and will have to stay in the hospital for about 10 days. If the kidneys stones – or related infections – have significantly and irreversibly damaged a kidney (which is not a common case), it may be necessary to remove the entire kidney. In such cases, the remaining healthy kidney will successfully overcome the deficiency of the other. However, in most cases, kidney stones are just a painful discomfort.