What is Nephrolithiasis?

Kidney Stones are also called as Nephrolithiasis.

How common are kidney stones?

It affects between 1 to 5% of the population.

Can a person have repeated episodes of stone formation?

In 50–80% of patients the stones recur.

What are the different kinds of stones?

Renal stones are principally composed:

1. Calcium Phosphate.
2. Calcium oxalate.
3. Uric acid.
4. Magnesium ammonium phosphate (struvite).

How do kidney stones form?

Kidney stone formation result from the following:

1. Low intake of water.
2. Increased calcium absorption from the gastrointestinal tract and it can run in families.
3. Leaky kidneys to calcium called renal hypercalciurea.
4. Increased oxalate absorption.
5. Diet very rich in purines like red meat.
6. No cause can be demonstrated in 3–5% of patients.

How do patients with renal stones present? OR What is renal colic?

Renal Colic is a manifestation of spasm of the ureter which is produced by the irritation of the stone and accompanying obstruction. The pain usually begins in the flank area and migrates towards the groin. The pain may subside after the stone or clot are passed and may be accompanied by a passage of blood in the urine. If infection occurs then it leads to fever, difficulty in urination and increase frequency of urination.

What is the general treatment of kidney stones?

The treatment of stones is based on the type of stones and therefore the stone should be submitted for examination whenever possible. The occurrence of stones can be diminished by:

1. Adequate water intake to maintain urine volume of at least 2 lit/day.
2. If increased intestinal absorption of calcium is suspected then intake of dairy products and certain calcium rich food should be limited.
3. Excess salt should be avoided with calcium containing stones as hugh sodium intake increases calcium excretion.
4. For calcium oxalate stones, oxalate rich foods such as green leafy vegetables.

A detailed evaluation is required for stones formed recurrently. The test typically include the complete metofolic profile and to quantify the amount of calcium, uric acid, auxilitate, citrate i.e. excreted in a 24 hour urine collection.

What are the different methods available for the removal of stones?

Extra–corporeal shock wave Lithotripsy

Lithotripsy has been successfully used since it was first introduced in 1980.No surgery is required. High amplitude shock waves are sent which pulverizes the stones. Most commonly for small stones. Success rate is 90–95%. More sittings are require for bigger stones.
Percutaneous Nehrostolithotomy
This procedure involves manipulation of the stones by entering the kidney through the back.
Ureteroscopy
Usually fiber optic scopes inserted through the urethra into the ureter. Stones can be fragmented by ultrasonic waves or laser. Used very commonly.
Open lithotomy
Stones removed by opening the abdomen.