What is the symptoms of kidney stone? Is kidney stone dangerous?

Kidney Stones

Except for the brain, the kidney is man's most sophisticated, discriminating, and intricately developed organ. At any time approximately one fifth of the entire blood supply is flowing through the two kidneys. The kidneys take from the blood passing through them those products which in their judgment are best removed and retain those that the body still requires. In this way the kidneys control the composition of the blood and of man's internal chemistry.

The components which are not retained in the blood are passed out of the kidney filter complex as urine. The urine is formed in the kidney. Each kidney passes its urine into a long thin muscular channel, the ureter, by which it is conveyed into the bladder. Urine is temporarily stored in the bladder before being voluntarily voided to the outside world. It has been repeatedly demonstrated that the composition of the blood is determined not by what the mouth takes in but by what the kidneys retain.
If the blood contains an excessive amount of stonemaking material, such as calcium or an abnormal amount of protein, or if there is blockage and infection in the kidney, then the normally minute, soluble matter in the urine forms insoluble particles. When enough of these adhere to each other, a stone forms in the pathway of the urinary stream. These stones may appear in the kidney, ureter or bladder. They are never normal and always indicate disease and carry the potential for serious disturbances. There is a relatively large margin of safety in kidney disease because the organs are paired and the reserve so great that an individual can live with part of one functioning kidney.

What does a kidney stone consist of? 

There are several types of stones. The most common are composed of minerals containing calcium phosphate or oxalate or uric acid. The shape of a stone conforms to that of the area in which it is formed. Those that form in the kidney can be staghorn, those in the ureter are bulletshaped, those in the bladder are usually spherical. Uric acid stones are different from the other two kinds in that they are not directly visible on an X ray.

What happens with a typical kidney stone attack? 

A stone can produce pain, increased frequency of urination, chills and fever, blood in the urine, or any combination of these symptoms. The typical attack of kidney pain, called colic, occurs when a stone blocks the urinary channel. It often starts with loin pain that goes into the groin. There is often sweating and retching. Narcotics are usually required to control the pain. Because this pain is so severe, the patient seeks help to prevent another such attack.

I am now seventy years of age. What caused me to get a bladder stone? 

Stones can occur in any instance in which the urine is retained. Bladder stones are most often due to some type of prostatic obstruction, which prevents the bladder from adequately emptying itself.

How can one be sure that stones are present? 

There are only two ways to demonstrate that a stone is present: It is seen on an X ray or the patient passes it. An intravenous pyelogram is an X ray of the entire urinary system that is obtained by injecting a contrast material into a forearm vein and watching its transit through the urinary tract. By this method obstructions, tumors and stones are accurately revealed about 90 percent of the time. This technique is actually a photograph of the entire urinary system.

Must all stones be treated? 

No treatment is required if the stone or stones are so localized that they produce no symptoms and no damage to the urinary system. However, periodic urine examinations and X-ray studies are required to follow their progress.

How can I avoid a recurrence of stones? 

A large fluid intake is necessary. You may also require regulation of diet and correction of urinary acidity. Specific obstructions that favor stone formation require corrections. Various parts of the urinary tract may require periodic stretching or dilation. Urinary antibiotics are given liberally, the choice of antibiotics being made on the basis of its action on the bacteria found in the urine of the particular individual. A periodic checkup with a urologic X ray is the only way to be certain about the true internal situation.

Under what circumstances are stones prone to occur? 

We see this in individuals who require prolonged orthopedic immobilization or who are paraplegic. Stones are also commonly observed in individuals with gout because they have excess uric acid; this same excess is seen in association with certain blood diseases, especially polycythemia. Stones also form in about 10 percent of individuals with hyperparathyroid function. Some individuals have a biochemical abnormality which allows them to form unusual stones made of xanthine or cystine. This abnormality cannot be specifically corrected. In many other instances there is no apparent reason for the formation of a stone.

If the stone is in my kidney, why do you want to operate on my neck? 

People who are repeated stone formers may have an abnormality in the amount of calcium they form and require investigation for this possibility. Your blood tests consistently show that you have an excess amount of calcium in both the blood and the urine. This is caused by an increased activity in one or in each of the four little glands in the neck that lie alongside the thyroid gland. The removal of the abnormal parathyroid gland tissue will correct the condition and prevent further stone formation.

Kidney Stones Symptoms and Treatments

How are kidney stones treated? Can they be dissolved? 

Calcium stones cannot be dissolved because there is no medication given by mouth or any other way that will do this. However, many stones will pass spontaneously with the liberal use of a high fluid intake and regulated diet. An effort can be made to remove the stone by manipulation techniques done through the bladder. This is an operative procedure, but no incision is necessary. In some instances a special wire loop can be passed through the cystoscope into the ureter and the stone can be manipulated into the bladder, from where it is more easily extracted. This basketing for the removal of stones is undertaken in selected instances. In some cases a catheter can be slipped past the stone, allowing draining of the area above it, and in this way the stone is encouraged to pass.

When must the stone be removed surgically? 

Surgery is advised if th'ere is persistent infection, obstruction to the kidney, urinary bleeding or persistent pain.

Treatment for kidney stones without surgery

What is the nature of the surgery? 

Every surgeon treating kidney stone disease tries to do the minimum operation that is consistent with restoring the functions of the urinary system. He will attempt to correct the irregularity that was responsible for stone formation, extract the stone, drain the infection, and reestablish proper urinary flow. The magnitude of the procedure can vary from simple stone removal to the need to remove a totally destroyed and unsalvageable kidney. The principle is to be as conservative as is consistent with getting a good result. In all situations the surgeon also has to be guided by the function of the other kidney.


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