Kidney stones involve:
Crystal Formation: Supersaturation of urine with stone-forming substances (calcium, oxalate, uric acid) leads to crystal formation.
Stone Growth: Crystals aggregate and grow into stones, varying in size from tiny grains to large masses that can obstruct the urinary tract.
Obstruction: Stones can obstruct the flow of urine, causing pain and potential kidney damage.
Complications: Kidney stones can lead to urinary tract infections, hydronephrosis (swelling of the kidney due to urine buildup), and chronic kidney disease.
Clinical Evaluation
Symptoms: Assessment of symptoms such as severe, sudden flank pain, hematuria (blood in urine), nausea, vomiting, and frequent urination.
Physical Examination: Examination findings may include costovertebral angle tenderness and signs of dehydration or infection.
Diagnostic Tests: Urinalysis to detect blood or crystals in the urine, imaging studies (CT scan, ultrasound, X-ray) to visualize stones, and blood tests to assess kidney function and identify metabolic abnormalities.
Severe, sudden pain in the side and back, radiating to the lower abdomen and groin.
Hematuria (blood in the urine), which may appear pink, red, or brown.
Nausea and vomiting due to intense pain.
Frequent urination and urgency, especially if the stone is near the bladder.
Painful urination (dysuria) if the stone moves into the ureter or urethra.
Fever and chills if a urinary tract infection is present.
Treatment aims to relieve symptoms, remove or break up stones, and prevent recurrence:
Pain Management: Analgesics and anti-inflammatory medications to manage pain.
Hydration: Increased fluid intake to help pass the stone.
Medical Therapy: Medications to relax the ureter and facilitate stone passage, or to dissolve certain types of stones.
Procedural Interventions: Extracorporeal shock wave lithotripsy (ESWL) to break up stones, ureteroscopy to remove or break up stones with a laser, or percutaneous nephrolithotomy for large or complex stones.
Preventive Measures: Dietary changes, increased fluid intake, and medications to prevent recurrence, based on the type of stone and underlying metabolic abnormalities.