KIDNEY STONE: How is the examination, treatment and prevention?

Examination and diagnosis

If your doctor suspects you have Kidney Stones, you may undergo diagnostic tests and procedures, such as:

• Blood tests. Blood tests can show the amount of calcium or uric acid in your blood. Blood test results help monitor your kidney health and may cause your doctor to check other medical conditions.

• A 24-hour urine test may indicate that you are excreting too much rock-forming minerals or too few rock blocks. For this test, your doctor may ask you to do urine collection twice, for two consecutive days.

• Imaging. An imaging test may show Kidney Stones in your urinary tract. Examinations such as plain abdominal xfoto, as well as abdominal CT scan are required.

• Other imaging options include ultrasound, noninvasive tests, and intravenous urography, requiring the injection of dye into the blood through the arm vein and taking X-rays (intravenous pyelogram) or obtaining a CT (CT urogram) imaging CT image through the kidney and the bladder Urine.

• Stone analysis. You may be asked to urinate through a strainer to catch rocks flowing with urine. Laboratory analysis will reveal the composition of your Kidney Stone. Your doctor uses this information to find out what is causing your Kidney Stones and set up a plan to prevent more Kidney Stones

Treatment

Small stones with minimal symptoms

Most Kidney Stones do not require invasive treatment. Things that can be done with small stones are:

• Minimize water. Drinking as much as 2 to 3 liters per day can help clear your urinary tract system.

•          Painkiller. Small stones that pass through the urinary tract can cause pain and discomfort. To reduce pain, your doctor may recommend pain relievers such as ibuprofen, acetaminophen.

• Medical therapy. Your doctor may give you medicine to help get Kidney Stones out through the urinary tract. This type of drug is known as an alpha blocker, and it works by relaxing the muscles in the ureters, helping the Kidney Stone to pass through the urinary tract faster and with less pain.

The stones are big and that cause the symptoms

Kidney stones that can not be treated with conservative measures (either because they are too large to pass by themselves or because of bleeding, kidney damage or ongoing urinary tract infections) require more extensive treatment. Procedures may include:

• Using sound waves to break rocks. For certain Kidney Stones, doctors recommend a procedure called extracorporeal shock lithotripsy (ESWL).

• ESWL uses sound waves to create strong vibrations (shock waves) that can break the stone into small sizes and can come out with urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or mild anesthesia to make you comfortable.

• ESWL can cause blood in the urine, bruises in the back or abdomen, bleeds around the kidneys and other organs adjacent, and discomfort as the stone fragments pass through the urinary tract.

• Surgery is performed to remove the stone with a very large size in the kidney. A procedure called percutaneous nephrolithotomy involves surgery to remove Kidney Stones by using a telescope and a small instrument inserted through a small incision in the back.

• You will receive general anesthesia during surgery and be hospitalized for one to two days when you recover. Your doctor may recommend this surgery if ESWL is not successful.

• Uses urethroscope to remove stones. To remove the smaller stones in your ureters or kidneys, your doctor may use a urethroscope equipped with a camera through your urethra and bladder.

Once the stone location can be identified, a special tool can pick up a stone or break it into pieces that will flow in your urine. Your doctor can then place a "stent" in the ureter to reduce swelling and improve healing. You may need general or local anesthesia during this procedure.

• Parathyroid gland surgery. Some calcium phosphate stones are caused by an overactive parathyroid gland, located at the four corners of your thyroid gland, just below the Adam's apple. If these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and Kidney Stones can form as a result.

• Hyperparathyroidism sometimes occurs when small and benign tumors form in one of your parathyroid glands or you develop other conditions that cause these glands to produce more parathyroid hormone. Releasing the growth of the glands will stop the formation of Kidney Stones. Or your doctor may suggest a treatment condition that causes your parathyroid glands to produce too many hormones.

Kidney stone prevention

Lifestyle changes

You can reduce your risk of Kidney Stones if you:

• Drink plenty of water. For people with a history of Kidney Stones, doctors usually recommend urination of 2.5 liters of urine a day. Your doctor may ask you to measure your urine results to ensure that you drink enough water.

• If you live in a hot, dry climate or exercise frequently, you may need to drink more water to produce enough urine. If your urine is light and clear, you may drink enough water.

• Eat fewer foods that contain more oxalates. If you tend to build calcium oxalate stones, your doctor may recommend limiting foods that contain lots of oxalate, such as beets, spinach, sweet potatoes, beans, tea, chocolate and soy products.

• Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose non-animal protein sources, such as peas. Consider using a salt substitute.

• Continue to consume foods rich in calcium, but be careful with calcium supplements. Calcium in the diet has no effect on the risk of Kidney Stones. Continue to consume foods rich in calcium unless your doctor suggests otherwise. Ask your doctor before taking calcium supplements, as this is associated with an increased risk of Kidney Stones. You can reduce the risk by taking supplements with food. A low calcium diet can improve the formation of Kidney Stones in some people.

• Ask your doctor to get a referral to a dietitian who can help you develop a meal plan that reduces your Kidney Stone risk.

Medicines used

Medicines can control the amount of minerals and acids in your urine and may help in people who make up some kind of stone. The type of medicine your doctor prescribes will depend on the type of Kidney Stone you have. Here are some examples:

• Calcium stones To help prevent calcium stone formation, your doctor may prescribe thiazid diuretics or phosphate-containing preparations.

• Uric acid stones. Your doctor may prescribe allopurinol to reduce uric acid levels in the blood and urine and medications to keep your alkaline urine. In some cases, allopurinol and alkaline substances can dissolve uric acid stones.

• Struvite stones To prevent struvite stones, your doctor may suggest strategies to keep your urine free from the bacteria that cause the infection. Long-term use of antibiotics in small doses can help achieve this goal. For example, your doctor may recommend antibiotics before and for a while after surgery to treat your Kidney Stones.

• Stone cystine. Stone cystine can be difficult to treat. Your doctor may suggest that you drink more fluids so you produce more urine. If that alone does not help, your doctor may also prescribe drugs that reduce the amount of cystine in your urine.