CONDITIONS
Renal Stones

 
 

Overview

Renal calculi, also known as kidney stones, are solid deposits of crystals formed in the urinary tract. The urinary tract consists of the kidneys, ureters, bladder and urethra.

These calculi may be associated with mild to very severe symptoms.

 
 
 
Signs and symptoms of kidney stones include:
  • Flank pain which may radiate towards the groin
  • Blood in the urine
  • Urinary tract infections
  • A sensation of needing to frequently pass urine

Kidney stones are common. Approximately 10% of people will experience symptoms from kidney stones in their lifetime.

There are several types of stones. These stones are classified according to their biochemical composition. The most common calculi are composed of calcium and oxalate. These stones make up about 70% of all kidney stones.

Risk factors for kidney stone formation

We may be able to identify modifiable risk factors for kidney stone formation following certain anatomical and biochemical investigations. Dietary changes and increased fluid intake combined with tailored prevention strategies may reduce the likelihood of kidney stones forming in future.

If you have had a kidney stone before, then there is about a 50% chance of forming another stone in the next decade. It is normally a combination of risk factors for kidney stone formation that lead to calculi forming.

Diagnosis

The signs and symptoms of kidney stones are non-specific. For this reason, it is often required to look for renal calculi using radiographs or scans. A CT scan is the best way to diagnose kidney stones. Plain X-rays and abdominal ultrasound may frequently identify the presence of calculi within the urinary tract as well.

Treatment of kidney stones

Kidney stone treatment depends largely on the size, number and position of the stones within the urinary tract. Different treatment modalities may be combined to treat stones.

For most patients, concurrent with diagnosis, initial treatment is aimed at controlling pain and treating a urinary tract infection if present. Then further treatment may include:

  1. Medical expulsive therapy: The focus is on managing pain and facilitating the spontaneous passage of stones.
  2. Ureteric stent insertion: A plastic tube is inserted and bypasses blockages in the ureter caused by stones. This allows the kidney to drain and the removal of stones at a later stage. Stent insertion is often required following surgery to remove kidney stones.
  3. Extracorporeal shockwave lithotripsy: Focused soundwaves are generated and focused on breaking up stones. Stone fragments are allowed to pass spontaneously.
  4. Ureterorenoscopy and stone fragmentation: A camera is passed through the urethra up the urinary tract. Stones are located and fragmented with a laser. Fragments are extracted with a basket retrieval device.
  5. Percutaneous Nephrolithotomy: This technique is often used for larger/multiple kidney stones. A tract/keyhole is created, and direct telescopic access to the kidney is obtained via the back or flank. Stones are fragmented and extracted via a small incision.

Because kidney stones often recur long term follow-up is often required. General measures and specific medical treatments may be applied to reduce the likelihood of new stones forming.

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