All You Need To Know About Calculations, And Most Importantly: Here's What You Need To Do

By Cristiano Antonino Last updated Jun 18, 2023

Kidney stones, also referred to in medical jargon as “nephrolithiasis” or “renal lithiasis”, are similar to pebbles that form inside the kidneys when the substances normally present in the urine become too concentrated and aggregate in the form of solid material

What are kidney stones?

Kidney stones are pebbles that can remain in the kidney or, over time.

They tend to pass from the latter to the lower urinary tract, the ureter, to reach the bladder and, finally, to be expelled through the process of urination.

Kidney stones are a rather widespread problem in the West and in our country in particular.

It is estimated that it affects about 5% of the female population and 10% of the male population.

When can they appear?

The age with the greatest incidence is between 30 and 50 years, stones rarely appear in subjects under 20 years of age.

Recurrence is a phenomenon that occurs very often: depending on the reference studies, from 25 to 50% of cases after 5 years.

The growing trend of this disorder in recent decades is sometimes attributed to a higher consumption of animal protein than in the past.

Generally the manifestation of urinary stones is associated with an unbalanced diet, a genetic predisposition and low fluid intake.

The formation of kidney stones is also facilitated by some inflammatory processes.

Kidney stones can be of different types and sizes

When they are of contained volumes, they can be asymptomatic and eliminated completely spontaneously without the patient experiencing any disturbance.

However, in many cases kidney stones end up generating a sharp and violent pain in the lumbar region.

This symptom is peculiar to calculi and due to its characteristics it falls within the more general picture of what is called “renal colic”.

In order to avoid the formation of kidney stones it is necessary to keep the urine in a state of undersaturation, i.e. well diluted, through constant hydration aimed at generating diuresis over 2 liters.

The most commonly encountered stones are formed by calcium salts, but there are also those of uric acid and those of struvite, deriving from a particular urinary infection.

There are also those made up of cystine, generated by a rare hereditary disease.

To correctly diagnose the type, it is essential to analyze the composition of the stone once it has been expelled, through a chemical or crystallographic examination.

Symptoms of kidney stones

As already mentioned, when small in size, kidney stones can be expelled through the urine without causing any pain.

In some cases, however, kidney stones can lead to the onset of an acute and sudden sensation of pain, which extends into the abdominal and lumbar area and is known as renal colic.

When the circumstance occurs in which the characteristic “pebble” remains trapped in the kidney or cannot easily pass through the urinary tract, various symptoms may occur such as:

persistent and severe pain in the lower back and abdomen; sometimes it can radiate to the groin and can last for a few minutes or hours (renal colic).
Often described as feeling like a “knife in the side”
nausea
restlessness and inability to keep still
stranguria, i.e. the need to urinate more than usual
dysuria, i.e. pain when urinating
haematuria, i.e. traces of blood in the urine, caused by the traumas caused by the passage of the calculus on the wall of the urinary tract.

If the presence of a calculus completely obstructs the ureter, accumulation and stagnation of urine inside the kidney (hydronephrosis), bacterial proliferation and infection of the ipsilateral kidney (called pyelonephritis) can occur.

The disturbances generated by the kidney infection are similar to those caused by stones and add up to them

high fever (38°C and above)
chills
tiredness and weakness
cloudy and foul-smelling urine
diarrhea

Cures and remedies

Kidney stones can range in size from the size of a grain of sand to the size of a golf ball.

Evidently, as the size increases, the expulsion process will be less easy, if not impossible in a spontaneous and painless way.

A calculation around 4 millimeters, for example, has a high probability of spontaneous expulsion.

Larger dimensions, on the other hand, will make therapeutic intervention necessary.

Until a few years ago the only practicable way was the surgical one which, through the use of different methodologies, reached a resolution of the situation with the removal or fragmentation of the stones.

Today an innovative technique has taken hold, called lithotripsy, which allows you to treat stones without making cuts.

It is based on the production of shock waves sent with precision, with the aid of X-rays or ultrasound, in order to hit the stones themselves.

These waves pass through the soft tissues of the body and pour their energy onto the stones in order to generate their fragmentation (therefore their subsequent expulsion).

The treatment of each stone also provides for the dilution of the urine: take plenty of liquids, especially water (tap water is also recommended).

Several investigations assert that a daily hydration equal to or greater than 2 liters limits recurrences, which are frequent for this type of disorder.

Furthermore, it is desirable to significantly reduce the consumption of salt and the intake of animal proteins such as meat, eggs and fish.

Unlike what has been claimed in relatively recent times, it is not necessary to eliminate dairy products from the diet, but you can easily opt for a normal-calcium diet.

In some cases, the elimination of foods such as milk or cheese could generate major problems at the skeletal level, especially if the patient had high levels of calcium dispersion in the urine.

Sometimes, in fact, stones and osteoporosis can have correlations.

As seen, when kidney stones are small enough, they can easily be expelled through urination. Even if they are not very large, however, they can sometimes generate pain that lasts a couple of days and disappears when they are eliminated.

In case of acute pain, the doctor can prescribe painkillers to be taken even several times during the day, based on the intensity of the disturbances.

If nausea and vomiting occur, antiemetic drugs can be taken to relieve them. Antibiotics, on the other hand, are administered in case of urinary tract infection.

Finally, hospitalization may be recommended in some particular cases:

pain that does not subside within an hour of taking painkillers and antiemetic drugs
dehydration and the presence of unstoppable vomiting
pre-existing kidney disease (for example, if you have only one kidney)
pregnancy
other diseases present at the same time.

When the stones are too large to be expelled naturally, different techniques can be used, depending on the specific case.

However, it is good to know that such treatments can cause complications such as: