by The Welthi Bureau 20th March, 2020
Renal stones are a common problem across the world. Many people suffer with pain due to stones in the kidney. Welthi spoke to Dr Kalyan Kumar, consultant urologist, Star Hospitals, Hyderabad, to understand the causes and preventive measures needed to avoid recurrence of stones.
Why do stones occur in kidney?
Dr Kalyan: There is no one identifiable reason for formation of stones. They form due to many factors like genetics, lifestyle, diet, water intake, congenital malformations. Prolonged dehydration is a common factor leading to kidney stones because the chemicals that normally dissolve in water would tend to form crystals when the amount of water is less.
People with congenital malformations, i.e, abnormalities in formation of body parts during birth, have very high tendency to get stones in kidneys repeatedly because the physiological process is altered in them.
One other reason for kidney stones is intake of diet rich in oxalate. Spinach and red meat are rich in oxalates and it is good to consume them in moderate quantities.
Obesity also promotes renal stones.
Can renal stones be dissolved through medicines?
It is a myth that medicines and diet would dissolve the renal stones/reduce their size. A stone once formed in the kidney cannot get dissolved by taking medicines. At the most, medicines can hasten flushing out of the stones through urine. Further, restricted diet also cannot cure the already existing stones in the kidney.
Renal stones have to be broken down by laser beams or removed through physical effort.
The chance o a stone dropping out naturally depends on its size. Usually, small stones have a greater chance of spontaneous expulsion through urine. For stones beyond 6-7mm in size, the chance of natural expulsion is decreased.
If the stone is of a very less size not causing pain or any infection, then the patient can wait for it to get flushed out by itself through urine or use medicines to hasten the process.
Why do stones cause pain?
Stones once formed will either remain in the kidney or deposit elsewhere along the urinary tract. When these stones obstruct the flow of the urine, it results in pain and also affects the functioning of the kidney. If a stone is bigger than the size of the ureter, it blocks the way of the urine leading to pain.
However, it is not necessary that all stones should be associated with pain. Sometimes, even large stones can remain in the kidneys without causing any pain.
Is it necessary that stones be removed when there is no pain?
Stones are harmful as they act as the base for infection and can reduce renal functioning and also lead to sepsis. This is a long term effect. Hence, it is necessary that stones be removed.
What are the new techniques in removing renal stones?
In the past, open surgical techniques were commonly used for removing stones from the urinary tract. Since more than two decades, minimal invasive surgeries have been in practice in stone removal. Minimally invasive surgeries cut down the period of hospitalisation and also aid in faster recovery with reduced risk of infections.
Patients undergoing minimally invasive surgeries can usually get discharged in 24 hours. They can get back to work in 4-5 days.
Of late, even minimum incision is also being avoided as technology has helped in running flexible endoscopes through the existing urinary tract. This process is called retrograde intrarenal surgery (RIRS). If the size of the stone is big, laser beams are used to fragment it and the doctor also ensures that the debris too is removed to avoid further infections.
Sometimes, renal stones are removed through miniaturised incision percutaneous nephrolithotomy (mini-PERC). For this, a cut is made in the patient’s back and then the kidney is punctured to remove the stone.
What are steps that need to be taken to avoid recurrence of renal stones?
Basically, intake of red meat, sea food and salt should be avoided by the patient to avoid repeated formation of stones.
The patient should keep himself/herself hydrated by taking a good amount of water regularly.
Regular exercise also reduces the chance of stones again. It is also important to avoid excess intake of salt in diet.
Removing stones existing in the urinary tract is different from preventing recurrence of the stones. Once the chemical composition of the renal stones is known, the doctor can advise the patient on the dietary restrictions.
Book Appointment: Dr Kalyan Kumar, consultant urologist, Star Hospitals, Hyderabad
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