Kidney stones

Kidney Function

Kidneys form a paired organ located in the abdominal cavity, on either side of the spine, just below the diaphragm. Their primary function involves removing harmful metabolic waste products from the blood, eliminating these substances via urine production. This process effectively “cleanses” the blood.

Description of the Disease

Kidney stones disease occurs when small, solid pieces of material called stones accumulate in the kidneys. These stones, formed from various minerals and salts, can also move into other urinary system organs, such as the ureters and bladder. In Lithuania, about 2% of the population suffers from kidney stones disease. The condition is rare in young people, with peak incidence occurring between 30-50 years of age. Men are affected several times more often than women.

Causes of the Disease

No specific cause exists for the formation of kidney stones. Rather, the condition arises from favorable conditions. Kidney stones usually start forming when urine concentration increases, causing various substances that form crystals (calcium, oxalates, uric acid) to combine. Kidney stones come in several types: oxalate, uric acid, struvite, phosphate, and carbonate. Determining their origin can indicate the conditions that led to their formation.

Risk Factors

Non-modifiable risk factors include:

• Older age
• Male gender
• Family history (relatives with a history of kidney stones disease)

Modifiable risk factors include:

• Dehydration (inadequate fluid intake)
• Dietary habits (high consumption of protein, salt, and sugar)
• Obesity

Symptoms

Kidney stones may remain symptomless until they move into the ureter. Typical clinical manifestations include:

• Back, flank, or severe lower back pain
• Painful urination
• Visible blood in the urine
• Fever (if an infection occurs)
• Nausea and vomiting

Changes in pain nature or location likely indicate a kidney stone moving through the ureter.

Diagnosis

Clarifying the patient’s complaints and prescribing blood and urine tests help determine the increased concentration of substances that cause stone formation. X-rays, ultrasound of the kidneys, and, in unclear cases, computed tomography serve as instrumental examinations.

Treatment

Most kidney stones do not cause symptoms and do not require interventional treatment. Monitoring, increased fluid intake, and dietary adjustments are commonly recommended. Analgesics help manage mild pain. Small kidney stones (up to 5 mm) may pass with urine. When stones are large or cannot be treated conservatively, various instrumental or surgical methods are used. One popular treatment method is extracorporeal shock wave lithotripsy, which breaks down stones with specific waves. In some surgical cases, the entire kidney may need to be removed due to stones like coral stones that could not be eradicated otherwise.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology