What is kidney stone?

Kidney stone; They are hard masses with mineral content formed in the kidney canals.

Why does it happen?

The reasons for the formation of these stones and the mechanism of formation are not known exactly. However,

familial predisposition,

Congenital urinary tract anomalies,

Some systemic diseases (Gout, Cystinuria etc.) may cause

Where and how does it occur?

Where there is urine, there may be stones, they may form in the pelvis of the kidney and in the pool of the kidney. Insufficient production of some protective substances in the urine by the body causes stone formation. Kidney stones are more common in hot, high altitude and tropical countries. There is the effect of the sun, the body’s vitamin D synthesis increases due to the sun. Vitamin D synthesis causes more absorption of substances in the intestines, especially calcium, and calcium stones are formed due to their more excretion in the urine.

What is the incidence in the community?

It is quite common.

Is it more common in women or men?

It is 3 times more common in men than women.

Which health problems accelerate the formation of kidney stones in a person?

Recurrent urinary tract infections pose a risk for kidney stones. In addition, kidney diseases such as cystinuria, metabolic diseases such as thyroid diseases or chronic pancreatic disease may predispose to the formation of kidney stones. Gout, a type of rheumatic disease, increases the rate of uric acid in the body and causes uric acid stones to form frequently. Uric acid stones are more common in men than women. Chronic intestinal inflammation is one of the diseases that often causes kidney stones to form.

What are the factors that increase the risk of stone formation?

Not drinking enough fluids during the day

Genetic Factors

Family history and personal history: Those with a family history of stones are more likely to form stones.

Age, gender and race: Kidney stone disease is mostly seen in the age range of 30-50 years.

little movement or inactivity

Diet

Does kidney stone give any symptoms? If so, what are these symptoms?

Pain of varying severity

Nausea / Vomiting

blood in the urine

Is the problem confused with other diseases? If so which are they?

Other diseases that cause abdominal pain should be considered. Acute appendicitis should be ruled out by performing tests in stone pain in the right lower quadrant.

How is the diagnosis of kidney stone made?

Imaging methods and laboratory tests are used in the diagnosis of kidney stones. It is usually seen if there is a kidney stone on the X-ray. While this film is being shot, the patient is hospitalized. However, not all stones can be seen on a direct x-ray. The system in which all stones are seen is computerized tomography.

What methods come to mind when kidney stone treatment is mentioned?

Medical Treatment : The majority of stones up to 5 mm in size can be reduced with painkillers, antispasmodic medication and plenty of fluid intake. The larger the stone, the less likely it is to drop it without intervention.

ESWL: Stone breaking with external shock waves

Percutaneous Nephrolithotomy (PNL): It is a current method applied when the stone in the kidney is larger than 2 cm or cannot be broken with ESWL. Under general anesthesia, a 1 cm incision in the lumbar region is entered into the kidney and the stones are taken out as a whole or by breaking them in the same way. In percutaneous nephrolithotomy surgery, which is an endoscopic, that is, a closed surgical method, images are magnified to a television screen with an endocamera. Stones are generally crushed by pneumatic, ultrasonic or laser stone crushers.

Urethoroscopy (URS): If the stones in the ureteral canal do not fall out or cannot be broken with ESWL, they can be treated by entering the urinary tract with the help of instruments called ureteroscope. Ureteroscopes are devices with a diameter of 2.5-3 mm, with a working channel along their length and a lens that provides the image. With rigid ureteroscopes, the external urinary tract and bladder are passed and entered into the ureter, and the stones are treated by breaking them with a Holmium laser or pneumatic stone crusher. With these ureteroscopes, stones in the lower and middle ureter can be treated. Flexible, that is, bendable ureteroscopes, on the other hand, are used in the treatment of stones in the upper ureter as well as in the pockets called pools and calices in the kidney, since their tips can be rotated in various directions and angles. After ureteroscopic stone treatment, patients are discharged home on the same day or one day later.

In which cases surgery is performed, in which cases non-surgical methods are applied and what is their success rate?

We now anticipate the least invasive treatment methods in the current approach. The structure, number, size and location of the stone are the most important elements that play a role in the selection of the treatment method.

What is the risk of recurrence of the problem if measures to prevent stone formation are not taken in patients with kidney stone treatment?

If preventive measures are not taken and some lifestyle changes are not made, the risk of recurrence of kidney stones due to environmental and genetic factors is quite high.

What is meant by stone formation preventive treatment?

Lifestyle changes play an extremely important role in preventing stone formation. Some measures such as avoiding fast food, consuming plenty of fluids and giving weight to exercise can be counted as ‘preventive changes’. In addition to these, there are some drug treatments that will be carried out under the control of a doctor. Early diagnosis with equally spaced health checks is important.

What should a person with kidney stones do?

Drink plenty of water, especially in summer, this is even more important.

Restrict drinks such as tea, coffee and cola as much as possible.

Limit salt consumption

Regular exercise or walking

Sudden weight loss should be avoided.

Can kidney stone formation be prevented? If yes, can it be blocked?

The risk of new stone formation can be reduced by making a few changes in lifestyle and diet. It is necessary to consume vegetables and fruits because of the foods containing fiber and their beneficial effects. However, it is necessary to avoid vegetables and fruits rich in oxalate (spinach, cocoa, tea leaves, walnuts, wheat bran). The amount of calcium taken should be limited unless there is strong reason to make such recommendations. Plenty of fluids should be consumed.

What are the misconceptions about kidney stones?

Calcium foods, strawberries and nuts make stones: FALSE!
Stone formation in the person is genetic and any type of food can cause stone. The precaution is to consume plenty of fluids.

Drinking too much water tires the kidneys: FALSE!
The ability of the kidneys to adjust the fluid according to the water entering the body is quite high. Therefore, excess fluid does not tire the kidney.

A person cannot live with one kidney: FALSE!
It is even possible to live 100 years without any problems with a single kidney. There are thousands of such patients. Unless there is a disease that will affect the kidney (high blood pressure, diabetes, stones, etc.), it is okay to live with one kidney.

Does the size of the stone matter in kidney stone reduction?

Yes, it is important.

How are kidney stones removed?

Stones under 5 mm may fall spontaneously. Plenty of water and movement helps the stones fall. It is possible to remove stones with drug therapy that expands the ureteral channels. Stones larger than 5 mm are also removed by operation.

Which application should be made in which size?

Stones larger than 6mm are dropped by intervention. Some of the stones between 4-6 mm fall off spontaneously and some with intervention. Stones less than 4 mm fall off on their own.

What is the effect of herbal treatment on kidney stone reduction? Do you have any warnings about this?

Some plants are effective in reducing stones because they work the kidneys. Of course, it is valid for stones under 4mm. My suggestion is that they do not do such a thing without consulting their doctor. Every plant may not be beneficial, on the contrary, it will even harm.

Does consuming lemon help reduce kidney stones?

Studies have shown that lemon juice prevents the formation of some stones. The citrate in lemonade is effective against kidney stones. Therefore, part of the fluid requirement can be taken in the form of lemonade.

What is the difference between kidney sand and kidney stone?

There is no difference between them.

What are the possible risks in interventions?

There is no such thing as risk-free surgery. The risks of open and closed kidney stone surgeries are the same. Bleeding is the most common complication. In studies, the probability of bleeding enough to require blood donation was found to be between 1% and 10%. As with any surgery, there is a possibility of infection in this surgery. In order to minimize this risk, it is necessary to investigate the presence of microbes in the urine before the surgery and to start preventive (prophylactic) antibiotics during the surgery. In very rare cases, injury to the intestine and surrounding organs may occur, as the procedure for entering the kidney is performed “blindly” with an x-ray device during this surgery. This risk is higher, especially in very thin patients.

What are the latest innovations in kidney stone treatment, what advantages do they bring to the patient and the doctor?

Innovations continue in both diagnosis and treatment methods. The biggest contribution in this regard is the reliance of medical engineering developments on medical applications. For example, what we described in the previous sections such as ESWL, PNL, URS are the innovations of recent years.

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