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Renal Stone

Definition:

Renal stones are the result of a buildup of dissolved minerals or salts on the inner lining of the kidneys. [2]

Overview

  • Basically, Renal stone disease is common, affecting individuals of all countries and ethnic groups.
  • Additionally, In the UK, the prevalence is about 1.2%, with a lifetime risk of developing a renal stone at age 60–70 of about 7% in men.
  • In detail, In some regions, the risk is higher, most notably in countries like Saudi Arabia, where the lifetime risk of developing a renal stone in men aged 60–70 is just over 20%. [1]
  • Kidney stones have many causes also can affect any part of your urinary tract from your kidneys to your bladder.
  • Often, stones form when the urine becomes concentrated, allowing minerals to crystallize also stick together.
  • Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they’re recognized in a timely fashion.
  • Besides this, Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone.
  • In other instances for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications surgery may be needed. [3]

Types

Not all kidney stones are made up of the same crystals.

The different types of kidney stones include:

Calcium:

Calcium stones are the most common.

They’re often made of calcium oxalate (though they can consist of calcium phosphate or maleate).

Eating fewer oxalate-rich foods can reduce your risk of developing this type of stone.

High-oxalate foods include i.e.:
  • Potato chips
  • Peanuts
  • Chocolate
  • Beets
  • Spinach

However, even though some kidney stones are made of calcium, getting enough calcium in your diet can prevent stones from forming.

Uric acid:

  • This type of kidney stone is more common in men than in women.
  • They can occur in people with gout or those going through chemotherapy.
  • This type of stone develops when urine is too acidic.
  • A diet rich in purines can increase acidic level of urine.
  • Purine is a colorless substance in animal proteins, such as fish, shellfish, and meats.

Struvite:

  • This type of stone is found mostly in women with urinary tract infections (UTIs).
  • They are made up of Magnesium ammonium phosphate.
  • These stones can be large and cause urinary obstruction.
  • They result from a kidney infection.
  • Treating an underlying infection can prevent the development of struvite stones.

Cystine:

  • Cystine stones are rare.
  • They occur in both human beings who have the genetic disorder cystinuria.
  • With this type of stone, cystine an acid that occurs naturally in the body leaks from the kidneys into the urine. [4]

Pathophysiology

Renal Calculus

  • Urinary calculi consist of aggregates of crystals, usually containing calcium or phosphate in combination with small amounts of proteins and glycoproteins.
  • In developed countries, however, most calculi occur in healthy young men, in whom investigations reveal no clear predisposing cause.
  • Renal stones vary greatly in size.
  • There may be particles like sand anywhere in the urinary tract, or large round stones in the bladder.
  • In developing countries, bladder stones are common, particularly in children.
  • In developed countries, the incidence of childhood bladder stones is low; In detail renal stones in adults are more common.
  • Staghorn calculi fill the whole renal pelvis and branch into the calyces; additionally they are usually associated with infection and composed largely of struvite.
  • Deposits of calcium may be present throughout the renal parenchyma, giving rise to fine calcification within it (nephrocalcinosis), especially in patients with renal tubular acidosis, hyperparathyroidism, vitamin D intoxication and healed renal tuberculosis.
  • Cortical nephrocalcinosis may occur in areas of cortical necrosis, typically after AKI (Acute Kidney Injury) in pregnancy or other severe AKI. [1]

Sign & Symptoms

The clinical presentation is highly variable.

Most patients with renal stone disease are asymptomatic, whereas others present with pain, haematuria, UTI or urinary tract obstruction. [1]

A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter the tube connecting the kidney and bladder.

Kidney Stone Pain Area

At that point, you may experience these signs and symptoms i.e.:

  • Severe pain in the side also back, below the ribs
  • Moreover; Pain that radiates to the lower abdomen and groin
  • Pain that comes in waves also fluctuates in intensity
  • Painful urination
  • Either Pink, red or brown urine
  • Either Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent need to urinate
  • Urinating more often than usual
  • Fever also chills if an infection is present
  • Urinating small amounts

All in all, Pain caused by a kidney stone may change for instance, shifting to a different location or increasing in intensity as the stone moves through your urinary tract. [3]

Causes

Environmental and dietary causes e.g.:

  • Low urine volumes i.e.: high ambient temperatures, low fluid intake
  • Diet: for example; high protein, high sodium, low calcium
  • Increase sodium excretion
  • High oxalate excretion
  • High urate excretion
  • Low citrate excretion

Acquired causes e.g.:

  • Hypercalcaemia of any cause
  • Either ileal disease or resection (increases oxalate absorption also urinary excretion)
  • Renal tubular acidosis type I

Congenital and inherited causes e.g.:

  • Familial hypercalciuria
  • Medullary sponge kidney
  • Cystinuria
  • Renal tubular acidosis type I (distal)
  • Primary hyperoxaluria [1]

Diagnosis

Sample

Test

Stone
  • Chemical Composition
Blood
  • Calcium
  • Phosphate
  • Uric acid
  • Urea also electrolytes
  • Bicarbonate
  • Parathyroid hormone
Urine
  • Dipstick test for protein
  • Blood
  • Glucose
  • Amino acids
24-hr urine
  • Urea
  • Creatinine clearance
  • Sodium
  • Calcium
  • Oxalate
  • Uric acid

[1]

CT Scan:

  • A CT scan of the abdomen is one way to test for kidney stones.
  • A CT scan will ascertain the state of the ureter, bladder, and kidneys, whether or not a stone exists, the kidney stone’s exact size and location, whether or not a blockage has occurred, and the state of other organs in the area, such as the appendix, aorta, and pancreas.

Ultrasounds:

  • Ultrasounds have also been shown to have high detection rates and can diagnose many complications associated with kidney stones.
  • Pregnant women should receive an ultrasound rather than a CT scan to avoid unnecessary radiation.

X-rays:

  • Once a person is diagnosed with a kidney stone, simple X-rays will be used to track the progress of the stone through the excretory system.

Treatment

Treatment for kidney stones varies, depending on the type of stone and the cause.

Small stones with minimal symptoms:

Most small kidney stones won’t require invasive treatment.

You may be able to pass a small stone by:

Drinking water i.e.:
  • Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system.
  • Drink enough fluid mostly water to produce clear or nearly clear urine.
Pain relievers i.e.:
  • Passing a small stone can cause some discomfort.
  • To relieve mild pain, use pain relievers such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve).
Medical therapy i.e.:
  • Generally Your doctor may give you a medication to help pass your kidney stone.
  • Additionally, This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly also with less pain.

Large stones:

Procedures may include:

Using sound waves to break up stones i.e.:
  • For certain kidney stones depending on size and location your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (in other words, ESWL).
  • Moreover, ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine.
  • Besides this, The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.
  • All in all, ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.
Surgery to remove very large stones in the kidney i.e.:
  • A procedure called percutaneous nephrolithotomy (in other words, PCNL) involves surgically removing a kidney stone using small telescopes also instruments inserted through a small incision in your back.
  • You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover.
  • Lastly, Your doctor may recommend this surgery if ESWL was unsuccessful.
Using a scope to remove stones i.e.:
  • To remove a smaller stone in your ureter or kidney, additionally your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.
  • Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine.
  • Your doctor may then place a small tube (stent) in the ureter to relieve swelling also promote healing.
  • You may need either general or local anesthesia during this procedure.
Parathyroid gland surgery i.e.:
  • Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam’s apple.
  • When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result.
  • Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone.
  • Removing the growth from the gland stops the formation of kidney stones. [3]

Indications for intervention to remove stones from the urinary tract:

Clinical Presentation

Procedure

Obstruction and/or anuria Emergency PCNL or stent
Pyonephrosis associated with stone Emergency PCNL or stent
Stone in a patient with solitary kidney Urgent  PCNL, stent, ESWL or ureteroscopy
Severe   pain and persistence of stone in renal tract Urgent  PCNL, stent, ESWL or ureteroscopy
Pain and persistence of stone in renal tract Elective PCNL, ESWL or ureteroscopy

[1]

Prevention

You may reduce your risk of kidney stones if you:

Drink water throughout the day i.e.:

  • For people with a history of kidney stones, doctors usually recommend passing about 2.6 quarts (2.5 liters) of urine a day.
  • Your doctor may ask that you measure your urine output to make sure that you’re drinking enough water.
  • If you live in a hot, dry climate or you exercise frequently, you may need to drink even more water to produce enough urine.
  • If your urine is light and clear, you’re likely drinking enough water.

Eat fewer oxalate-rich foods i.e.:

  • Basically, If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates.
  • These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate also soy products.

Choose a diet low in salt and animal protein i.e.:

  • In brief, Reduce the amount of salt you eat and choose non animal protein sources, such as legumes.

Continue eating calcium-rich foods, but use caution with calcium supplements i.e.:

  • Maintain good calcium intake (calcium forms an insoluble salt with dietary oxalate, lowering oxalate absorption and excretion)
  • Avoid calcium supplements separate from meals (increase calcium excretion without reducing oxalate excretion)
  • Lastly, Diets low in calcium can increase kidney stone formation in some people.

Homeopathic Treatment

Homeopathic treatment for Renal stone is  natural, safe and without any side-effects, and one can enjoy immense relief from these frustrating symptoms.

It is a patient-oriented science and medicines are prescribed on the characteristics of the individual rather than just the symptoms of the disease.

Berberis Vulgaris – for left sided kidney stone:

  • Generally, Berberis Vulgaris is one of the top listed medicines for kidney stones formed on the left side.
  • A unique symptom is pain in left kidney that radiates down the ureter also into the urinary bladder.
  • The pain can be shooting, stitching, either cutting or stinging in nature.
  • The pain may worsen especially from motion or jarring movement.
  • Urine may be yellow also may contain slimy sediments.
  • The kidney region is also sensitive to touch.

Lycopodium Clavatum –  for right sided kidney stone:

  • Lycopodium Clavatum is an excellent choice of medicine specifically for treating kidney stones of the right side.
  • Moreover, The person needing Lycopodium Clavatum has pain in the right kidney or right ureter.
  • The pain worsens especially before urination.
  • In detail, Urine is scanty.
  • Besides this, The kidney pain subsides after passing urine.
  • Red sediments may appear in urine.
  • All in all, In some cases, the urine may be purulent, turbid, or pale.

Hydrangea Arborescens – for stone in kidney with white or yellow sand in urine:

  • It is popularly known as the stone breaker.
  • Additionally, Hydrangea Arborescens is used to crush kidney stones, stones in ureter as well as bladder.
  • A significant symptom to look out for is either white deposits or yellow sand in urine.
  • If one notices either white or yellow sand deposits, then Hydrangea Arborescens is the sure shot cure.
  • Soreness in kidney region may also be felt in such cases.
  • Lastly, In some cases, blood may appear in urine.

Cantharis Vesicatoria – for kidney stone with burning urination:

  • Cantharis Vesicatoria is of great help in kidney stone where there is intense burning on passing urine.
  • The burning may also be present before urine is passed and may continue after urination.
  • Another attending feature is kidney pain with frequent urge to pass urine.
  • Tenesmus of bladder may also be marked where the urge to pass urine is almost constant, together with unsatisfactory urination.
  • Urine may contain jelly-like mucus.

Sarsaparilla Officinalis – for kidney stone with burning at close of urination:

  • Used in case of kidney stone with excessive burning at the close of urination.
  • Urine passed is scanty.
  • Urine may contain slimy or sandy particles.
  • Sarsaparilla Officinalis is also prescribed for right-sided kidney stones.

Ocimum Can & Tabacum  – for kidney stones when pain is attended with nausea/vomiting:

  • For kidney stones with pain attended with nausea/vomiting, Ocimum Can also Tabacum benefit most.
  • Ocimum Can shows remarkable results in kidney stone of the right side with nausea or vomiting while Tabacum is indicated for left-sided kidney stone with either nausea or vomiting.
  • Other features to look out for before prescribing Ocimum Can are red/saffron coloured urine, bladder tenesmus, burning on urinating also restlessness.
  • Some accompanying symptoms that will decide on Tabacum as the best medicine are  sensitive renal region, yellow-red urine also cold sweat.

Pareira Brava – for kidney stones when pain from kidney radiates to thigh:

  • Pareira Brava is a valuable medicine for kidney stone, especially in cases where pain from the kidney radiates down the thigh.
  • In some cases, the pain may radiate down to the feet from the kidney region.
  • There is also a constant urge to urinate.
  • Urine is passed with marked pain.
  • In men, pain may also be felt in glans penis while urinating.
  • Either Red sand or stringy mucus may be observed in the urine. [5]

FAQs

Frequently Asked Questions

What is Renal Stone?

Renal stones are the result of a buildup of dissolved either minerals or salts on the inner lining of the kidneys.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Renal Stone?

  • Berberis Vulgaris
  • Lycopodium Clavatum
  • Hydrangea Arborescens
  • Cantharis
  • Sarsaparilla
  • Pareira Brava

What causes Renal Stone?

  • Low urine volumes
  • Diet: high protein, high sodium, low calcium
  • Increase sodium excretion
  • Hypercalcaemia of any cause
  • either Ileal disease or resection
  • Familial hypercalciuria
  • Medullary sponge kidney
  • Cystinuria

What are the symptoms of Renal Stone?

  • Severe pain in the side and back, below the ribs
  • Pain that radiates to the lower abdomen and groin
  • Pain that comes in waves also fluctuates in intensity
  • Painful urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea also vomiting
  • Persistent need to urinate

Give the types of Renal Stone?

  • Calcium
  • Uric acid
  • Struvite
  • Cystine

References:

  1. Davidson’s Principles and Practice of Medicine (22nd edition) Ch. 17
  2. https://www.medicalnewstoday.com/articles/154193.php
  3. https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759
  4. https://www.healthline.com/health/kidney-stones#prevention
  5. https://www.drhomeo.com/kidney-stones/kidney-stones-and-homeopathy/