Treatment. Kidney Stones

If you have any kidney stone symptoms, it’s better to see a doctor and perform diagnostic tests.
Standard kidney diagnostic tests include:

• Urine testing.  A urine collection test may show that your levels of stone-preventing substances are too low or that your levels of stone-forming minerals are too high. 
• Blood testing. Via blood test, the doctor can check if uric acid or calcium levels are too high. Moreover, blood tests can identify other diseases that might be associated with symptoms. 
• Imaging. Dual-energy or high-speed computerized tomography can detect kidney stones even if they are tiny. A kidney stone can also be seen using ultrasound diagnostics. Moreover, the doctor can assign an X-ray diagnostic, but it cannot detect small stones.
• Analysis of passed stones. The doctor will ask you to urinate through a strainer to collect kidney stones that you excrete and analyze them in a laboratory. By analyzing the results, a doctor can determine the causes of kidney stones and prescribe the correct treatment. 

Treatment of kidney stones

Depending on the size of stones, a doctor may prescribe various treatments.

Treatment of small kidney stones:

Commonly, the small stones in kidneys may not require invasive treatment methods. Instead, you can deal with them by:

• Pain relief medications.  To relieve pain caused by the passing of small stones, a doctor may prescribe some pain relievers with ibuprofen. Naproxen sodium-containing medication can also be used for this purpose.
• Water balance. As long as you don’t have any contraindications, your doctor may recommend you drink about 2-3 quarts of water every day to prevent stone formation by keeping your urine dilute enough.
• Medical therapy.  Alpha-blockers, the medications that relax ureteric wall muscles, may be prescribed by your doctor. These medications make the process of passing the stones through the ureter quicker and less painful.

Large kidney stones treatment

More extensive methods may be necessary for kidney stones that are too large to pass through the ureter or those causing bleeding, urinary tract infections, or kidney damage. 

•  Surgical removal of large kidney stones. One of the surgical methods is percutaneous nephrolithotomy. In percutaneous nephrolithotomy, a surgical instrument and small telescope are inserted through a small incision in the patient’s back to remove the stone.

• Use of sound waves. In accordance with the size and location of the kidney stone, the doctor will prescribe extracorporeal shock wave lithotripsy (ESWL). Strong vibrations created by sound waves break large kidney stones into smaller ones that can pass in the urine. ESWL lasts about 40-60 minutes. You can feel some pain during the procedure, so commonly, the doctor provides some sedation or light anesthesia.

After the procedure, the patient can have bloody urine and bleeding around the kidney and adjacent organs. Patients can also experience an unpleasant sensation when stone fragments pass through their urine or experience bruising on their backs and abdomens.

• Parathyroid gland surgery. One of the kidney stones causes can be an overproduction of parathyroid hormone by the parathyroid gland. It leads to an increase in calcium levels that cause the formation of calcium phosphate stones. The tumor on the gland can cause its overactivity. Surgical removal of the growth can prevent stones formation.
• Use of scope for the removal of stones.  To deal with smaller kidney stones, your doctor may pass a ureteroscope (thin tube equipped with light and camera) through the urethra and bladder to reach the ureter. Special tools are used to entrap and shatter stones as they are discovered.

Prevention of the formation of kidney stones

We can divide the methods of prevention of stones into two categories: lifestyle changes and medications.

Lifestyle changes include:

1. Reduced consumption of oxalate-rich food. If you’re prone to the formation of calcium oxalate stones, you should eat fewer oxalate-reach food (such as chocolate, tea, spinach, okra, black pepper, soy products, etc.).
2. Maintain water balance throughout the day. To maintain your urine diluted enough, you should drink around 2 liters of water (2.1 quarts). Clear and light urine is an indicator of adequate consumption of water.
3. Be careful with calcium supplements. You can continue to eat calcium-rich food unless your doctor says otherwise. unlike calcium supplements, calcium-rich nutrition doesn’t influence stones formation. Before taking calcium supplements, you should consult your doctor since it can result in stones. Calcium-deficient diets can also cause kidney stones.

Medications

Depending on the type of stones, a doctor may prescribe different types of kidney stone treatment.

There are four main types of kidney stones: uric acid stones, calcium stones, struvite stones, cystine stones.