Kidneys are the filtering organ of our body that remove waste materials from the blood, which are then excreted from the body in the form of urine. Stones or stone-like hard masses develop, when minerals and acids present in the urine crystallize and accumulate inside the kidneys. If the stones are small, they can easily pass through the urinary tract, and then out of the body without causing discomfort. But, large stones can get stuck inside the urinary tract, and produce a host of symptoms, including severe pain. It has been observed that the occurrence of kidney stones is less in women than men. Nevertheless, women can also get these stones due to numerous reasons, and experience the painful symptoms.
Did you know?
A single kidney can execute the functions, that in normal circumstances two kidneys perform. When we lose one kidney, the nephrons (the individual filter of the kidney) manage to filter as much blood as two kidneys would.
Symptoms of Kidney Stones
Kidney stones symptoms in women are more or less similar to those experienced by men. These symptoms are usually produced when the stones gets stuck in the kidney, or come out of the kidney and enter the ureter and cause blockage and irritation. Such a situation can produce a number of symptoms, which are mentioned below.
Lower Back Pain
The pain caused by kidney stones can be mild or severe, depending on their size. The small kidney stones can produce mild cramping pain in the lower abdomen and the back, which many women may confuse with the pain that they experience during menstruation. On the other hand, the large stones can cause blockage of the ureter, which in turn can result in muscle spasms, and dilation of the ureter and the renal pelvis. This can manifest in a type of sudden cramping pain in the lower abdomen and the groin area, that comes in waves. It is known as renal colic, and many women compare it with the pain of childbirth.
Painful Urination
This symptom occurs when a kidney stone gets stuck in the ureter, and blocks the passage of urine either partially or completely. Along with pain, one can also experience a burning sensation while trying to pass urine.
Frequent Urge to Urinate
Like painful urination, this symptom is also produced when the stone gets lodged inside the ureter, and pushes against the wall of the ureter.
Bloody or Cloudy Urine
Presence of blood in urine (hematuria) can indicate an infection caused by kidney stones. Blood can also be present, when the stone becomes lodged in the urinary tract, especially inside the ureter and cuts the lining of the ureter. Some people having kidney stones can pass cloudy urine having a foul smell, which can be a symptom of kidney infection and/or a blocked ureter.
Fever
As mentioned above, kidney stones can cause infection at times, in which case, one can experience fever as well. The fever can be accompanied by chills. Infection usually results when a kidney stone blocks the passage of urine, or causes irritation in the urinary tract.
Nausea and Vomiting
Passing a kidney stone can be very painful, due to which one can get nausea and vomiting. Likewise, presence of an infection and fever, and the associated weakness can produce such symptoms.
Causes of Kidney Stones
There are different types of kidney stones, such as - calcium stones, oxalate stones, struvite stones, uric acid stones and cystine stones. Usually, kidney stones form when the urine becomes too concentrated and it contains more calcium, oxalate and uric acid than fluid. This allows such substances to crystallize and deposit in the kidney, eventually forming stones. Any factor that blocks the excretion of urine can cause the formation of kidney stones.
Sometimes, frequent urinary tract infection can also cause the development of kidney stones, which are known as struvite stones. Calcium stones are usually found in the form of calcium oxalate, and sometimes also as calcium phosphate. Calcium stones are the most common type of kidney stones which are formed when calcium, not used by the body, combine with phosphate or oxalate. Similarly, high levels of oxalate in the body can contribute to the formation of oxalate stones. Oxalate is a naturally occurring salt that can be found in a number of foods such as nuts, whole wheat, oatmeal, and chocolates.
Uric acid stones, on the other hand, are formed due to dehydration and over-consumption of foods rich in animal proteins, and alcoholic drinks. Medical conditions like, gout and certain metabolic disorders can promote the formation of uric acid stones, by increasing the level of uric acid in the urine. Cystine stones are quite rare. Usually people having a hereditary disorder (where the kidneys expel more cystine from the body, thereby increasing its level in the urine) are more susceptible to the formation of these stones.
Risk Factors
Certain factors have been observed to increase the risk of developing kidney stones. These factors are:
- Dehydration
- A family history of kidney stones
- A personal history of kidney stones
- A diet rich in protein, sugar, and sodium, but poor in fiber
- Obesity
- Having an intestinal bypass surgery
- Consuming calcium and vitamin D supplements in excess
- Diseases of the digestive system such as diarrhea and inflammatory bowel disease.
- Infections of the urinary tract
- Medical conditions like hyperparathyroidism, cystinuria, gout, renal tubular acidosis, hyperoxaluria, hyperuricosuria, and hypercalciuria
- Certain medications such as antacids, aspirin, and protease inhibitors
Diagnosis and Treatment
Clinical diagnosis of kidney stones is made on the basis of the symptoms, X-ray, and CT scan of the urinary tract, urine tests, and blood tests. The treatment for kidney stones depends on the type and the size of the stones. If the stone is small, then increasing fluid intake can help to flush it out from the body. Mild pain caused by small stones can be managed with the help of pain relievers like ibuprofen and acetaminophen. But, if the stone is large and is causing considerable pain, bleeding, and infection of the urinary tract, then invasive treatment would be required, which can involve the following procedures.
Extracorporeal Shock Wave Lithotripsy (ESWL): This procedure uses ultrasound waves to create vibrations, which are strong enough to break the stones into pieces, so that they can easily pass through the urine. Such vibrations are called shock waves. The procedure can, however, cause pain. That's why, it is performed under light anesthesia. If the stone has lodged in the ureter, then it is captured with the help of a ureteroscope, which is passed into the ureter through the urethra and the bladder. Once the stone is captured, it is removed or broken down into smaller pieces with laser beam or shock waves.
Ureterorenoscopy: This procedure is used when the kidney stones get stuck in the ureter. It involves passing a ureteroscope into the ureter through the urethra and the bladder in order to locate the stone. Once the stone is located, it is either removed by using a specialized instrument, or is broken down into small pieces by the application of laser beams.
Percutaneous Nephrolithotomy (PCNL): If the kidney stone is very large, then it is removed surgically, through this procedure. For surgical removal of the stone, a small incision is made in the back, through which a nephroscope (a telescopic instrument) is inserted into the kidney. Once the stone is located with the help of nephroscope, it is taken out of the body, or broken down into pieces by the application of laser or pneumatic energy. This procedure is usually employed for stones having a diameter of 21-30 mm, and also when the patient is obese and so, and not suitable for ESWL procedure.
Open Surgery: Open surgery for removing kidney stones is used only in rare instances, when the stone is abnormally large and is not possible to remove it with any of the aforementioned procedures. The same goes for some people with unusual anatomy, which makes them unsuitable for other treatment options. Open surgery is carried out by making a cut in the back, in order to gain access to the kidney and the ureter, so that the stone can be removed with the appropriate surgical instrument.
In addition to these four treatment options, sometimes surgery is performed to remove tumor/tumors developed in the parathyroid glands. A tumor formed in the parathyroid glands can cause hyperparathyroidism (overproduction of parathyroid hormone). This can result in the recurrence of calcium stones, as a high level of parathyroid hormone can increase the level of calcium in the body.
Preventive Measures
These simple tips can prove helpful in preventing the recurrence of kidney stones:
- Drink plenty of water throughout the day, as it will help to keep urine diluted and minimize the risk of getting kidney stones. This can help to flush out small kidney stones as well.
- Reduce the intake of coffee and tea.
- Avoid over-consumption of foods rich in oxalates, especially if there is a recurrence of calcium stones. Some oxalate rich foods are asparagus, rhubarb, beetroot, celery, parsley, leeks, spinach, sweet potatoes, soy products, nuts (almonds, cashew nuts and peanuts), oatmeal, whole wheat, berries and chocolates.
- Reduce the consumption of animal proteins (meat, poultry, and fish), if kidney stones are found to be caused by a high level of uric acid.
- Always take calcium supplements only after consulting your doctor, as these supplements have been observed to increase the risk of getting kidney stones.
- Reduce the intake of salt.
- Drinking some fruit juices, especially the citrus juices (orange or grapefruit juice) may lower the risk of stone formation in the kidneys.
- Don't neglect the symptoms of a urinary tract infection. Seek your doctor's help to treat such an infection and prevent their recurrence.
A basic idea or knowledge about the kidney stones symptoms in both women and men is quite important to ensure early detection, and removal of the stones. So, be sure to seek immediate medical attention, if you experience symptoms like, an excruciating pain in the lower back area, blood in urine or pain while urinating, cloudy urine with a foul odor, and a pain accompanied by fever and chills. Remember that, kidney stones can sometimes lead to complications like, blockage, infection and inflammation, which can result in kidney damage.