Kidney & Urinary Tract Stone Disease

Kidney & Urinary Tract

Stone Disease

Kidney and Urinary Tract Stone Disease

The kidneys are two bean-shaped organs that help in the removal of wastes from the body.

As the kidneys filter blood off impurities, minerals and acid salts can accumulate and harden over time. Theses kidney stones result from crystals in the urine aggregating together when the urine becomes highly concentrated. Normally these crystals pass through the urinary tract without problems. Occasionally, stones large enough can cause obstruction of the kidneys which may result in severe pain (back and groin), bleeding, infection and even kidney failure.

Renal stone formation is a common urinary tract disorder that can form in any individual and unfortunately further stone formation and symptoms will occur in 50% of previously symptomatic patients within 10 years. For more information on kidney stone prevention click here. Please be aware this is general advice only and more specific advice can be provided after further blood and urine tests. Also if you pass the stone or it is removed surgically this can also be sent for biochemical analysis.

Causes

Renal stones form when certain salts and minerals in the urine become highly concentrated and build up. This can happen due to

• Insufficient fluid intake 
• Increased production of certain chemicals such as Calcium, oxalate and phosphate in the urine
• Certain medications
• Family history
• Intestinal disease such as Crohn’s disease

When do kidney stones need to be treated?

• Serious infection from obstruction (Urosepsis – can be life threatening)
  • High fevers/chills/shakes needs URGENT MEDICAL ATTENTION at the nearest hospital Emergency Department 
• Obstruction with kidney failure (also emergency)
• Obstruction with stone not passing with trial of spontaneous passage
• Pain (in the back or groin) not relieved with medical therapy
• Stones in single functioning kidney due to high risk of kidney failure
• Recurrent urinary tract infections (UTIs)
• Painless nonobstructing (asymptomatic) stones sometimes require treatment due to risks of infection, kidney damage and other situations eg
  • Large stone size
  • Certain occupations (eg pilots, isolated areas, frequent travellers)

What treatments are available to treat stones?

Non surgical

• Trial of spontaneous passage
  • A large proportion of stones are small and pass without treatment
    • Smaller than 5mm = 90% pass spontaneously
    • Larger than 5mm < 50% pass spontaneously
  • In certain situations, a tablet called Tamsulosin (flomaxtra) may be beneficial in helping pass a kidney stone which is obstructing the ureter
• Dissolution therapy
  • =5% stones are uric acid & may be dissolved with oral medications

Surgical treatment

If surgery is deemed necessary, the vast majority can now be treated with newer minimally invasive laser surgical techniques which can be performed on multiple stones of any composition, in any location within the ureter and kidney without any open cuts (incisionless) allowing quicker recovery (See below).