Nephrolithiasis is a urinary system disease. Nephrolithiasis is commonly known as kidney stones. Kidney stones form due to the deposition of minerals and salts in the kidney. Approximately 10-15% of the US population is affected by this condition.
Diagnosis of Nephrolithiasis
There are Different Types of Nephrolithiasis. These types depend on the deposition of minerals and salts, e.g., Calcium, Uric Acid, Cystine, or Struvite. Therefore, different evaluations and tests are performed to diagnose the condition’s type and actual cause.
Some kidney stones are considered “Silent stones” as they show no signs and symptoms unless detected by a general X-ray for a medical health exam.
Suppose a patient shows symptoms such as flank pain and hematuria(blood in urine); this shows something wrong. The evaluation and test performed to rule out the cause of the disease include:
- Medical History
- Physical Examination
- Urinalysis (content, appearance, and concentration of urine is tested)
- Blood Test (indicates the excess quantity of calcium, phosphate, or uric acid in the blood)
- Urine Culture (Lab test performed to check the presence of any bacteria or germ in the urine)
- Examination of passed urine (Urine Stainer is used to detect the presence of any stone in the urine you passed)
- Imaging Tests
The imaging test for Nephrolithiasis includes the following
- Abdominal X-Ray
- Ultrasound
- CT-Scan
- KUB X-ray (Kidney, Ureter, and Bladder X-ray is used to detect the size and shape of the kidney stones)
- Non-Contrast CT scan (NCCT) of the Abdomen and Pelvis (considered Gold standard to detect the stones)
Treatment of Nephrolithiasis
After diagnosing the type and cause of the stone, the next step to be taken is treatment. Treatment varies based on the type, size, and nature of nephrolithiasis, such as if it’s causing pain and blocking the urine or not.
Some crystals/ kidney stones are too small in size that can be excreted out from the body when you urinate. In comparison, some are large and require proper medication or surgery.
Small-sized Nephrolithiasis (Kidney Stones)
If you have a small stone in your kidney, you’ll be recommended to follow the below-given protocol.
- Drink Plenty of water
- Analgesics (Pain killers)
- Alpha-blockers (to relax your muscle so that the stone can pass out with urine)
- Antiemetics (to treat nausea and vomiting symptoms)
Large-sized Nephrolithiasis (Kidney Stones)
Nephrolithiasis that is too large to pass through urine causes kidney damage, bleeding, and infection in the Urinary tract leading to complications. Removal of these stones requires Lithotripsy or Surgery.
Lithotripsy
This treatment option includes two types:
- Extracorporeal Shock Wave Lithotripsy (ESWL)
- Flexible Ureteroscopy and Laser Lithotripsy (FURSL)
Lithotripsy
Surgery
- Ureteroscopy: A small telescope is used in this procedure to break the stone with the help of a laser.
- Percutaneous Nephrolithotomy (PCNL): A minimally invasive surgery performed to remove large kidney stones.
- Parathyroid Gland Surgery: It is performed if the cause of stones is high calcium levels. The parathyroid gland regulates the production of parathyroid hormone. The excess production of this hormone leads to high levels of calcium.
- Open Stone Surgery: It is an infrequent treatment option for nephrolithiasis. Only 0.3% to 0.7% of cases undergo this surgery.
FAQS
- How is nephrolithiasis treated?
- Can kidney stones go away on their own?
- What is the best diagnostic method for nephrolithiasis?
- Can an X-ray reveal the existence of nephrolithiasis?