Kidneys are the filtration unit of the body - it eliminates the waste products from the body in the form of urine.

During the process of filtration of blood in the kidneys certain chemicals are deposited on the kidneys as crystals. These crystals grow gradually to form kidney stones.

Small stones pass through naturally. Large stones need to be removed. Stone cause pain in the loin and disturbances in the unirary function such as frequency, burning while passing urine and   blood   in the urine.

Stones can be detected by taking a St X-Ray of the KUB and an Ultrasonography of the KUB. Details can be figured out by I.V.P. (Intra Venous    Pyelography).

Small stones can be treated by ESWL or LITHOTRIPSY.

The word Lithotripsy means stone disintegration. This is achieved by a machine called Lithotriptor. Stones less than or equal to 1 cm. in size are ideal for this procedure. The first step is localisation, which is achieved by an isocentric ultra sound imaging syatem. Once localised, the shock wave therapy head is activated. The energy is delivered targeted at the Kidney Stone. Over a period of 45 minutes the stone disintegrates under continuous ultra sound monitoring. The fragments so created are then washed away in normal urination over a period of time.

TREATMENT & PROCEDURE :

ADVANTAGES OF LITHOTRIPSY :

• No anaesthesia
• No scar
• No pain
• Day-care procedure
• No infection

Large kidney stones are treated by Key Hole Surgery called PCNL (Per Cutaneous Nephro Lithotomy). A puncture is made in the loin under anaesthesia and a tract is dilated up to the kidney. The stone is disintegrated and the bits are removed through the same tract. The patient is discharged in two days from the hospital.

PROCEDURE :

The surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. Using a nephroscope the stone is located and removed. For large stones, a type of energy probe (ultrasonic, electrohydraulic, pneumoballistic) may be required to break the stone into small pieces. Patient is hospitalized for a few days and may have a nephrostomy tube left in the kidney during the healing process.

ADVANTAGES OF PCNL :

• Stones are completely removed
• Suitable for large stones, branched stones, stones in multiple location
• Patient does not rely on the natural passage of stones from the kidney
• Minimum morbidity and early return to normal life and work.

URETEROSCOPY :

Stones in the ureter can be accessed by Ureteroscopy. The patient is anaesthetized. The ureteroscope is passed through the urethra and bladder into the ureter. Once the stone is detected, a fibre is passed through the Ureteroscope to touch the stone. The other end of this fibre is connected to a disintegrating machine called LITHOCLAST. When this Lithoclast is switched on, the stone is completely disintegrated. Then all these fragments are washed out.
Finally, the ureter is fitted with a Double J Stent for two weeks.

IF STONES ARE NOT REMOVED :

They can cause

• Pain
• Infection
• Bleeding
• And ultimately, kidney failure

PREVENTION :

• Good water drinking habits
• Check blood
• St. X-Ray KUB
• Diet

KIDNEY STONE DIET :

WATER INTAKE

It is important that you drink large volume of water, more than two litres so that you pass two litres of urine per day.

CALCIUM INTAKE

They recommended dietary allowance for calcium is four hundred to five hundred milligrams per day. To get this amount of calcium, you need to limit milk and milk products to a maximum of one cup per day. You also need to reduce intake of calcium rich foods.

These include:

• Cheese, Skimmed Milk
• Sea food such as a Crab, Chingri
• Rajmah, Soyabean
• Til (Sesame), Poppy Seeds, Lime Peel
• Phalsa
• Curry Leaves, Black Arbi Leaves, Fenugreek Leaves
• Jaggery

OXALATE STONE :

Oxalates in the urine precipitate with calcium to form calcium oxalate stones. You should therefore avoid foods rich in oxalate. Food rich in Oxalates include -

• Tea Cocoa
• Baked Beans
• Vegetables- Beet, Brinjal, Ladies Finger, Capsicum
• Fruits - Black Grapes, Strawberries
• Misc - Peanuts, Tomato, Chocolates

URIC ACID STONE :

• These stones are associated with Gout
• These  stones   need   acidic   urine
• If concentration of uric acid is high, restriction of meat is beneficial. Also one needs to avoid tea, coffee and cocoa.