Kidney stones

By Group 3 : 1. Sisti anindita (1032161019)

2. Ella Novri Hasana (1032161022)
3. Annisa Yunita Maharani (1032161016)

An introduction :
The kidney is one of the key organs of human body that helps in the process of removing
waste products away from the body by way of urine. Urine contains many dissolved minerals
and salt. When your urine has high levels of these minerals and salts, it causes stones. Kidney
stones can start small but can grow large in size, even filling the inner hollow structures of
the kidney. Some stones stay in the kidney, and do not cause any problems. Sometimes, the
kidney stone can travel down the ureter, the tube between the kidney and the bladder. If the
stone reaches the bladder, it can be passed out of the body by urine. If the stone becomes
lodged in the ureter, it blocks the urine flow from that kidney and causes pain.

Kidney stone (the medical term is renal calculi) are small hard stones that from in the kidney
when the salts in the urine become solid. They can vary in size and location. Most stones are
small and are flushed out in the urine. Some grow over many years to become quite large.
Stones can lodge anywhere in the urinary tract and cause severe pain. There can be one or
more stones present at any one time. Anyone can get a kidney stone, most occur between the
agest of 20 and 60.

Sytomps of kidney stones

Stones in the kidney often do not cause any symptoms and can go undiagnosed. When a stone
leaves the kidney, it travels to the bladder through the ureter. Often the stone can become
lodged in the ureter. When the stone bloocks the flow of urine out of the kidney, it can cause
the kidney to swell (hydronephrosis), often causing a lot of pain.

Common symptoms of kidney stones are:

 A sharp, cramping pain in the back and side, often moving to the lower abdomen or
groin. Some women say the pain is worse than childbirth labor pains. The pain often
starts suddenly and comes in waves. It can come and go as the body tries to get rid of
the stone.
 A feeling of intense need to urinate.
 Urinating more often or a burning feeling during urination.
 Urine that is dark or red due to blood. Sometimes urine has only small amounts of red
blood cells that can’t be seen with the naked eye.
 Nausea and vomiting.
 Men may feel pain at the tip of their penis.
 Fever and chills
Treatment and Medication
While in the emergency department, you may be given:
 A strong painkiller to ease your pain
 Medication for nausea.
 Fluids into the vein (intravenous) to help flush out the stone.
 A urine test to look for infection, blood and cyrstals.
 A blood test to look at the salts in your blood and how well your kidney are working.
 An X-ray or CT scan to see whether there is a stone and check the state of the urinary
tract (this may be done as an outpatient).

Certain medications have been shown to improve the chance that a stone will pass. If the
stone is small, then it may just pass out in urine. The most common medication prescribed
for this reason is tamsulosin. Tamsulosin (flomax) relaxes the ureter, making it easier for the
stone to pass. May also need pain and anti-nausea medicine as waiting to pass the stone.
Drinking water, drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out
urinary system.

Kidney stones that can’t be treated with conservative measures, either because they’re too
large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary
tract infections may require more-extensive treatment. Procedures may include:
 Extracorporeal shock wave lithptripsy (ESWL) uses sound waves to create strong
vibrations (shock waves) that break the stones into tiny pieces that can be passed in
urine. ESWL is up to 99% effective for stones up to 22mm(0.8in) in diameter.
 Ureteroscopy. Sometimes knows as retrograde intrarenal surgery (RIRS). It involves
passing a long, thin telescope called a ureteroscopy through urethra (the tube urine
passes through on its way out of the body) and into your bladder. It’s then passes into
ureter to where the stone is stuck. A plastic tube called a stent may need to be
temporarily inserted inside to allow the stone fragments to drain into the bladder. For
stones up to 15mm (0.6 in), a ureteroscopy is effective in 50-80% of cases.
 Percutaneous nephrolithotomy (PCNL). PCNL involves using a thin telescopic
instrument called a nephroscope. A small incision is made in back and the
nephroscope is passed through it and into the kidney. The stone is either pulled out or
broken into smaller pieces using a laser or pneumatic energy. PNCL is 86% effective
for stones that are 21-30mm (0.8-1.2 in) in diameter.

How to prevent the kidney stones

 Drink enough water. The recommended is 8 glasses of water per day.

 Maintaining a healthy body weight. Being overweight can put stress on the kidney.
 Reducing alcohol intake. Alcohol causes cells to increase fluid output while
preventing fluid absorption, leading to dehydration.
 Avoiding excessive caffeine consumption. Caffeine speeds up metabolism and can
cause dehydration.
 Eat less sodium. Too much salt in the urine prevents calcium from being reabsorbed
from urine to the blood. This causes high urine calcium, which may lead to kidney
stones.
  Consume foods that can protect the kidneys, such as: basil, celery, apples, grapes,
pomegranates.

Sources:
 Emergency department factsheets. 2010. State government victoria
(www.health.vic.gov.au/edfactsheets)
 Urolgy care fooundation. Developed in 2015
(www.urolgyhealth.org/stones)