Kidney Stones

Jenny Zha

Background/History
Kidney stones are hard, solid crystal-like concentrations that form in the kidneys from dietary minerals.
They form when the water, minerals and salts in urine is out of balance; for example, there might not be enough liquid to dissolve the minerals and salts, or there might be an excess, leading to kidney stones

They can be as small as a grain of sand, but as big as a golf ball

Most are not more than a third of an inch big

Stones are usually small and can be passed out of the body.
However, larger stones can block the flow of urine, which causes intense pain

They are classified by either location or by how they are composed

Kidney, Ureter (tube that carries urine from the kidneys to the bladder), Bladder Calcium, Uric Acid, Cystine, Struvite

Background/History
Calcium stones:
The most common They occur more often in men (ages 20-30) than in woman Likely to come back Calcium combines with oxalate, phosphate, or carbonate to form the stone

Cystine stones:
Form in people who have a genetic disorder called cystinuria

Struvite stones:
Found in women who have urinary tract infections. These stones can grow to be very large Can block the kidney, ureter, or bladder

Uric Acid stones:

More common in men Can offer with use of gout or chemotherapy

Background/History
The existence of kidney stones were known since thousands of years ago
Medical records of kidney stones were discovered in many early civilizations (China, India, Mesopotamia, Rome, Greece, etc)

In 1901, a kidney stone was discovered in the pelvis of a mummy that dated back to 4,800BC Lithotomy, or the surgical removal of stones, was one of the first surgical procedures performed Roman encyclopedist Aulus Cornelius Celsus De Medicina recorded a description of lithotomy, and was the basis for the procedure up to the 18th century

Background/History
In 1520, new techniques of lithotomy were discovered, but the operation was dangerous. However, in 1878, Henry Jacob Bigelow introduced litholapaxy, or the procedure of crushing of a stone in the bladder and washing out of the fragments
This dropped the mortality rate down from 24% to 2.4%

In 1980, Dornier Medtech created lithotripsy, which is a medical procedure that uses shock waves to break up stones in the kidney, bladder, or ureter
After the operation, pieces of the stone will pass out naturally in urine This is the most widely used method

Symptoms
Some kidney stones do not produce any symptoms; however, people with kidney stones often report pain in their low back, side or abdomen.
Pain can be very severe and can cause nausea and vomiting Pain is reportedly one of the strongest pain sensations felt by humans

Kidney stones also cause blood in the urine. Problems/pain urinating may also be from the cause of kidney stones

Diagnostic Test
Silent stones are usually found in x-rays during a general checkup.
These stones will usually be passed out naturally.

Stones may also be found if a patient complains about urinary pains; they are then sent for an x-ray or sonogram
Usually, the doctor will do a urine test and/or a blood test which can indicate any abnormal substances that can cause kidney stones

The urinary system might be scanned with a special xray intravenous pyelogram (IVP)

Prevention/Cure/Treatment
The likelihood of getting kidney stones can be reduced by:
Drinking a lot of water so that urine flow is constant Eating a diet of less animal protein and low in salt Eating fewer oxalate-rich foods (for example, chocolate, tea, etc)

People who have gotten them in the past will most likely get them again.

Prevention/Cure/Treatment
Cure = dissolving the kidney stones and naturally passing them out Most small stones (less than 5mm) will be passed out naturally by the body, so the doctor will only prescribe some medicine for the pain if needed and recommend drinking a lot of fluids If the stones are large and are blocking the urinary tract, or if an infection was found, extracorporeal shock wave lithotripsy, ureteroscopy, nephrolithotripsy, and open surgery will be used.

Prevention/Cure/Treatment
Extracorporeal shock wave lithotripsy (ESWL): Shock waves that can pass through the body easily will be able to break the stones. Ureteroscopy: The surgeon passes a thin telescope tube up the urinary tract to locate it, and subsequently breaking or removing it. Nephrolithotripsy: The surgeon puts a narrow telescope into the kidney through a cut in the patients back, and subsequently breaking or removing it. If the patient does not qualify for any of the above, the surgeon will do an open surgery to remove the stone, but this method is rarely used.

Prognosis
Though kidney stones may develop at any age, adults 40 years or older have a much higher chance of developing it. Men are more likely to develop kidney stones. High-protein/sugar/sodium diets will lead to increased risk of getting kidney stones Digestive diseases can cause an increase in the risk of getting kidney stones Family history of kidney stones will also influence whether a person develops it or not.

Prognosis
Life expectancy generally unaffected if treated, unless there are other diseases/complications present. Quality of life overall is generally unaffected if treated.
However, if left untreated, kidney stones cause extreme pain.

Primary Source #1
New technique that nudges kidney stones towards the kidney exit. Uses low intensity ultrasound waves, able to move the stones from kidneys down to the descending tubes Success testing on live pigs, who have similar kidneys to humans. Sound wave treatments leave behind small pieces of kidney stones that can be the basis for other kidney stones, and therefore are not completely efficient. This treatment should be used in correlation with one of the other methods. Currently refining animal experiments, will be tested on humans in 2 years

Primary Source #2
Doctors at St. David's Round Rock Medical Center have new technology that only leaves a small scar
Kidney stone is accessed through a small cut in the back

Less painful operation A medical jackhammer goes in through the small cut to break up the kidney stones before they are sucked out Quick recovery rate 5 day recovery

Homeostasis
Homeostasis: The ability of a system or living organism to adjust its internal environment to maintain a stable equilibrium

Kidney stones can disrupt or prevent the excretion of urine. This will prevent the organism from excreting nitrogenous wastes, unneeded ions and water. Thus, homeostasis in the body is disrupted.

Works Cited
Kidney stones. Medline Plus. N.p., n.d. Web. 9 June 2011. <http://www.nlm.nih.gov/medlineplus/ency/article/000458.htm>. Kidney Stones. Wrong Diagnosis. N.p., n.d. Web. 9 June 2011. <http://www.wrongdiagnosis.com/k/kidney_stones/tests.htm>. Kidney Stones - Treatment Overview. WebMD. N.p., n.d. Web. 9 June 2011. <http://www.webmd.com/kidney-stones/kidney-stonestreatment-overview>. Mayo Clinic. N.p., n.d. Web. 9 June 2011. <http://www.mayoclinic.com/health/kidneystones/DS00282/DSECTION=risk-factors>. Rettner, Rachael. New Kidney Stone Treatment Would Nudge Rather Than Blast. Live Science. N.p., n.d. Web. 9 June 2011. <http://www.livescience.com/5774-kidney-stone-treatment-nudgeblast.html>. What are Kidney Stones? HeathMD. N.p., n.d. Web. 9 June 2011. <http://www.medicinenet.com/kidney_stone/page2.htm>.