Renal calculi

Renal Calculi or kidney stones are the crystalline deposits of minerals and salts inside your kidneys. This is one of the most common disorders of kidneys. It affects a great number of people every year. A poor diet, lack of exercise, and less intake of water can be some underlying causes of kidney stones. These stones affect other parts of the urinary system too. The severity of the disease depends upon the organ and time of identification. A stone in the urethra can be very chronic, whereas a stone in the kidneys is easily passed by medications through urine. The size of the stones also matters a lot in treating the disease.

Kidney stones can be very painful and cause alternate phases of painful experience. The stone consists of chemicals such as calcium, cystine, urate, oxalate, xanthine, and phosphate. The stone in the kidneys can travel to other parts of the urinary system. Thus, doctors aim to remove it by passing it to the bladder and eventually out of the body through urine.

Definition of Renal Calculi

Renal Calculi are the hard deposits of minerals and salts in the kidneys or other parts of the urinary tract, leading to severe pain. 

Causes of Renal Calculi

There is no exact cause for this disease. However, many underlying factors can contribute to it. Some of these causes may be lack of water in daily routine, lack of proper exercise, poor diet, and after effect of any surgery. Fructose, a substance in sugar, in excess can also cause kidney stones. The family history of the disease is also important for the doctors to know. 

Symptoms of Renal Calculi

The symptoms may vary from person to person, depending upon the size and type of kidney stones. Patients with big stones or many stones often feel more pain and are more critical than patients with small stones. 

Some of the common symptoms of it are as follows-

• Pain in your lower back or side of your body in the abdominal region.
• Nausea and vomiting due to excessive pain.
• Spotting blood in the urine.
• Painful urination. 
• Difficulty or unable to urinate.
• The frequent urge of urination 
• Fever or chills due to excess pain.
• Cloudy urine with a bad odour. 

Renal Calculi Classification

Not all kidney stones are the same; they differ in the process of their formation. You must know the type of kidney stone for complete eradication of it. However, the renal calculi classification is under these four categories:

1. Calcium stones- Calcium stones are the most common type of stones in the kidneys. They are present in the form of calcium oxalate. Oxalate is present in our diet. Due to heavy intake of oxalate or the kidneys being unable to purify, they get accumulated in the kidneys and form stones. Chocolates, fruits, certain vegetables, and nuts have oxalate in them. 

Surgeries, high Vitamin D content in the body, and other renal infections such as renal tubular acidosis increases the chances of this infection. It can also be due to less intake of fluids due to which kidneys fail to excrete them properly.

1. Struvite Stones- Though they are not so common, they can grow large in a short time. They do not cause many symptoms in the early stages. It can be due to the response of a urinary tract infection.
2. Uric Acid stones- Uric acid stones are also a common type of kidney stone. They are due to excessive intake of purines in the diet. Purines are present in organ meat and shellfishes. This purine intake causes higher production of monosodium urate, which forms stones. It can also be because of certain genetic factors. 
3. Cystine Stones- Cystine stones are quite rare and are due to genetic disorders. A genetic disorder called cystinuria causes kidney malfunction in which the kidneys produce an excess of certain amino acids. 

Diagnosis of Renal Calculi

The diagnosis of renal calculi may involve the following procedures:

• Blood Test- Blood tests are performed to check any excess uric acid or calcium in your blood. An excess of these can eventually cause the building up of kidney stones. 
• Urine test- The doctors will ask the patient to collect their urine sample in two alternate days. The doctors will examine the urine to check for any excess stones forming minerals in it. 
• Imagining- Imaging like CT (computerised tomography) scans or X-rays is very effective in recognising any stones in the kidneys. CT scan is much better to identify even small stones which X-rays can miss. 
• Analysing kidney stones- The patient is asked to use a strainer while urinating the stones out. The analysis of the stones helps doctors to know about the root cause of the disease. This eventually helps the prevention of any future disorder. 

Treatment 

The treatment for kidney stones varies from person to person depending upon the size of their stones. Some of these treatments which can be used for treating the disease are as follows-

• Medications- In case of small stones, the doctors will give you medications that will help in the removal of kidney stones. These medications relax the muscles of the ureters and the stones are easily passed, causing much less pain. 

The doctors may also ask to drink more water for the easy and successful elimination of these stones. A proper light diet is necessary with these medications.

• Breaking of Larger Stones- In the case of larger stones, which cannot be eliminated through urine. The doctors perform extracorporeal shock wave lithotripsy (ESWL) for breaking-up of bigger stones into smaller ones. The lithotripsy can last 40 to 50 minutes and can cause pain afterwards. Now, the stones are in a smaller size and so, they are removed by medications through urine. 
• Surgery- In case of larger stones in the area which need immediate treatment, surgery is necessary. The doctors will give anaesthesia to the patient before performing the surgery. The procedure of surgically removing kidney stones is the percutaneous nephrolithotomy. 

Conclusion 

Renal calculi or kidney stones are the excessive accumulation of salts and minerals due to the malfunctioning of kidneys. Kidneys fail incomplete removal of these salts from the body leading to their accumulation. Renal calculi classification is in four basic categories, namely, calcium oxalate, uric acid, struvite, and cystine. The treatment involves, firstly, the diagnosis of the type of stone and then proceeding towards treatment.