by Dr. Quy Vo Van*

Kidney stones are hard deposits made of minerals and salt that form inside your kidneys. They have many causes and can be found in any part of your urinary tract, from your kidneys to your urethra (tube connecting the kidney to the bladder), and bladder.

They are especially common in hot tropical countries, such as Viet Nam, as they often form when the urine becomes concentrated, allowing minerals to crystallise and stick together.

Most kidney stones are passed out naturally, which can be quite painful. If detected early, they do not cause permanent damage, but it is important to recognise them and seek treatment to avoid complications.

What are the symptoms?

A kidney stone is usually asymptomatic until it gets lodged somewhere in your urinary tract or when it is in the process of passing through your system. Symptoms include:

·         Severe flank/back pain, below the ribs that comes in waves

·         Pain that radiates to the lower belly and

·         More frequent urge to urinate and/or painful urination

·         Pink, red or brown urine

·         Cloudy or foul-smelling urine

·         Nausea and vomiting

·         Fever and chills

Typically the pain can change in intensity and also location.

Kidney stones form when your urine contains more crystal-forming substances than the fluid in your urine can dilute or prevent from sticking together.

Are there different types of kidney stones?

·         Calcium stones: The most common, usually from calcium oxalate which occurs naturally in many foods, such as certain fruits and vegetables, nuts and chocolate. High doses of Vitamin D can increase the risk.

·         Struvite stones: A reaction to urinary tract infections.

·         Uric acid stones: In persons who do not drink enough fluids, who sweat too much, and persons on a high protein diet.

·         Cysteine stones: These stones form in people with a hereditary disorders

Any risk factors?

·         Your genes: If it runs in the family your chances to get one are higher.

·         Dehydration: lf living in a tropical climate, not drinking enough and sweating.

·         Certain diets: Too much protein, salt or sugar

·         Being obese

·         Some other medical conditions and previous surgeries

When to see a doctor?

Seek immediate medical attention if you experience:

·         Pain -so severe that you can’t sit still or find a comfortable position

• with nausea and vomiting
• with fever and chills

·         Bloody urine

·         Difficulty passing urine

Diagnosis

If your doctor suspects a kidney stone, he will order certain blood and urine tests as well as imaging.

Treatment

There are several treatments depending on the type and size of the stone and whether you have an infection.

A small stone without many symptoms can be treated with pain killers and drinking plenty of water to flush it out.

For larger stone or stones that cause pain or obstruct/ reduce kidney function, cause bleeding or infections, more extensive treatment is required:

Non-invasive techniques, such as extra-corporeal shock wave lithotripsy (ESWL), minimal invasive techniques such as ureteroscopy/ Laser fibro- ureteroscopy, laparoscopy, or percutaneous nephrolithotomy (PCNL), or Mini PCNL for very hard and big stones are available.

Like with everything the best treatment is prevention. Some simple life style changes can help:

·         Drink enough fluids, preferably water or herbal tea.

·         Eat fewer oxalate-rich foods.

·         Limit your salt and animal protein intake.

·         Ask your doctor before taking calcium supplements.

If kidney stones run in your family, if you have any risk factors or if you just want to make sure everything is fine, ask your doctor for advice.

*Dr. Quy Vo Van is a highly qualified specialist in Urology and has years of training and experience in the newest technologies for disease of the uro-gential system. He has been successfully consulting and treating patients at the Hanoi French Hospital for many years.

If you have any questions or concerns regarding kidney stones, prevention and treatment, please contact us at 84 – 24 3577 1100, access www.hfh.com.vn, or email us at contact@hfh.com.vn. Address: 1 Phương Mai, Đống Đa, Hà Nội