Kidney stones are known as renal stones or renal calculi (single renal calculus). There are many causes of renal stones - dietary, hereditary (genetic), idiopathic (unknown).
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Incidence
Kidney stones and bladder stones occur commonly in Malaysian families. We have long hot weather and people tend not to drink sufficient water. They prefer to ignore the dangers of dehydration and possible kidney stone formation.
Malaysia is famous for its thick sweet milk tea (teh tarik or chai), which is consumed in the morning, afternoon and evening. It is taken with roti canai or plain dry biscuits (biskut Marie or biskut Cap Ping Pong). Teh tarik and roti canai are Indian cuisine, which Malaysians have adopted and blended into Malaysian cuisine.
Scenario 1: There was a big elderly man who liked thick sweet milk tea so much that he must consume it daily. He had a bladder stone for a long time before he decided to have it removed. When the bladder stone was removed, it was a big chalk-white ball - as big as a softball (bigger than a hockey ball). He kept the bladder stone as a souvenir! His unusual souvenir became an attraction for the village elderly.
Scenario 2: A young working girl liked thick sweet milk tea and often consumed it daily. She had little kidney stones which exited in her urine. However, one day, an usually large elongated kidney stone tried to exit her body, but got stuck half-way out at the orifice. She was in so much pain. She was rushed to the hospital in an ambulance, where the stone was pulled out without anaesthesia! She screamed! Hospitalisation was necessary to monitor her condition and she was discharged after two days. She switched jobs and became a successful entrepreneur. However, she has short stature and features of a kidney stone sufferer.
Scenario 3: A father of seven worked as a field supervisor for his college students. He refused to drink water when he was doing field work as there were no proper public toilets. He would only drink water at home. After working 30+ years, he developed kidney stones and suffered excruciating pain, which was relief with traditional ointment. He lived in a hot house and sweated profusely. No amount of water seemed to be able to replace his water loss. He refused intravenous saline and glucose infusions. He could not open his dry eyes and therefore could not see his food nor his children around him. He eventually died of severe dehydration - just skin and bones.
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Causes
Stones can form often when we don't drink sufficient water or eat certain food. There are many causes of kidney-related problems (also known as renal problems).
Kidney stone and pain
Kidney stones are also known as renal calculi (single calculus). They can form in the kidney and if they break off, the broken pieces can travel down the ureters (urine tubes) and lodge there. Whether the stones are lodged in the kidneys or the ureter, they will give rise to pain, sometimes very severe pain. Kidney stones cause excruciating pain known as renal colic.
Patients with renal stones suffer excruciating pain, which makes them unable to enjoy daily activities and sports. Life can be dreary for kidney sufferers. Some choose to ignore little pain or experience no pain.
Renal pain will cause patients to go to hospital to seek treatment and relief. Some will go to hospital only when nothing else seems to work at home. Some will call up friends to find help. Some will wait for someone to come by and visit them at home while stuck in bed. Patients are at a loss as to what they can do for themselves.
All of a sudden, relatives and close ones find themselves in charge of a patient with kidney problems, and often times, a kidney stone sufferer with the stone not yet removed. They don't know what to do either. All they can do is watch someone in pain till help comes along.
Chemistry of kidney stones
Kidney stones are chemical precipitates. As precipitates they can therefore be dissolved chemically. Some stones are easily dissolved. However, some stones maybe harder to dissolve.
Food
Lemon peels contain huge amounts of oxalates. The oxalates turn into crystals within our body and interrupt calcium absorption to a large extent. The unabsorbed calcium solidifies within the kidneys and gallbladder in the form of stones (calcium oxalate stones).
Passing stones in urine
Tiny kidney stones can exit via urine. However, kidney stones are actively growing crystals in the kidneys and these can grow to be quite big if not removed. When these big kidneys stones (like staghorns) try to exit the kidneys into the ureters, they will get lodged, bruise and tear the ureters, causing pain and blood in urine.
Bladder stones
Bladder stones form in the urinary bladder. The bladder is a big elastic pouch - ie, it expands with urine, bladder stone or both. Bladder stones can become as big as a softball or hockey ball.
Blood in urine
The presence of blood in urine is known as hematuria. Passing stones in urine can cause hematuria. Bloody urine is worrying as it can mean an active infection or kidney stones.
Tiny kidney stones can exit via urine. However, kidney stones are actively growing crystals in the kidneys and these can grow to be quite big if not removed. When these big kidneys stones (like staghorns) try to exit the kidneys into the ureters, they will get lodged, bruise and tear the ureters, causing pain and blood in urine.
Bladder stones
Bladder stones form in the urinary bladder. The bladder is a big elastic pouch - ie, it expands with urine, bladder stone or both. Bladder stones can become as big as a softball or hockey ball.
Blood in urine
The presence of blood in urine is known as hematuria. Passing stones in urine can cause hematuria. Bloody urine is worrying as it can mean an active infection or kidney stones.
*****
Incidence
Kidney stones and bladder stones occur commonly in Malaysian families. We have long hot weather and people tend not to drink sufficient water. They prefer to ignore the dangers of dehydration and possible kidney stone formation.
Malaysia is famous for its thick sweet milk tea (teh tarik or chai), which is consumed in the morning, afternoon and evening. It is taken with roti canai or plain dry biscuits (biskut Marie or biskut Cap Ping Pong). Teh tarik and roti canai are Indian cuisine, which Malaysians have adopted and blended into Malaysian cuisine.
Scenario 1: There was a big elderly man who liked thick sweet milk tea so much that he must consume it daily. He had a bladder stone for a long time before he decided to have it removed. When the bladder stone was removed, it was a big chalk-white ball - as big as a softball (bigger than a hockey ball). He kept the bladder stone as a souvenir! His unusual souvenir became an attraction for the village elderly.
Scenario 2: A young working girl liked thick sweet milk tea and often consumed it daily. She had little kidney stones which exited in her urine. However, one day, an usually large elongated kidney stone tried to exit her body, but got stuck half-way out at the orifice. She was in so much pain. She was rushed to the hospital in an ambulance, where the stone was pulled out without anaesthesia! She screamed! Hospitalisation was necessary to monitor her condition and she was discharged after two days. She switched jobs and became a successful entrepreneur. However, she has short stature and features of a kidney stone sufferer.
Scenario 3: A father of seven worked as a field supervisor for his college students. He refused to drink water when he was doing field work as there were no proper public toilets. He would only drink water at home. After working 30+ years, he developed kidney stones and suffered excruciating pain, which was relief with traditional ointment. He lived in a hot house and sweated profusely. No amount of water seemed to be able to replace his water loss. He refused intravenous saline and glucose infusions. He could not open his dry eyes and therefore could not see his food nor his children around him. He eventually died of severe dehydration - just skin and bones.
*****
Causes
Stones can form often when we don't drink sufficient water or eat certain food. There are many causes of kidney-related problems (also known as renal problems).
Kidney stone and pain
Kidney stones are also known as renal calculi (single calculus). They can form in the kidney and if they break off, the broken pieces can travel down the ureters (urine tubes) and lodge there. Whether the stones are lodged in the kidneys or the ureter, they will give rise to pain, sometimes very severe pain. Kidney stones cause excruciating pain known as renal colic.
Patients with renal stones suffer excruciating pain, which makes them unable to enjoy daily activities and sports. Life can be dreary for kidney sufferers. Some choose to ignore little pain or experience no pain.
Renal pain will cause patients to go to hospital to seek treatment and relief. Some will go to hospital only when nothing else seems to work at home. Some will call up friends to find help. Some will wait for someone to come by and visit them at home while stuck in bed. Patients are at a loss as to what they can do for themselves.
All of a sudden, relatives and close ones find themselves in charge of a patient with kidney problems, and often times, a kidney stone sufferer with the stone not yet removed. They don't know what to do either. All they can do is watch someone in pain till help comes along.
Chemistry of kidney stones
Kidney stones are chemical precipitates. As precipitates they can therefore be dissolved chemically. Some stones are easily dissolved. However, some stones maybe harder to dissolve.
Food
Lemon peels contain huge amounts of oxalates. The oxalates turn into crystals within our body and interrupt calcium absorption to a large extent. The unabsorbed calcium solidifies within the kidneys and gallbladder in the form of stones (calcium oxalate stones).
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Detection
Kidney stones are detected by x-ray, IVP, ultrasound, and CT scan.
Investigations
AXR = abdominal x-ray (x-ray of the abdomen)
KUB = kidney, ureter, bladder
IVP = intravenous pyelogram
CT = computed tomography
Renal profile
Urinalysis
Abdominal x-ray
Kidney stones are opaque and can be seen on x-ray of the abdomen (known as AXR). X-ray of the kidney, ureter, bladder is known as KUB.
IVP
A dye or contrast media is used to detect structures of the KUB. It detects problems of the urinary tract due to kidney stones etc.
Kidney ultrasound
Kidney ultrasound
Kidney stones can be detected by ultrasound of the abdomen - KUB. The patient must drink sufficient water an hour prior to the procedure and have his/her bladder full for this procedure. The patient then lies on the stomach and the KUB region is scanned.
Abdominal CT
CT of the abdomen and pelvis helps to detect cause of pain due to kidney and bladder stones.
Renal profile
This looks for abnormality of serum calcium and serum phosphate as well as altered kidney function.
https://labtestsonline.org/understanding/analytes/renal-panel/tab/sample/
https://labtestsonline.org/understanding/analytes/renal-panel/tab/sample/
Urinalysis
The Urine Dipstick Test looks for possible infection of the renal system.
Urine FEME looks for microscopic evidences such as casts (epithelial cells), crystals, yeasts, red blood cells, white blood cells, pus and other (if any).
https://medicinenewbie.blogspot.my/search?q=urinalysis
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Treatment
1. Cystone
2. Tamsulosin
3. ESWL = Extracorporeal Shockwave Lithotripsy
Urine FEME looks for microscopic evidences such as casts (epithelial cells), crystals, yeasts, red blood cells, white blood cells, pus and other (if any).
https://medicinenewbie.blogspot.my/search?q=urinalysis
*****
Treatment
1. Cystone
2. Tamsulosin
3. ESWL = Extracorporeal Shockwave Lithotripsy
Cystone
An Ayurvedic herbal prep which can help to dissolve kidney stones rapidly is Cystone. It is sold at local pharmacies. There are wonder stories about using Cystone for getting rid of kidney stones from patients who suffered years from kidney stones. Patients pass out sandy urine for a few days and the kidney stone is gone for good. https://medicinenewbie.blogspot.my/search?q=cystone
Tamsulosin
Tamsulosin is used to assist kidney stones exit in urine in difficult cases. It is also used in men with enlarged prostate gland as in prostate cancer, where urination is problematic.
ESWL
Larger kidney stones must be removed in the renal clinic or surgery. Large kidney stones can be removed by blasting the kidney stones as in the procedure extracorporeal shockwave lithotripsy (ESWL). ESWL is a mechanical means to break up kidney stones. This procedure is an outpatient procedure and the patient goes home after the procedure, unless there are other complications and need for extended stay. Patients may need some form of anaesthesia. The patient lies on a waterbed and laser light is passed through the kidney stone to break it up. The fine broken stone pieces will pass out in the urine. If a piece of kidney stone is too big and trapped in the ureter, it will need to be pushed back up into the kidney for further ESWL, until it is sufficiently small and safe to pass through the ureter and out into urine.
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Recurrence
Will kidney stones recur? It depends. If the diet is unchanged and patients continue to consume little water (remains dehydrated), then kidney stones may return. Adding more fruits and vegetables to the diet will help patients to stave off kidney stones .... hopefully for good.
Patient education
For patients who have hypertension, have kidney problems (eg kidney stones), and live in hot climate, some dietary modifications are necessary and consuming plenty of fluids will help. Personal education and willingness to make changes are of prime importance in patients with kidney problems. No amount of advice will help them unless patients themselves choose to change - ie, consume sufficient water daily, reduce salty food consumption, eat more fruits and vegetables daily, and stay out of the sun.
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Conditions at home
Most patients cannot afford the luxury of this life and do not have air-conditioning at home. They live in extremely hot houses without shirts on (for men) and just wrapped in sarongs (kemban for women). Sometimes old houses suffer from severe heat due to the nature of roofs that are installed. Previously people used attap roof for kampung houses. Nowadays people use Addex roof for kampung houses. Attap is cooler but has lost favour among villagers. Addex is preferred today, but it is not as good as attap. As such patients have no means to make their living quarters cool and conducive for safe living.
Designing homes
Thus, house design is of great importance in hot countries of the Equator, like Malaysia. Not all house designs and building materials are suitable for hot weather. Some form of natural ventilation and affordable means of cooling houses are needed. Architects and engineers have thus to come up with better house designs so that kidney problems can be reduced among poor people living in the Equator.
Global warming
Malaysia is hot (31C) at midday and cooler (24C) at night. Reducing exposure to the sun and heat maybe helpful for those with kidney problems. Drinking plain water before leaving home/office should help. Refusing to drink sufficient fluid in order to avoid having to go to toilet is a big reason why many refuse to drink sufficient fluid daily. Thus, these people fall victim to kidney problems, including kidney stones. As global warming heightens and the kidney stone belt widens, we can expect to see more patients with kidney problems.
External links:
http://www.healthcommunities.com/kidney-stones/radiology-diagnosis.shtml
https://en.wikipedia.org/wiki/Kidney_stone_disease
https://en.wikipedia.org/wiki/Abdominal_x-ray
https://www.radiologyinfo.org/en/info.cfm?pg=ivp
http://www.webmd.com/a-to-z-guides/intravenous-pyelogram-ivp#1
https://www.radiologyinfo.org/en/info.cfm?pg=abdominct
https://www.bigstockphoto.com/image-14677913/stock-photo-ivp-pyelogram-of-patient-with-kidney-stone
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/kidney_ultrasound_92,p07709/
http://www.webmd.com/kidney-stones/extracorporeal-shock-wave-lithotripsy-eswl-for-kidney-stones
https://en.wikipedia.org/wiki/Tamsulosin
