Dr. Sohrab Mittal
Kidney stones are a major health problem in India. Studies have shown that 12% of him in India suffer from kidney stones, 50% of whom may have lost kidney function. An estimated 10 million people in the country suffer from kidney stones, and the prevalence is increasing each year. The most common morbidity of kidney stones is renal colic, which is painful, often acute, and requires immediate attention. Lack of awareness about the condition and its proper treatment is a major factor in the large number of cases. Furthermore, the lack of access to quality medical care in rural and remote areas leaves many kidney stone patients undiagnosed and untreated. This leads to higher morbidity and mortality.
Kidney stones and factors leading to diagnosis
Most of these stones are formed by a combination of genetics and environmental factors such as diet and lack of exercise. Studies have shown that people with a family history of kidney stones are more likely to develop them. Certain disorders of the small intestine and some medications can also increase the likelihood of calcium oxalate stone formation. Dietary factors that increase the risk of stone formation include sodium, protein, potassium, calcium, magnesium, and Contains other nutrients. Animal protein intake can also promote the formation of calcium kidney stones. Urinalysis, serum creatinine, electrolytes, and parathyroid hormone testing are the basic tests recommended for all stone formers as an initial evaluation. Her x-rays (X-KUB) and ultrasound of the kidneys, ureters, and bladder are performed on all patients (90% of kidney stones are radiopaque).
Preventive measures for kidney stones
In general, kidney stones can be prevented with certain dietary restrictions, lifestyle changes, and drinking plenty of fluids, especially water. To prevent calcium oxalate stones, cystine stones, and uric acid stones, you should consume plenty of fruits, vegetables, and citric acid to make your urine alkaline. On the other hand, for prevention of calcium phosphate and struvite stones, the urine should be acidified. Cranberry juice and foods rich in betaine (wheat bran, wheat germ, spinach, etc.) help control urine pH.
In addition to this, limiting consumption of animal protein, sodium, and stone-forming foods such as chocolate and certain nuts can also help.
Types of treatment and surgery
Accepted treatment options for kidney stones range from watchful waiting to surgical removal of the stone. Small kidney stones can pass through the urinary tract spontaneously without treatment. For small stones, changing your diet and drinking plenty of water can help. In addition, reduce salt intake, increase citric acid-rich foods (lemons, oranges), oxalic acid-rich foods (spinach, nuts, beets) and purine-rich foods (animal protein, alcohol such as beer). Beverages) should also be avoided.
For certain kidney stones, depending on size and location, a procedure called extracorporeal shock wave lithotripsy (ESWL) may help. A shock wave from outside the body targets the kidney stone and causes it to fragment. Small pieces are then excreted through the urine.
If the stone is too large to pass by itself or through the ESWL, surgical intervention may be required. The type of surgery that is best for a particular patient depends on many factors, including stone size and shape, location within the urinary tract, presence of comorbidities, general renal health, and patient and surgeon preference. As medicine advances, the focus of treatment has evolved from open surgery to less invasive methods. Pristyn Care offers painless laser technology and minimally invasive methods for immediate kidney stone pain relief.
Ureteroscopy can also be used as a treatment option. During this procedure, a small scope is inserted into the ureter (the tube that carries urine from the kidneys to the bladder) to remove the stone.
Another type of kidney stone surgery is percutaneous nephrolithotomy (PCNL). For this procedure, a small incision is made in the patient’s back and a scope is inserted into the kidney. A scope is used to crush and remove stones. PCNL can be used to treat large stones that cannot be treated with ureteroscopy.
The most common procedure is RIRS (Retrograde Intrarenal Surgery) to operate inside the kidney using a flexible ureteroscope to remove the upper ureters and small kidney stones.
Technological developments have improved minimally invasive surgery for stone disease, reducing morbidity and increasing stone removal rates. The decision about the type of surgery to use for a particular patient is best made by a surgeon experienced in treating kidney stones.
Conclusion
Elective surgeries and other planned procedures were being postponed for fear of the impact of COVID. However, promotion of mass vaccination, retraining of medical staff to manage COVID and non-COVID patients, and rethinking the layout and protocols of service delivery in hospitals and clinics will significantly reduce the number of patients receiving these treatments. It helped me gain trust. Many advances have been made in the successful treatment of kidney stones. Minimally invasive surgery using laparoscopic instruments and high-resolution cameras has emerged as a highly effective approach. The procedure is not without risks for patients, but studies have shown that the benefits greatly outweigh the potential drawbacks. Research on these surgical approaches will continue, with a focus on improving camera resolution, instrument mobility, manipulability, and tactile feedback during laparoscopic surgery.
(The author is a urologist at Pristyn Care. The views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)
