How improved technology has revolutionised kidney stone management

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Illustration of a human kidney cross section. Image courtesy University of Waterloo/Wikipedia Commons

Kidney stones are small, hard deposits in the kidneys that are made up of minerals and acid salts. In India, kidney stones are a major health concern for both men and women. According to a study, 12 per cent of Indians are affected by stones, of which 50 per cent are likely to have lost of kidney function. An estimated 10 million people in the country suffer from kidney stones. A large number of these people are left undiagnosed and untreated due to a lack of access to quality healthcare, especially in rural and remote areas.

Causes

Stones can be formed due to a combination of genetics and environmental factors like poor diet and lack of physical exercise. According to studies, people with a family history of kidney stones are more prone to developing stones.

Symptoms

The most common symptom prevalent in patients with kidney stones is severe pain usually on the side of the abdomen. People may also experience pain in the back or side parts of the body. Other symptoms include pain during urinating, nausea or vomiting, blood in the urine, and sweating.

If a person is having any of these symptoms, they must get their urine analysis, serum creatinine, electrolytes, and parathyroid hormone tests done as an initial evaluation. X-ray of the kidney, ureter, and bladder (X-KUB) and ultrasound may also be recommended for the patient for diagnosis.

Treatment options

Depending upon the medical condition of the patient, treatment options range from watchful waiting to surgical removal of the stone. Small stones may pass through the urinary tract without any treatment. This is possible with dietary modifications and drinking plenty of water.

Another treatment option that might be recommended by the doctor is extracorporeal shock wave lithotripsy (ESWL), which can be effective for some kidney stones. A kidney stone is subjected to shock waves from the outside, which causes the stone to break. Later, the minute fragments are eliminated by the urine.

Stones that are too large to pass on their own or through ESWL may require surgical intervention. With advances in medical science, the focus of therapy has evolved away from open surgery towards less invasive methods like pulse modulated laser with ‘Moses’ effect.

The ‘Moses’ laser is the new innovative 120-watt high-power laser that has revolutionised the way kidney stones are treated. It is efficient in treating any size of kidney stone. It can fine dust the stone in the kidney, making it easier to pass. Unlike other lasers, it needs no puncture and is scarless. It is a one-day procedure, resulting in a cost reduction of the treatment. The technology ensures that there are no bleeding complications during the procedure.

Technological developments have improved minimally invasive surgery for stone disease, resulting in lower morbidity and higher stone clearance rates. The decision of which type of surgery to use for a particular patient is best made by a surgeon with experience in treating kidney stones.

Prevention

In general, dietary and lifestyle changes like drinking a lot of fluids—especially water can help prevent kidney stones. Depending on the structure of the stone, different diet plans can be recommended. Uric acid, calcium oxalate and cystine stones can be avoided by alkalizing the urine with a diet high in fruits, vegetables and citrate, either naturally occurring or taken as a supplement. On the other hand, urine must be acidified to prevent calcium phosphate and struvite stones; cranberry juice and foods high in betaine (wheat bran, wheat germ, spinach, etc.) can help regulate urine pH levels. Additionally, restricting the intake of sodium, foods high in animal protein, and foods that cause the formation of kidney stones, such as chocolate and some nuts, can be beneficial.

The author is Chairman, SCUG: Silicon City Urology Group, Urologist – Endourologist, Laser & laparoscopic surgeon, Robotic surgeon, and Renal Transplant Surgeon, Director, Apollo institute of Renal Sciences. Views are personal.

Disclaimer: The information in this article is for educational purposes only and is not meant to provide any medical or clinical advice. Please consult your doctor for more information.

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