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Urological diseases Urology

how many kidney stones can you have?

 

  • Kidney stones are the solid crystal of salts of the minerals and the acids which deposit on the inner surfaces of the kidney.
  • We can have one or more than one stone in the kidney or the ureter at the same time.

 

 What is a Kidney stone?

 

 

how many kidney stones can you have?

 

  • It is also known as renal calculi or urolithiasis or nephrolithiasis.
  • Kidney stones are the solid crystal of salts of the minerals and the acids which deposit on the inner surfaces of the kidney.
  • It may be formed on the kidney, ureter, urinary bladder, and urethra.
  • Kidney stones are minute. These stones grow in size and can cause the blockage of the uterus.
  • Kidney stones cause unbearable suffering and extreme pain. But, if a kidney stone is treated by the health care professional, it rarely causes permanent damage.

How many kidney stones can you have?

  • We can have one or more than one stone in the kidney or the ureter at the same time.

 

Who develops kidney stones?

 

  • 8.8% of the Americans
  • The risk of developing kidney stones is more in men than women
  • Associated with diabetes, obesity, and hypertension.
  • More common in the Southeastern United States because the temperature is warmer there and there are higher rates of dehydration.

 

Types of kidney stones :

 

The types of kidney stones are :

i. Calcium oxalate stone:

  • 80% of the stones are calcium oxalate stone.
  • These stones are visible on the X-ray.
  • They happen when there is increased urine calcium or oxalate and decreased urine volume or citrate.

ii. Calcium phosphate stone

  • Less than 5% of the stones are calcium phosphate stones.
  • These stones are not visible on X-ray
  • They happen when there is increased urine calcium or urine pH.
  • Associated with hyperparathyroidism, distal Renal Tubal Acidosis, alkalinization treatment.

iii. Uric acid stone :

  • 10% of the stones are uric acid stones.
  • These stones are not visible X-ray.
  • They happen when there is increased urine uric acid and decreased urine pH and volume.
  • Uric acid stone is associated with gout.
  • It’s a possibility to have Staghorn with this stone.

iv. Struvite stone:

  • 10% of the stones are struvite stone.
  • These stones are visible on the X-ray.
  • They happen when there is increased urine pH and urease-positive UTI.

v. Cystine stone

  • Less than 1% of the stones are cystine stones.
  • They are faintly visible on x-ray.
  • They happen when there is increased urine cystine.
  • Staghorn is common with this stone.

 

Symptoms of kidney stone

 

The symptoms of the kidney depend on the sizes of the stones. For the small kidney stones, the symptoms may be mild.

 

Renal stone symptoms

  • Flank pain
  • Blood in the urine.

Ureteral stone symptoms

  • Acute colicky flank pain
  • Sharp pain in the back and side
  • Lower abdominal pain radiating to the groin
  • Pain on the urination
  • Nausea and vomiting
  • Fatigue
  • After stones get infected you can have a fever
  • Obstruction in oliguria and anuria
  • Hematuria
  • Hydronephrosis

 

Obstructing Stone Warning Symptoms

 

  • Fever, chills, signs of sepsis
  • In traceable vomiting
  • Uncontrolled pain
  • Acute kidney injury
  • Bilateral obstruction or obstruction of a solitary kidney.

Bladder stone symptoms

  • Blood in urine
  • Incomplete bladder emptying
  • Associated with BPH or neurogenic bladder.

 

Causes of kidney stones

 

  • Highly concentrated urine is the key to the formation of stone in the kidney.
  • Imbalance of the Ph level in the urine
  • Gout
  • Inflammatory bowel disease
  • Dehydration
  • Urinary tract infections
  • Crystal aggregation.

Risk factors of kidney stones

  • Dehydration
  • Family history
  • Obesity
  • High mineral concentration in the drinking water
  • People living in warm climates due to the risk of fluid loss
  • High dietary intake of animal protein

Diagnosis of kidney stones

  • Renal ultrasound
  • An X-ray called KUB (A kidney, ureter, and bladder )
  • CT –scan in abdomen and pelvis without contrast
  • Intravenous pyelography
  • Retrograde pyelogram
  • Cystoscopy
  • Blood analysis
  • Urine analysis

Treatment of kidney stones

Asymptomatic non-obstructing stone

  • Observation
  • Serial imaging
  • Await symptoms or increased size, before pursuing treatment.

Parenchymal stone

  • No need for treatment or surveillance.

Once the stone starts to go down to the ureter and you start to feel pain. All of you don’t need to do surgery. Stones can pass easier with the help of the medicines :

Trial passage

  • Tamsulosin (Flomax): Relaxes the ureter, Used in BPH
  • Hydration
  • Pain control: NSAIDs
  • Anti-nausea medication
  • Strain urine to collect stone for analysis.

 

 Emergent surgery for warning symptoms

 

Ureteral Stent to un obstruct kidney

  •  Relieve pressure/hydronephrosis to improve pain/nausea
  •  Allow drainage of UTI/pus
  •  Improve renal function

Extracorporeal Shockwave Lithotripsy

  • The stone must be visible on X-ray
    • Bowl preparation
  • The stone must be less than 2 m
  • If not, will require a ureteral stent.

Some cautions:

The patient:

  • can
  • not be anticoagulation,
  • should not be pregnant,
  • should not have severe obesity,
  • skeletal malformation,
  • distal obstruction, or
  • renal artery aneurysm.

 

Ureteroscopy with laser lithotripsy

  •  Rigid or flexible ureteroscopy
  •  Ureteral stent after

Percutaneous Nephrolithotomy (PCNL)

 

Two-stage processes

• For staghorn stones, especially greater than or equal to 2 cm, Calyceal diverticulum stone, and Narrow infundibulum

1. Access

  •  Interventional radiology
  • Place nephrostomy
  • Days before PCNL.

2. Surgery

 

Cystoscopy and laser lithotripsy of bladder stone

If too large, open bladder to cut out stone.

 

Uric acid stone can be dissolved

  • Urinary alkalinization
  • Uric acid is 10 more dissolvable at pH than pH 5
  • Potassium citrate, sodium bicarbonate, sodium citrate

 

 

Prevention of kidney stones

 

Dietary intake :

  • Low protein intake
  • Low calcium intake
  • Avoiding eating of the foods containing oxalate eg. Tea, peanuts
  • Limit sodium intake

Hydration

  • Drinking lots of the water 3 liters of the water per day

Exercise and physical activity

  • Avoidance of physical activities and exercise that may lead to changes in the environmental conditions which may cause dehydration and excessive sweating.

Others :

  • Drink plenty of the coconut and barely water regularly.
  • Avoid eating meat products, poultry, and fish
  • Have fresh ripe apples, melons, and grapes.
  • Avoid foods with vitamin D, antacids, and calcium base.

 

Medications of kidney stones

  • Potassium citrate
  • Hydrochlorothiazide
  • Acetohydroxamic acid
  • Alpha- mercapto propionyl glycine
  • Repeat 24hours urine collection to assess response to dietary or medication changes.

Frequently Asked Questions (FAQs)

Can you have multiple kidney stones at once?

Kidney stones are the solid crystal of salts of the minerals and the acids which deposit on the inner surfaces of the kidney. We can have one or more than one stone in the kidney or the ureter at the same time.

Where do you hurt with kidney stones?

The symptoms of the kidney depend on the sizes of the stones. For the small kidney stones, the symptoms may be mild. You will have :
Acute colicky flank pain
Sharp pain in the back and side
Lower abdominal pain radiating to the groin
Pain on the urination

What is the fastest way to relieve kidney stone pain at home?

Drink plenty of the coconut and barely water regularly, Avoid eating meat products, poultry, and fish, Have fresh ripe apples, melons, and grapes and Avoid foods with vitamin D, antacids, and calcium base.

How much water should I drink a day with kidney stones?

We should drink 3 liters of water per day and drink plenty of coconuts and barely water regularly.

 

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Categories
Urology

How much do antibiotics for UTI cost ?

Cost of UTI antibiotics

Antibiotics for UTI treatment cost range from 5$ to 500$ . A urine culture can cost more than 100$.

 

What is Urinary Tract Infection UTI?

 

Urinary Tract infections are infections of the urinary tract.

 

The main symptoms of urinary tract infection are:
• A burning feeling when you urinate
• Frequent urination
Bacteria cause most urinary tract infection.

 

Health center generally cure urinary tract infection with antibiotics

 

Antibiotics suppress the growth of bacteria and kill it.

 

Older people generally test positive for urinary tract infection.

 

There is no need to do urine test for no clear symptom of urinary tract infection.

 

If the test in done without appearance of the symptoms it may bring another complication.

 

 

This complication is especially seen in older adults.

 

More complication results more cost of UTI antibiotics.

 

Following are some reasons of it:

 

Urine tests usually don’t help if you don’t have
UTI symptoms.

 

People of older age can have bacteria in their urine despite of the fact that they don’t have developed Urinary Tract Infection.

 

This fact is truly seen for nearly all of medical center residents.

 

Medical professional will suggest for  urine test if an older adult has clear symptoms of urinary tract infection,

 

UTI symptoms include  increased convolution , irritability, or dizziness.

 

The test has high chance of showing some bacteria.

 

For this purpose the antibiotics for urinary tract infection may be needed which costs from 50-500$.

 

Tests & treatments for urinary tract infections (UTIs) in older patients.

 

When you need them—and when you don’t ?

 

But if the bacteria is in the urine and not causing a real infection, the antibiotic won’t cure  the clear symptoms.

 

The reasons such as irritation, convolution fall may be symptoms of another disease so it need further testing.

Cost of antibiotics for UTi

Antibiotics can cause serious problems.

 

Antibiotics can have other  side effects developed especially  in older patients .H

 

Side effects of the antibiotics  can develop fever, rash, nausea.

 

And vomiting, diarrhea, ruptured tendons, nerve damage, kidney failure.

 

Excess use of  antibiotics often can cause vaginal yeast infections.

 

Also it causes severe diarrhea, a hospital stay, and even death in older patients.

 

Also, there is high chance of fatal case for old patients as the antibiotic can react with other medicine which they take.

 

Avoid antibiotics when you can Lower you cost of UTI antibiotics

 

Unnecessary antibiotics don’t offer any benefits.

 

Do not take antibiotics for bacteria in the urine frequent.

 

Antibiotics can kill “friendly” germs and help drug resistant bacteria to grow.

 

Resistant bacteria cause illnesses that are harder to cure and more costly to treat.

 

Treatment of drug resistant bacteria is not easy.

 

Medical professionals  have to issue other different antibiotics.

 

The use of untested medicine can also cause fatal effect .

 

So the cost of UTI medicine treatment can increase heavily.

 

When should you have a urine test to have low UTI antibiotics cost?

 

You should get a urine test if you have new or worsening urinary symptoms like red color , frequent urge.

 

You should also get a urine test if you have a fever or if a blood test suggests that you have an infection.

 

Before testing your urine note that you don’t have other complications or disease.

 

It includes fever, cough or any form of illness which causes the urine color to change from normal.

 

Early diagnosis of UTI cause low cost of UTI antibiotics.

 

Also Read :- How often should healthcare workers be tested for tb?

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