Many of us have probably heard of kidney stones. It is a very typical issue that many people deal with. Did you know, though, that kidney stones can be fatal? Neither did Ambika (real name changed) a 65-year-old chronic diabetic patient hailing from Tiruttani.
Ambika has always believed that at her age, her long-term diabetes will be the greatest risk. But as it turned out, she had ended up in the emergency room at Peacock Hospital because of kidney stones. “I had been experiencing pain in the side of my stomach and a burning sensation during urination, but I assumed that I must be beginning to have UTI,” says Ambika. Within a few days, she started vomiting and having a high-grade fever which finally led to her being shifted to Peacock Hospital, Tiruttani.
Preliminary testing revealed that Ambika had kidney stones, which were the source of her back pain and other UTI-like symptoms. The chief urologist, Dr. M. Sree Kiran, was consulted right away. He requested an ultrasound, which identified Ambika’s perirenal abscess. Perirenal abscesses are bacterially infected areas of pus-filled kidney tissue. According to Dr. Kiran, this happens when kidney stones obstruct urine flow and encourage the growth of bacteria.
Kidney stones usually begin as small plaques which develop into microliths. These microliths are easily removed by the body if enough water is consumed. However, when water consumption is low these microliths tend to aggregate to form larger stones which are cause for concern. When these stones get dislodged and move through the ureter it causes immense pain and discomfort which are the cardinal signs of kidney stones.
Dr. Kiran explains that kidney stones can occasionally grow so big that they cannot pass through the ureter and gradually fill the entire kidney. This was what had happened to Ambika. Pyelonephritis or pyonephrosis is the end result, where the flow of urine from the kidney to the bladder is impeded, leading to infections and the transformation of urine into pus. “The possibility of kidney function loss makes this a life-threatening situation. At this stage we are not merely treating kidney stone and its symptoms, we are trying to save the patient’s life and their kidney,” explains Dr. Kiran.
There is no special treatment needed for smaller (less than 6mm) stones. Patients are instructed to drink more water so that the stone can pass through urine. Retrograde intrarenal surgery (RIRS), which uses a laser to dust the stone, is used to treat any stone that is 6mm to 2.5cm in size. When kidney stones are larger than 2.5 cm, percutaneous nephrolithotomy (PCNL) is used. Both of these approaches are frequently used at Peacock Hospital and come highly recommended by Dr. Kiran.
However, for Ambika, the first line of action was to drain the pus and excess urine from the kidney by doing a nephrostomy. “Only after clearing the kidney of the infectious pus can the removal of the stone be done. Considering the size of the stone, this was done in a step-by-step manner to ensure that no damage occurs to the kidney and the stone is completely removed,” says Dr. Kiran.
Ambika is now out of danger and is more careful about what goes into her body. She has made the changes in her diet and lifestyle as recommended by Dr. Kiran. Kidney stones might be small but they can become life-threatening if left untreated for long periods.