Renal calculi/ Kidney Stone

Renal calculi/ Kidney Stone

Kidney stones as the name goes are a solid mass of crystal of varying size that can originate anywhere along the urinary tract, i.e: kidney, ureter, bladder, and urethra. This is one of the most painful conditions.

Types of Kidney Stones

Kidney stones are classified depending on the nature of the mineral present in them, based on this they are 5 types-

• Calcium stones are found usually in the form of calcium oxalate usually seen in the kidney because of their large size and occur due to metabolic disorders.
• Calcium phosphate stones are less common. Calcium phosphate stones tend to form when the urine is alkaline, meaning it has a high pH.
• Struvite stones occur due to repeated urinary infections and observed mainly in females
• Uric acid stones are observed in persons consuming high protein diet
• Cystine stones are observed in persons suffering from genetic disorders called cystinuria

Causes of Kidney Stone

• Repeated urinary infection and bad personal hygiene
• Decrease intake of water or chronic prolonged dehydration. People living in regions with warm climates and those who sweat a lot may be at a higher risk than others.
• High protein and high calcium diet
• A family history of kidney stones can be a predisposing factor
• Inflammatory bowel disease or chronic diarrhoea can affect the absorption of calcium and water resulting in stone formation
• Chemotherapy, renal tubular acidosis, cystinuria, hyperparathyroidism are some condition which can cause kidney stones

Symptoms of Kidney Stone

• Flank (lower back, below the ribs) pain radiating to the perineum or inner thigh
• Pain comes in waves and fluctuating in intensity
• Pain on passing urine, blood-tinged urine, cloudy urine and foul-smelling urine
• Nausea and vomiting
• Urinating more often than usual, persistent need to urinate
• High-grade fever and chills usually when infection is present

Treatment of Kidney Stone

• Diagnosis is arrived at based on the symptoms and investigations such as routine blood and urine examination, X-ray (KUB) and CT become necessary to know the location, number of the stone present and to rule out infection and anaemia due to blood loss
• Small stones do not require treatment as it can pass on its own or with flush therapy under physician’s guidance
• Pain medication such as NSAID is prescribed to relieve excruciating pain
• A smaller stone in the ureter, bladder or urethra which has not passed out through flush therapy is removed using ureteroscope in which the surgeon uses a small wire with the camera and light source inserted into the bladder through the urethra with a small cage to catch the stone and snag it this entire procedure is done under anaesthesia
• Large symptomatic stones are crushed into smaller bits using extracorporeal shock wave lithotripsy (ESWL) and flushed out using flush therapy; this entire procedure is done under mild sedation as it can cause discomfort and pain to the patient
• Large stones in the kidney are surgically removed through percutaneous nephrolithotomy when ESL is unsuccessful
• In severe cases where the stone is massive (staghorn calculi) occupying the entire kidney, an open surgery/traditional surgery is performed to get rid of the stone and repair the kidney. Usually, in such cases, most of the kidney tissue on the affected side is lost leaving nothing to repair.

Ayurveda and Renal calculi

According to Ayurveda renal calculi are referred to as Vrukka ashmari and is caused due to vitiation of all the three doshas namely vata, pitta and kapha. Unhealthy lifestyle and diet cause accumulation of toxin in the body resulting in the formation of Vrukka ashmari. Ayurveda is a holistic system of medicine focusing on treating overall well being rather than just treating the symptoms, the treatment consists of various diuretic herbs to dissolve the stone and various cleansing techniques to strengthen the body.

Ayurvedic therapies (Panchakarma)

• Mrudu Virechana (induced purgation) treats the vata dosha, eliminates the toxins and pain
• Anuvasana Basti (medicated oil enema) expels the stones from the tubular system, enhances the healing process and reduces the inflammation.
• Abhyanga and swedana are used for systemic detoxification, reduce stress, strengthen the body and balances the doshas.

Diet changes for Kidney Stones

• Avoid salt as much as possible as it burdens the kidney.
• Dairy, poultry and red meat should be shunned as they increase the amount of acid in the urine
• Intake of healthy liquids and fibre rich food is promoted
• Avoid eating dry and heavy food
• Avoid refined sugar and processed food.
• Drink tender coconut water instead of tea or coffee as it is a natural diuretic and calms the doshas
• Onion, lemon, lady’s finger, kidney beans, pomegranate, radish, tomato, pineapple and basil promote kidney functions and are beneficial if included in the diet.

Lifestyle changes

• Exercise in moderation and avoid dehydration.
• Keep sipping in plenty of liquids every half an hour.
• Empty the bladder often, dot suppress the urge to urinate, stagnation of urine in the bladder not only increases the chance of infection but also predisposes to stone formation

Ayurvedic herbs

• Varuna this herb has many healing properties of which its properties to break down kidney stone is the most prominent one.
• Punarnava is an effective diuretic and has an antispasmodic action
• Pashanabheda relieves urinary symptoms such as burning sensation and pain along with being a potent diuretic flushing out the toxins from the body.
• Gokshura promotes the flow of the urine maintaining a continuous flow and flushes out the stones from the renal system
• Elettaria cardamomum balances the vata and kapha dosha along with treating kidney stones
• Cucumis sativus has a rich water content which detoxifies the body, neutralises the toxins and cleanses the bladder of the bacteria.

Yoga and Pranayama

Yoga can help relieve symptoms and reduce the size of the kidney stones. Asanas such as Ustrasana (camel pose), Bhujangasana (cobra pose), Balasana (child pose), Viparita karani and Pavanamuktasana (wind relieving pose). These asanas clear out the blockage in the tubular network, reduces backward pressure, increase the blood supply and detoxifies the bean-shaped organ preventing further formation of renal stones.

Kapalabhati and anulom vilom pranayama enhances the function of the kidney, lowers the creatinine levels in the blood, restores tubal patency and is a complete detox of the excretory system.

Naturopathy and Kidney Stone

According to naturopathic perspective, kidney stones occur due to unhealthy diet and lifestyle rather than a genetic or metabolic disorder.

Treatment of Kidney Stones in Naturopathy

Cook about 50 gms of barley in 500ml of water till the grains are soft and crushable, separate this water from the cooked barley add a pinch of coriander powder and lime juice to this water. Drink this water preferably early in the morning, this is one of the best detoxes to get rid of renal stones and treat diseases related to the renal system. Barley has excellent diuretic property flushing out toxins and stones from the system.

Also, a naturopathic detox program helps to remove toxins from the body.

Diet modification

• Include food that has a high ratio of magnesium to calcium such as banana, oats, soy, barley, brown rice and soy
• Consume a high fibre diet consisting of  flax seeds, psyllium seed husk, pumpkin seeds, bamboo, banana shoot and sprouts.
• Include green leafy vegetables, fruits, vegetables, whole grains and fish
• Poultry can be consumed in moderation and preferably organic
• Red meat is better avoided.
• High protein diet, fried, refined sugar, excessive dairy, salt, carbonated beverages, caffeine and the packed foods are better avoided

Lifestyle modification

• Adequate hydration prevents concentration of urine and crystal formation
• One should drink 50% of body weight in an ounce of water daily
• Reduce the risk of urinary tract infection by maintaining a clean environment within the house as well as outside
• Practise the right method of ablution i.e: forwards to backwards, is very essential
• Low magnesium in the body has been linked with the stone formation; hence magnesium supplements are beneficial in preventing stone formation
• Practising yoga and pranayama daily for 30 minutes is beneficial in treating the symptoms and prevention in stone formation

Botanical herbs

Stone root (Collinsonia Canadensis), Bearberry (Arctostaphylos uva ursi), corn silk (Zea mays), Gravel root (Eupatorium purpureum) and Cleavers (Galium aparine) acts as a diuretic and treats urinary tract infection

Cramp Bark (Viburnum opulus), Kava Kava (Piper methysticum), Khella (Ammi visnaga) and Sevenbark (Hydrangea arborescens) relaxes smooth muscles and is an antispasmodic used in treating pain originating from the kidney.