German Urology Society doctors have reported that kidney stones are solid deposits of mineral salts that form in the kidneys and can cause severe pain when passed. They noted that kidney stones are caused by the following reasons: insufficient fluid intake, as concentrated urine promotes crystal formation; dietary habits such as excessive salt, animal protein, or foods containing oxalates; metabolic disorders such as high levels of calcium, uric acid, or oxalates; urinary tract infections, especially in the case of struvite stones (infection stones); low physical activity, for example, due to prolonged lying or bed rest; some underlying diseases such as gout, hyperparathyroidism, and inflammatory bowel diseases; some medications such as diuretics, calcium supplements, and some antiepileptic drugs; and genetic predisposition. Kidney stones usually do not cause any discomfort as long as they remain in the kidney, but once they move to the ureter, they cause the following symptoms: sudden pain in the form of colic in the back, flank, or lower abdomen (renal colic), pain that spreads to the groin area, genitalia, or thigh; nausea and vomiting, which often accompany the pain attack; blood in the urine, visible or microscopic; frequent urination or pain during urination if the stone is in the lower part of the ureter; fever and chills with a urinary tract infection (a medical emergency). Without treatment, there is a risk of recurrent renal colic, chronic pain, and urinary tract infections, and in the worst case, permanent kidney damage. German doctors indicated that treatment depends on the size of the kidney stones, their location, and accompanying symptoms. Many small stones can pass naturally with urine, while larger or stuck stones require specialized treatment or removal. Conservative treatment (for small stones) includes: drinking plenty of fluids (at least 2-3 liters a day) to facilitate the stone's passage; exercising to help the stones pass; pain relievers such as ibuprofen or diclofenac to relieve renal colic; antispasmodics to relax the ureter; and medications to dissolve stones, for example, in the case of uric acid stones (alkalizing agents like potassium citrate). Stone removal (for large or stuck stones) is done through extracorporeal shock wave lithotripsy to crush the stone from the outside, which is a simple and painless procedure performed on an outpatient basis; ureteroscopy to remove or crush the stone with a scope through the urethra; percutaneous nephrolithotomy to remove large stones through a small incision in the kidney; and surgical removal, which is now rarely necessary, for example, in cases of anatomical abnormalities or very large stones.
