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KIDNEY STONES

Kidney stones are hard objects found in the pelvis of the kidney. They are normally small (2 to 3 mm in diameter) with a smooth surface. Approximately 1% of all autopsies reveal the presence of kidney stones, and many of the stones occur without causing symptoms. The symptoms associated with kidney stones occur when a stone passes into the ureter, resulting in referred pain down the back, side, and groin area. The ureter contracts around the stone, causing the stone to irritate the epithelium and produce bleeding, which appears as blood in the urine. In addition to causing intense pain, kidney stones can block the ureter, cause ulceration in the ureter, and increase the probability of bacterial infections.

Approximately 65% of all kidney stones are composed of calcium oxylate mixed with calcium phosphate, 15% are magnesium ammonium phosphate, and 10% are uric acid or cystine. In all cases approximately 2.5% of the kidney stone is composed of mucoprotein.

The cause of kidney stones is usually obscure. Predisposing conditions include a concentrated urine and an abnormally high calcium concentration in the urine, although the cause of the high calcium concentration is usually unknown. Magnesium ammonium phosphate stones are often found in people with recurrent kidney infections, and uric acid stones often occur in people suffering from gout. Severe kidney stones must be removed surgically. However, instruments that pulverize kidney stones with ultrasound have replaced most traditional surgical procedures.

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