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Nephrology: Kidney Related

Kidney Stones

Kidney stones are hard mineral deposits that form in the kidneys when urine becomes concentrated. They can cause severe pain, especially during passage, and may lead to infections or blockage.

Key Statistics in India (2024)
Prevalence: ~12% of Indians suffer from kidney stones (higher in North India’s “Stone Belt”).
Recurrence Rate: 50% within 5 years without prevention.
Most Affected Age Group: 30–50 years.
Gender Ratio: Men 3x more likely than women.
Top Causes: Dehydration, high-salt diet, obesity.

What Are Kidney Stones?

Kidney stones (renal calculi) are hard mineral deposits that form inside the kidneys, causing severe pain, infections, and urinary blockages. They vary in size—from a grain of sand to a golf ball—and can develop due to dehydration, diet, or genetic factors.

  1. Calcium Oxalate (70-80%) – Caused by high oxalate foods (spinach, nuts)
  2. Uric Acid (10-15%) – Linked to high-protein diets & gout
  3. Struvite (10%) – Due to chronic UTIs (more common in women)
  4. Cystine (1-2%) – Rare, genetic disorder

Severe flank/back pain (radiating to groin)
Blood in urine (hematuria)
Frequent, painful urination
Nausea & vomiting
Fever/chills (if infection present)

  1. Non-Surgical Treatments
  • ESWL (Extracorporeal Shock Wave Lithotripsy) – Breaks stones using sound waves 
  • Medications – For uric acid stones (allopurinol, potassium citrate)
  1. Minimally Invasive Surgery: Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure that removes kidney stones

FAQs

Can kidney stones be life-threatening?

Rarely, but they can cause kidney failure if untreated.

How long does it take to pass a 5mm stone?

Usually 1-2 weeks with hydration & pain meds.

What’s the fastest way to relieve kidney stone pain?

NSAIDs (Diclofenac) or hospital pain management.

Does insurance cover kidney stone treatment?

Yes, if medically necessary (check policy).

Kidney Cancer

Kidney cancer, most commonly renal cell carcinoma (RCC), occurs when abnormal cells grow in kidney tissue. It’s often detected incidentally during scans for other issues.

Kidney Cancer Stats in India

Annual Cases: ~20,000 new kidney cancer cases in India.
Robotic Surgery Cost: ₹4L – ₹8L (for partial/total nephrectomy).
5-Year Survival Rate: 75-90% if detected early (Stage 1).

What is Kidney Cancer (Added by us not in doc)

Kidney cancer, also known as renal cancer, begins in the kidneys — two bean-shaped organs located on either side of your spine. The most common type is renal cell carcinoma (RCC). Early-stage kidney cancer often has no symptoms, which makes regular screening and early detection crucial.

  • Blood in the urine (hematuria)
  • Persistent back or side pain
  • Unexplained weight loss
  • Fatigue
  • Fever that comes and goes
  • A lump or mass on the side or lower back
Note: These symptoms can overlap with other conditions. Always consult a healthcare provider for accurate diagnosis.

If you experience persistent back pain, blood in your urine, or unexplained weight loss, consult a urologist. Early detection significantly improves outcomes.

Diagnosis
  • Imaging Tests: CT scans, MRI, and ultrasound help visualize tumors.
  • Urine & Blood Tests: Check for signs of kidney function and cancer indicators.
  • Biopsy: In rare cases, a small tissue sample may be removed for testing.

Surgery (Primary Treatment):

  • Partial nephrectomy: Removes only the tumor or part of the kidney.
  • Radical nephrectomy: Removes the entire kidney, sometimes along with nearby tissue.

Non-Surgical Treatments:

  • Targeted therapy
  • Immunotherapy
  • Radiation (less common for kidney cancer)

Minimally Invasive Surgery for Kidney Cancer

Minimally invasive techniques like laparoscopic and robot-assisted surgery are now widely used for kidney cancer treatment. These procedures offer several benefits over traditional open surgery.

To know more about nephrectomies Click >
  • Smaller incisions
  • Less blood loss
  • Shorter hospital stays
  • Faster recovery times
  • Reduced post-operative pain
  • Lower risk of complications

FAQs About Kidney Cancer

Is surgery always required for kidney cancer?

Not always. Small tumors may be monitored (active surveillance), especially in older or high-risk patients. However, surgery is the most effective treatment for localized kidney cancer.

Can I live with one kidney after surgery?

Yes. Most people live healthy lives with one functioning kidney. The remaining kidney compensates over time.

Will I need chemotherapy after kidney surgery?

Chemotherapy is rarely used in kidney cancer. Targeted therapies or immunotherapies may be recommended if the cancer spreads.

Congenital Kidney Abnormalities

Congenital abnormalities of the kidney and urinary tract (CAKUT) are structural problems that develop before birth. They are among the most common birth defects and can affect one or both kidneys, the ureters, or related urinary structures.

These conditions vary in severity—from harmless anomalies to life-threatening disorders that require immediate medical attention.

Common Congenital Kidney Abnormalities

1. Horseshoe Kidney

  • The two kidneys are fused together at the lower end.
  • Often asymptomatic but may lead to urinary tract infections (UTIs) or kidney stones.

2. Renal Agenesis

  • One (unilateral) or both (bilateral) kidneys fail to develop.
  • Bilateral renal agenesis is life-threatening and usually incompatible with life.
  • People with unilateral agenesis can often live normally with one kidney.

3. Multicystic Dysplastic Kidney (MCDK)

  • One kidney is replaced by cysts and does not function.
  • Usually affects only one kidney and may shrink over time.

4. Polycystic Kidney Disease (PKD)

  • An inherited condition where fluid-filled cysts form in both kidneys.
  • Autosomal recessive PKD (ARPKD) may present in infancy or early childhood.
  • Can lead to kidney failure if not monitored and managed properly.

5. Duplex Kidney (Duplicated Collecting System)

  • Two ureters drain a single kidney.
  • May cause frequent UTIs or vesicoureteral reflux (backward urine flow).

6. Hydronephrosis

  • Swelling of the kidney due to urine buildup, often caused by blockage or reflux.

May resolve on its own or require surgical intervention.

  • Genetic mutations
  • Family history of kidney disorders
  • Maternal health issues during pregnancy
  • Chromosomal abnormalities (e.g., trisomy 13, 18)

Congenital kidney abnormalities may not cause symptoms right away. When symptoms do occur, they may include:

  • Abdominal mass or swelling
  • Recurrent urinary tract infections
  • Blood in the urine (hematuria)
  • Frequent urination or painful urination
  • High blood pressure

Poor growth in infants or children

  • Prenatal Ultrasound: Often identifies abnormalities before birth.
  • Postnatal Imaging: Includes renal ultrasound, CT scan, or MRI.
  • Voiding Cystourethrogram (VCUG): Detects reflux or structural issues.
  • Genetic Testing: May be recommended for inherited conditions like PKD.

FAQs About Congenital Kidney Abnormalities

Can congenital kidney problems be cured?

Some minor abnormalities may resolve on their own or never cause issues. Others may require surgery or long-term management but can often be controlled successfully.

Is it possible to live with one kidney from birth?

Yes. Many people with a single functional kidney (due to agenesis or MCDK) live normal, healthy lives with proper monitoring.

Will my child need surgery?

Not all children need surgery. It depends on the severity and symptoms. Doctors may opt for observation if the condition is mild.