Kidneys stones less than 8mm are best amenable to medical treatment no surgery is usually suggested for these stones unless:
- Stones need to be removed for medical fitness
- Stone pain may cause professional hazard such as in Pilots, Sailors and High Speed Racers
Stones that are small are managed with a combination of stone inhibitors and other modalities of treatment as outline below:
- Calcium oxalate stones are treated with a combination of Potassium Citrate and Thiazide diuretics
- Struvite stones are treated with acidification of urine and long term antibiotics
- Uric Acid stones are managed with the use of potassium citrate, and drugs like allopurinol and febuxostat
- Stones formed due to drugs are treated by identification of the medicine causing the stone and stopping the medication or replacing with a viable substitute
Since most stones are caused by a process of crystal deposition the medical therapy also aims to reduce the factors which increase absorption of these crystals. This includes
- Reduction of Salt Intake
- Avoiding Antacids
- Adequate intake of calcium
An essential role of the medical treatment is to slowly dissolve the stones and less them pass as crystals through the urinary passage.
Side Effects of Medical Therapy for Kidney Stones
The usual cocktail of syrups for medical therapy includes potassium citrate along with pyridoxine or vitamin B6 and Magnesium. The syrup causes some acidity due to its concentrated nature and it is advisable to drink it after mixing in half a glass of water.
Thiazide is a diuretic medication which means that it leads to the formation of more and more urine. This can sometimes dehydrate the body but the major risk associated with its use if the loss of potassium from the body.