What causes kidney stones? - Arash Shadman

TED-Ed

3 Jul 201705:15

EducationalLearning

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TLDRThe video script discusses kidney stones, which are hard crystalline masses that form in the urinary tract. The largest recorded stone weighed over a kilogram and was as large as a coconut. These stones are made of compounds like calcium, sodium, and uric acid, which can crystallize if urine levels are too high or too acidic/basic. Calcium oxalate is the most common crystal, forming about 80% of stones. Symptoms include severe pain, blood in urine, nausea, and vomiting. Most stones less than five millimeters pass naturally, while larger ones may require medication, soundwave lithotripsy, or surgery. Prevention includes drinking water, limiting high-oxalate foods, and ensuring adequate calcium intake. Despite increasing rates, the record for the largest kidney stone is unlikely to be broken soon.

Takeaways

📏 The largest recorded kidney stone weighed over a kilogram and was 17 centimeters in diameter.
🌿 Kidney stones form inside the body from compounds in urine such as calcium, sodium, potassium, oxalate, uric acid, and phosphate.
🔬 If urine becomes too acidic or basic, these particles can crystallize and form stones over time.
💠 Calcium oxalate is the most common crystal in kidney stones, accounting for about 80%.
🦠 Certain kidney stones can be caused by bacterial infections or result from genetic disorders or medication.
🚑 Kidney stones often go unnoticed until they move, causing severe pain and sometimes blood in urine.
💊 Small kidney stones (less than 5mm) can usually pass naturally with increased water intake and possibly painkillers.
💊 For slightly larger stones, medications like alpha blockers can help, and potassium citrate can make urine less acidic to dissolve the stones.
📍 Medium-sized stones can be treated with extracorporeal shock wave lithotripsy, which uses sound waves to break the stone into smaller pieces.
🔧 Larger stones may require more invasive treatments, such as stents, laser pulses, or surgical removal.
🥤 To prevent kidney stones, doctors recommend drinking plenty of water, limiting high-oxalate foods, and ensuring adequate calcium intake.

Q & A

What is the weight and diameter of the biggest kidney stone on record?
-The biggest kidney stone on record weighed more than a kilogram and was 17 centimeters in diameter.
Where do kidney stones form and what are they made of?
-Kidney stones form inside the body and are hard masses of crystals that can form in the kidneys, ureters, bladder, or urethra.
What are the common compounds found in urine that can contribute to the formation of kidney stones?
-Urine contains compounds such as calcium, sodium, potassium, oxalate, uric acid, and phosphate.
What happens when the levels of certain particles in urine get too high or urine becomes too acidic or basic?
-If the levels of these particles get too high, or if urine becomes too acidic or basic, the particles can clump together and crystallize, potentially forming a kidney stone.
What is the most common type of crystal that forms kidney stones?
-Calcium oxalate is the most common type of crystal to form kidney stones, accounting for about 80% of cases.
What are some less common materials that kidney stones can be made of?
-Less common kidney stones are made of calcium phosphate or uric acid.
How can a kidney stone cause pain when it moves?
-When a stone travels through the kidney and into the ureter, its sharp edges scratch the walls of the urinary tract, and nerve endings in this tissue transmit excruciating pain signals through the nervous system.
What are the symptoms that can accompany a kidney stone?
-Symptoms of a kidney stone can include nausea, vomiting, and a burning sensation while urinating.
What happens if a kidney stone is large enough to block the flow of urine?
-If a stone is large enough to block the flow of urine, it can create an infection, cause backflow, and potentially damage the kidneys themselves.
What is the typical treatment for smaller kidney stones that are less than five millimeters in diameter?
-For stones less than five millimeters in diameter, a doctor will often recommend drinking large amounts of water to help the stone pass and may also prescribe painkillers.
How does extracorporeal shock wave lithotripsy help in treating medium-sized kidney stones?
-Extracorporeal shock wave lithotripsy uses high-intensity pulses of focused ultrasonic energy aimed directly at the stone, creating vibrations and small bubbles that crush the stone into smaller pieces, making it easier to pass out of the body.
What are some preventive measures for avoiding kidney stones?
-Preventive measures include drinking plenty of water to dilute calcium oxalate and other compounds, limiting foods high in oxalate such as potato chips, spinach, rhubarb, and beets, and ensuring adequate calcium intake, as it can bind to oxalate in the digestive tract before it reaches the kidneys.

Outlines

00:00

😱 The Largest Kidney Stone Ever Recorded

The script discusses the largest kidney stone ever documented, which was over a kilogram in weight and 17 centimeters in diameter. It clarifies that kidney stones form internally and can be extremely painful to pass. These stones are composed of crystallized compounds found in urine, such as calcium, sodium, potassium, oxalate, uric acid, and phosphate. When the concentration of these compounds is too high or urine pH is off, they can form crystals that grow into stones over time. Calcium oxalate is the most common crystal type in kidney stones, making up about 80% of cases. Other types include calcium phosphate and uric acid stones, while struvite stones are less common and often caused by bacterial infections. Genetic disorders and certain medications can also lead to rarer types of kidney stones. The symptoms of kidney stones typically arise when they move, causing pain and sometimes blood in urine. If large enough to obstruct urine flow, they can lead to infection or kidney damage. However, smaller stones often pass without issue, sometimes aided by increased water intake and painkillers. Larger stones may require medication to help with passage, while medium-sized stones may be treated with extracorporeal shock wave lithotripsy, which uses sound waves to break the stone into smaller pieces. Invasive procedures are sometimes necessary for very large stones. The script concludes with advice on how to prevent kidney stones, including hydration, dietary recommendations, and the potential benefits of calcium intake. It also notes that kidney stone rates are increasing, though it's unlikely the record for the largest stone will be surpassed soon.

Mindmap

Keywords

💡Kidney Stone

A kidney stone is a hard mass of crystals that forms within the kidneys, ureters, bladder, or urethra. It is composed of compounds such as calcium, sodium, potassium, oxalate, uric acid, and phosphate. When the levels of these particles become too high or urine becomes too acidic or basic, they can clump together and crystallize, leading to the formation of a kidney stone. The presence of kidney stones can cause extreme pain, especially when they move and scratch the walls of the urinary tract. The largest recorded kidney stone weighed over a kilogram and was 17 centimeters in diameter, as mentioned in the script.

💡Calcium Oxalate

Calcium oxalate is the most common type of crystal found in kidney stones, accounting for approximately 80% of all cases. It forms when there is an excess of calcium and oxalate in the urine, which can combine to create crystals. These crystals can then grow over time to form kidney stones. In the context of the video, calcium oxalate is highlighted as a primary component of kidney stones, emphasizing the importance of managing calcium and oxalate levels in the body to prevent their formation.

💡Uric Acid

Uric acid is another compound that can contribute to the formation of kidney stones, although it is less common than calcium oxalate. High levels of uric acid in the urine can lead to the development of uric acid stones. These stones can form when the urine is persistently acidic, which can happen due to certain dietary habits or medical conditions. The script mentions uric acid as one of the components that can form kidney stones, indicating the multifactorial nature of their composition.

💡Struvite

Struvite, or magnesium ammonium phosphate, is a type of kidney stone that can be caused by bacterial infections. These stones are slightly different from the more common calcium oxalate stones and can form when bacteria in the urinary tract alter the chemical composition of the urine, leading to the precipitation of magnesium, ammonium, and phosphate. The video script refers to struvite stones to illustrate the variety of factors that can lead to kidney stone formation.

💡Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal shock wave lithotripsy, commonly referred to as ESWL, is a non-invasive medical procedure used to break down medium-sized kidney stones into smaller pieces that can more easily pass out of the body. The procedure uses high-intensity focused ultrasonic energy pulses aimed directly at the stone, causing vibrations and the formation of small bubbles within the stone, which ultimately leads to its fragmentation. The script describes ESWL as an option for treating kidney stones, highlighting its role in modern medical treatments.

💡Stent

A stent is a rigid tube that can be surgically placed in the ureter to expand it, allowing for the easier passage of kidney stones. In cases where stones are too large to be effectively treated with sound wave lithotripsy, a stent may be used in conjunction with other treatments, such as laser lithotripsy, to facilitate the removal of the stone. The script mentions the use of a stent as part of more invasive treatments for kidney stones.

💡Laser Lithotripsy

Laser lithotripsy is a minimally invasive surgical procedure used to break up kidney stones. It involves the use of optical fibers to deliver laser pulses directly to the stone, causing it to fragment into smaller pieces that can be passed out of the body. This procedure is particularly useful for larger stones that cannot be effectively treated with ESWL. The video script discusses laser lithotripsy as an alternative treatment method for kidney stones that are not amenable to sound wave lithotripsy.

💡Potassium Citrate

Potassium citrate is a medication that can help dissolve kidney stones by creating a less acidic urine environment. It is particularly useful for preventing the formation of new stones by altering the urinary pH. The script mentions potassium citrate as a treatment option, emphasizing its role in managing the acidity of urine and its potential to dissolve certain types of kidney stones.

💡

💡Nausea and Vomiting

Nausea and vomiting are common symptoms that can accompany a kidney stone. These symptoms are a result of the pain and discomfort caused by the stone as it moves through the urinary tract, stimulating nerve endings and causing distress. The script describes these symptoms as part of the overall experience of having a kidney stone, highlighting the significant impact on a patient's well-being.

💡Hydration

Drinking plenty of water is a key recommendation for both preventing the formation of kidney stones and helping to pass smaller stones naturally. Hydration works by diluting the concentration of stone-forming compounds in the urine, reducing the likelihood of crystal formation. The script emphasizes the importance of hydration as a preventive measure and as a part of the treatment process for kidney stones.

💡Genetic Disorders

Certain genetic disorders can increase the risk of developing kidney stones. These disorders may affect the way the body processes and excretes substances that can contribute to stone formation. The script briefly mentions genetic factors as one of the rarer causes of kidney stones, indicating that there is a hereditary component to consider in some cases.

💡Diet and Lifestyle

The script discusses the role of diet and lifestyle in the formation of kidney stones. Foods high in oxalate, such as potato chips, spinach, rhubarb, and beets, can contribute to the formation of stones and are recommended to be limited. Additionally, the script suggests that even though calcium is often found in stones, calcium in the diet can actually help prevent their formation by binding to oxalate in the digestive tract. This highlights the complex relationship between diet, lifestyle, and kidney stone formation.

Highlights

The largest recorded kidney stone weighed over a kilogram and was 17 centimeters in diameter.

Kidney stones form inside the body and can be extremely painful to pass.

They are hard masses of crystals that can form in various parts of the urinary system.

Urine contains compounds like calcium, sodium, potassium, oxalate, uric acid, and phosphate.

High levels of these particles or imbalanced urine pH can lead to crystallization and stone formation.

Calcium oxalate is the most common crystal type in kidney stones, accounting for about 80%.

Less common types include calcium phosphate and uric acid stones.

Struvite stones are caused by bacterial infections, while rarer stones can result from genetic disorders or medications.

Kidney stones often go undetected until they move and cause pain.

As stones move, they can scratch urinary tract walls and cause blood in urine, nausea, vomiting, and burning sensations.

Large stones can block urine flow, leading to infections and kidney damage.

Most kidney stones are not serious and do not require invasive treatment.

Small stones (less than 5mm) usually pass out of the body on their own.

Drinking water and taking painkillers can help with passing small stones.

Medications like alpha blockers and potassium citrate can assist with stone passage and dissolution.

Extracorporeal shock wave lithotripsy uses sound waves to break down medium-sized stones.

Invasive treatments like stents, laser pulses, and surgery are used for larger stones.

To prevent kidney stones, it's recommended to drink plenty of water and limit high-oxalate foods.

Calcium in the diet can help bind oxalate and prevent stone formation.

Kidney stone rates are rising, but the world record for the largest stone is unlikely to be broken soon.

Transcripts

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Takeaways

Q & A

What is the weight and diameter of the biggest kidney stone on record?

Where do kidney stones form and what are they made of?

What are the common compounds found in urine that can contribute to the formation of kidney stones?

What happens when the levels of certain particles in urine get too high or urine becomes too acidic or basic?

What is the most common type of crystal that forms kidney stones?

What are some less common materials that kidney stones can be made of?

How can a kidney stone cause pain when it moves?

What are the symptoms that can accompany a kidney stone?

What happens if a kidney stone is large enough to block the flow of urine?

What is the typical treatment for smaller kidney stones that are less than five millimeters in diameter?

How does extracorporeal shock wave lithotripsy help in treating medium-sized kidney stones?

What are some preventive measures for avoiding kidney stones?