It all starts with severe pain in the side and back, below the ribs, pain that spreads to the lower abdomen and groin or ache that comes in waves and fluctuates in intensity.

Experts, however, warn that when this graduates to frequent  urge to pass urine (darkish in colour), especially if it’s painful, and letting out foul smell, chances are that you have kidney stones, so you need to see your doctor as soon as possible.

A kidney stone or Nephrolithiasis is a hard, crystalline mineral material formed within the kidney or urinary tract.

Medics say that though kidney stones have known risk factors, its particular cause is not known. A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder.

Other signs and symptoms may include nausea, vomiting, fever, chills and urinating small amounts of bloody urine. Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through ones urinary tract.

Risk Factors

According to Jado Maniraguha, a physician with MedPlus Clinic, factors that increase risk of developing kidney stones include; family or personal history, for instance if someone in your family lineage has kidney stones, they are more likely to develop them too. And if you have already had one or more kidney stones, your offspring is at increased risk of developing it.

Dr. Joseph Kamugisha, an oncologist at Rwanda Military Hospital, says that low water consumption over a long time can lead to development of kidney stones, and digestive problems.

"Dehydration, not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may be at higher risk than others,” Maniraguha adds.

Dr Theobald Hategekimana, a urologist who also doubles as the medical director of the University Teaching Hospital of Kigali (Chuk), says certain diets like fatty, oily, and sugary foods can also lead to kidney stones.

Being obese, high body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones too.

Maniraguha remarks that gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect one’s absorption of calcium and water, increasing the levels of stone-forming substances in one’s urine.

"Other diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections,” he remarks.

Diagnosis

If your doctor suspects you have a kidney stone, he may have diagnostic tests and procedures, such as blood tests, which may reveal too much calcium or uric acid in blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.

A 24-hour urine collection test may show that you are excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.

Imaging tests may be done to see if you have kidney stones in your urinary tract. Options range from simple abdominal X-rays, which can miss small kidney stones, to high-speed or dual energy computerized tomography (CT) that may reveal even tiny stones.

"Other imaging options include an ultrasound, a noninvasive test, and intravenous urography, which involves injecting dye into an arm vein and taking X-rays (intravenous pyelogram) or obtaining CT images (CT urogram) as the dye travels through your kidneys and bladder,” Maniraguha    explains.

You may be asked to urinate through a strainer to catch stones that are passed. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what’s causing your kidney stones and to form a plan to prevent more kidney stones.

Treatment

For small stones, most people don’t need any treatment other than taking pain killers and drinking enough fluids.

One will need to keep drinking water and other fluids so as to easily pass the kidney stone. One’s doctor may prescribe medicine to help them pass it (the stone).

If pain is too severe or if the stones are blocking the urinary tract, your doctor will probably suggest a medical procedure, such as lithotripsy, or surgery to deal with the stone.

Cost of treatment

Dr Hategekimana, says that advanced kidney stones could lead to kidney failure, that may require a transplant or dialysis, both which are so expensive.

"Dialysis costs a patient about Rwf 1.5 million per month, and one has to stick to it for the rest of their life, unless they get a kidney transplant, which is also expensive,” he says.