Kidney Stones During Pregnancy

Kidney stones can be very painful to bear, especially when you are pregnant. While being pregnant does not increase your chances of getting kidney stones, it makes it complicated to diagnose and administer the usual methods of treatment due to the risks of harming the foetus. While most kidney stones may pass without the need for any treatment, some of them may cause intense pain. In such cases, medical treatment is recommended.

Causes of Kidney Stone During Pregnancy

Although being pregnant does not mean that you are at a higher risk of getting kidney stones, there are certain causes that can connect kidney stones and pregnancy. Some of the common causes of kidney stones during pregnancy are:

1. Lack of fluids: A common reason for kidney stones is the inadequate consumption of water. The lack of fluids in your body causes an increase in the concentration of minerals like phosphorous and calcium in the urine, which leads to the formation of kidney stones. During pregnancy, your body requires more water than usual. Drinking less than the required amount of water may thus lead to kidney stones.

2. Genetic predisposition: The genetic makeup of your body may also increase your chances of kidney stones. If you are from a family with a high incidence of hypercalciuria – a condition where there is an excess quantity of calcium in the urine – you may be more prone to kidney stones during pregnancy.

3. Bowel irritation: If you have gastrointestinal sensitivity, you may be prone to hypercalciuria or be at a higher risk of kidney stones. This is because chronic inflammation in the bowels may increase the number of calcium ions that are deposited on the kidneys, which then turn into crystals.

4. High calcium intake: Pregnant women are encouraged to consume more calcium – this may put extra pressure on the kidneys and cause crystal formation on the kidneys. Also, as your body absorbs a lot of calcium to aid the development of the baby, you may have a higher chance of getting kidney stones.

5. Increased filtration: Due to an increase in the filtration activity of the kidney, the amount of uric acid that you excrete may also increase, which may lead to uric acid stones.

6. Dilation of the uterus: The upper urinary tract may become large during pregnancy, which can cause an incomplete clearing of the urine and increase the risk of kidney stone formation.

7. UTIs: Constant urinary tract infections during pregnancy may be indicative of kidney stones.

Signs and Symptoms

The signs and symptoms of kidney stones during pregnancy aren’t unlike the usual ones. However, there are no specific symptoms that indicate kidney stones and any pregnancy complications caused due to it. Some of the common symptoms of kidney stones during pregnancy include:

1. Pain: Intense pain is one the first and the most common signs of kidney stones. The area of the pain is based on where the stone is, internally. If the stone is in your kidney, you will experience pain in the back, below the rib cage area. Once the stone moves down to the ureter, you will experience pain on the side of your body. As the stone moves further down the ureter, you may even feel pain near your genitals or in the thigh. Apart from this, you may also feel pain in your lower abdomen.

2. Pain during urination: If the stone has travelled down and is stuck at the lower end of the ureter, you are likely to have intense pain while urinating.

3. Blood in the urine: As the stones in the kidney move spontaneously, they may damage the tissues and the cells in the kidney. This may lead to blood in the urine.

Apart from these symptoms, you may also have vomiting, nausea, fever with chills (indicates infection), or may even feel some distension in the abdomen.

How Is Kidney Stone Diagnosed During Pregnancy?

A blood and urine analysis is performed to diagnose kidney stones during pregnancy. A urine test can identify blood, crystals of calcium or uric acid in the urine. A urine culture test can also recognise infection-causing organisms and determine what antibodies they are sensitive to.

A renal ultrasound may be conducted as it is a painless procedure that does not expose the foetus to radiation. However, the drawback of undergoing a renal ultrasound is that it cannot identify certain types of kidney stones and may not be able to identify the cause of an enlarged kidney (whether it is due to pregnancy or due to the obstruction caused by a kidney stone).

X-rays and CT scans are avoided to prevent any damage to the foetus. While an MRI is considered safe as it does not use radiation or contrast materials, it is still not advisable to use it to detect kidney stones during pregnancy.

Indications When Surgical Intervention Is Advised

If natural and conservative remedies do not work, you may have to opt for surgical intervention to get rid of kidney stones under these circumstances:

• The stones that have obstructed the urinary tract have caused pyelonephritis or inflammation due to bacterial infection
• If you have only one kidney
• Acute kidney failure
• Intense pain
• Risk of premature labour due to kidney pain

How to Get Rid of Kidney Stones While Pregnant

If you notice any symptoms of kidney stones, it is advisable to consult a urologist for treatment options. Here are some of the methods used to get rid of kidney stones during pregnancy. Treatment methods are also dependent on the nature of your kidney stones and the trimester that you are in.

1. Medical Treatment

Paracetamols are prescribed to relieve pain caused due to kidney stones. However, in the event that medication fails to reduce your pain, or if there is any indication of preterm labour, you may need surgical intervention.

2. Surgical Treatment

• Ureteroscopy – this procedure is used for diagnosis as well as for breaking down the stones. A small tube called a ureteroscope is inserted into the kidney, which passes through the ureter, the urethra, and the urinary bladder. The process uses a laser to break the stones. This procedure is only ideal for stones smaller than 1 cm.
• Tube or stent placement – this procedure uses a hollow tube passed through the ureters to drain the urine and the stones. It is minimally invasive and needs local anaesthesia at most.
• Shockwave therapy and open surgery – these are not prescribed to pregnant women due to risks to the foetus.

3. Natural/Home Remedies

Conservative methods and natural remedies are the most preferred treatment for kidney stones. Some of these include,

• Intake of water: Drinking at least 8 glasses of water every day can help dilute the minerals and organic salts in the urine. It also helps clear small stones from the kidneys.
• Fruits: Consuming fruits like watermelon, blueberries, peaches, and other fruits that have high water content is also beneficial.

• Avoid commercial juices: Packaged juices have a high mineral (and possibly added sugar) and salt content which may make your condition worse.
• Lemon: Lemon is known to break down medium-sized stones and also open up the ureters, helping the stones pass without much pain.
• Apple Cider Vinegar: ACV contains acetic acid which dissolved kidney stones. Just adding a tablespoon or two to 1 litre of water and drinking it through the day can be helpful. However, make sure to check with your doctor as the consumption of ACV should be limited during pregnancy.
• Basil Juice: Like ACV, basil contains acetic acid which can be helpful in breaking down kidney stones. Basil generally helps with inflammation as well. Simply take some fresh or dried basil leaves, boil them in water, and consume the tea. Avoid the prolonged consumption of this tea as it may cause problems like low blood pressure and blood sugar. Always consult with your doctor before trying any home remedy, especially during pregnancy.

Prevention

Some of the best ways to prevent kidney stones are:

•  Drink a lot of water. A minimum of two litres or eight glasses per day is essential.
• Reduce your salt intake. Avoid junk food especially, as it may contain unhealthy amounts of monosodium chloride.
•  Avoid excess calcium. Keep your calcium intake under 1000 to 1200 mg per day.
• Talk to your doctor about your medication. Certain medications can make a person susceptible to kidney stones. If you are on medication – any medication, regardless of whether you have been prescribed them during pregnancy – mention them to your doctor. In any case, however, do not stop consuming those medicines without your doctor’s approval.
• Reduce your consumption of certain foods. Green leafy vegetables, chicken, fish, nuts, beetroot, chocolate, peanuts, beef, red meat, tea, and coffee can make a person more vulnerable to kidney stones.

Kidney stones can occur during pregnancy, and in most cases can be treated using natural treatment methods. However, in case the pain is severe, you will need to opt for medical or surgical treatments to alleviate it. Always remember to reach out to a doctor immediately after you notice symptoms of kidney stones to get the appropriate treatment method and avoid complications.

Also read: Hydronephrosis In Pregnancy