If you or your friend or a family member have been recently diagnosed with kidney stones and would like to know more about kidney stones, their symptoms, treatment, and medications, keep reading this article. It will help you understand more about kidney stones and Allopurinol (medication used in kidney stones treatment).

What are Kidney stones, and what does it look like?

Kidney stones or renal calculi are a solid mass made of crystals formed in the kidney from substances in the urine. They can develop anywhere along your urinary tract. The urinary tract comprises of ureters, urethra, bladder, and kidneys. 

The solid mass can be as small as a grain of sand or as large as a pearl. Most of the time, kidney stones pass out of the body via urine without any treatment or assistance from the doctor. However, they may not go away a few times and are stuck in the urinary tract. Once they are stuck, they block the urine flow and cause significant pain. 

Depending upon the stone’s size and location, your doctor may recommend treatment. 

Kidney Stones Symptoms

The majority of people with kidney stones do not show symptoms. However, if the stone is displaced and moves in ureters, it can block the urine flow and cause the kidney to swell and the ureter to spam, which causes pain. The symptoms at that time include:

• Pain or burning sensation while urinating 
• Severe, sharp pain in the side and back
• Pain that comes in waves and varies in intensity 
• Pain radiating to the lower abdomen and groin 
• Blood in the urine 
• Urine may smell bad or look cloudy 
• Vomiting 
• Fever and chills 
• Nausea 
• Frequent need to urinate 

If the stone is small, you may not experience any pain or symptoms, and the stone will pass through your urinary tract. While if the stone is large, it will not pass via the urinary tract and may need treatment. 

Causes of Kidney stones

Kidney stones are likely to occur if your age is between 20-50 years of age. Various factors can increase the risk of developing a kidney stone. Men are more likely to develop stones compared to women. 

Risk Factors: You are likely to have Kidney stones if you: 

• Have a family history of Kidney stones 
• Dehydration 
• Hyperparathyroid condition 
• Medications (diuretics, antiepileptic drugs, and calcium-based antacids)
• Diet with high levels of protein, glucose, or salt 
• Inflammatory bowel diseases that increase calcium absorption 
• Obesity 
• Surgery (gastric bypass surgery)
• Supplements 

Kidney Stones Treatment and Medications 

Your physician may ask you to undergo diagnostic tests and procedures to confirm the presence of stones. Following procedures or tests may be requested: 

• Blood test (To determine calcium or uric acid levels)
• Ultrasonography 
• CT scan 
• Analysis of passed stone (for determination of the cause of stone)
• Urine testing

Once the diagnosis is confirmed, your physician will decide the treatment. The treatment for kidney stones varies; it depends on size, type of the stone, and cause. 

Small stones (Minimal symptoms)

If your kidney stones are small, you will not require invasive treatment. Your doctor will advise you the following: 

• Drink plenty of water as it prevents the new stone formation and may help in the removal of the small stones that are already present 
• Small stones may cause some discomfort; hence your doctor may prescribe you some pain killers (ibuprofen, naproxen sodium, diclofenac sodium)
• Alpha-blockers help your muscles in the ureter to relax and pass your stone more quickly with less pain (Tamsulosin) may be prescribed 

Large Stones (may cause a lot of discomforts)

If the kidney stones are too large to pass through the urinary tract, it may cause kidney damage, bleeding, or urinary tract infection. In such cases following treatment may be opted: 

• Lithotripsy: A procedure that uses shock waves to break large stones so that they can pass through the urine easily
• Ureteroscopy: This procedure is used when the stone is stuck in the bladder or ureter. The doctor may use a ureteroscope (an instrument) to remove the stone. The instrument has a small wire attached with a camera and is inserted into the urethra and passed into the bladder and to the point where the stone is located. The procedure requires general anesthesia, and it may last from 1 hour to 3 hours
• Tunnel surgery: It involves inserting a small scope through a small incision in your back to remove the kidney stone
• Parathyroid gland surgery (at times, calcium phosphate stones are formed due to overactivity of the parathyroid gland). The overactivity of the gland is due to small, benign tumors. Removal of the tumor growth from the gland stops the kidney stone formation) 
• Pain management: When the stone is about to be excreted via urine, it may cause a lot of discomfort. In such cases, your physician may prescribe you pain killers to reduce the symptoms
• Other medications: Depending on the type of stone present, various medications may also be prescribed. Other medications include: 

• Thiazide diuretics (to prevent calcium stones from forming)
• Phosphorous solutions (to prevent calcium stones from forming)
• Sodium citrate or sodium bicarbonate (to make the urine less acidic)
• Painkillers (ibuprofen, ketorolac, diclofenac)
• Allopurinol (for uric acid stones)

How does Allopurinol help treat Kidney Stones?

Allopurinol belongs to the xanthine oxidase inhibitor class of medication. It is used to treat kidney stones (uric acid stones) and high uric acid levels in the body caused by certain medications. Allopurinol works by reducing the production of uric acid in the body. High uric acid levels in the body can cause kidney stones.

Allopurinol Use, dosage, and frequency for Kidney Stones

Allopurinol is available in tablet form and taken by oral route. Your physician may prescribe you to take the medication once or twice daily. The medication is usually to be taken after a meal. You should take the medication at the same time so that you do not forget to take medication. 

Allopurinol tablets are available in two strengths, 100 mg and 300 mg. Usually, your physician will start your treatment at 100 mg and gradually increase the dose if the dose needs calibration. The maximum adult dose prescribed is 800 mg per day in divided doses.

Always follow the direction on your prescription label or instructions given by your healthcare worker. In case of any queries, always ask your doctor or pharmacist for an explanation. Do not take more or less than prescribed by your physician. 

If you miss taking the medication, take it as soon as you remember it. However, skip the missed dose and continue your regular dosing schedule if it is almost the next dose. You should not take a double dose. 

You will observe the full benefit of the treatment after several months. It is possible that during the initial phase of treatment, the number of kidney stones attacks may increase, although the attacks will decrease over a period. You should not stop taking Allopurinol even if you feel well. Always consult your physician before stopping the medication.  

Allopurinol Side effects 

Like all the medications, Allopurinol also has side effects. It is possible that you may not experience any side effects or may experience minor side effects. Inform your doctor if any of the below mentioned side effects are severe or do not go away:

• Diarrhea 
• Drowsiness 
• Stomach upset 

Some of the side effects can be serious and may require medical attention. Call your doctor immediately if you experience them: 

• Itching 
• Weight loss
• Loss of appetite 
• Painful urination 
• Skin rash 
• Swelling of lips or mouth 
• Fever 
• Sore throat 
• Chills 
• Blood in urine 
• Irritation of the eyes 

The above-mentioned side effects are not comprehensive. You may experience other side effects while taking this medication. Call your doctor immediately if you experience any unusual or persistent side effects.

Other precautions 

Please inform your doctor and pharmacist about allergies to Allopurinol or any of its ingredients. If you have any other allergies, do not forget to share the same with the healthcare professional. 

Inform your health worker about other prescription, non-prescription medications, and nutritional supplements that you are taking. Also, inform about vitamins and herbal supplements you are taking or planning to take. 

Inform your doctor if you ever had kidney, heart, or liver disease. You should inform your physician if you are pregnant, planning to get pregnant, or breastfeeding. If you become pregnant while on treatment with Allopurinol, inform your doctor immediately. 

Allopurinol may make you feel drowsy. You should not drive or operate machinery until you know how this medication affects you. 

You should not consume alcoholic beverages while taking Allopurinol, as alcohol reduces the effectiveness of the medication. 

Drink at least eight glasses of water or other fluids each day while on treatment with Allopurinol, unless directed to do otherwise by your physician. 

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