Kidney Stones: Symptoms, Causes, Diagnosis, Treatment & Prevention

Clusters of crystals called kidney stones are created in your urinary tract by minerals and other substances. The majority of stones naturally exit your body through urine, but while they do so, they can cause severe pain. Should the stone get too big to pass through naturally or become an obstruction, you may require a procedure to break it up or remove it.

What are kidney stones:

Kidney stones are solid masses or crystals that develop from materials in your kidneys such as salts, minerals, and acids. They can rarely be bigger than a golf ball, but they can also be as small as a grain of sand. Nephrolithiasis and renal calculi are other names for kidney stones.

You might not even be aware that you have a kidney stone, depending on how big the stone or stones are. Smaller stones may travel through your urinary tract symptomless as they pass through your urine. Your ureter, which is the tube that carries urine from your kidneys to your bladder, may become blocked by large kidney stones. Pee may back up as a result, and your kidneys' ability to filter waste from your body may be compromised. Bleeding is another possible outcome.

Kidney stones might take up to three weeks to go away on their own. When little stones pass through your urinary tract and exit your body, they can still cause excruciating pain. A provider can be necessary to split and remove a stone that is too big to pass by itself.

What symptoms indicate that kidney stones are present?

Pain in the lower back, abdomen, or side is the most typical sign of kidney stones (flank pain). It may feel as though it reaches from your side to your groin. Either a dull or strong sharp pain can be felt. Because it sometimes worsens in waves, it's sometimes referred to as colicky pain.

Additional signs and symptoms of kidney stones include:

• Vomiting as well as nausea.
• Urine that is bloody.
• Discomfort while urination.
• Not being able to urinate.
• Having frequent urinal urges.
• Chills or fever.
• Cloudy or offensive-smelling pee.
• Smaller Kidney stones can not hurt or exhibit other signs.

Kidney stones: what causes them?

Minerals, acids, and other materials such as calcium, sodium, oxalate, and uric acid can be found in your urine. These components can clump together to create crystals or stones when there are too many of them in your urine and not enough moisture. It can take months or years for kidney stones to form.

Kidney stone types:

The name of a stone comes from which type of crystal it is composed of:

• Stones are made of calcium phosphate and calcium oxalate. When you consume meals high in oxalate or low in calcium and don't get enough fluids, you may get calcium-based stones. Kidney stones most commonly occur as calcium-oxalate stones.
• Stones containing uric acid. Consuming animal proteins such as fish, eggs,  poultry, and beef might result in the formation of uric acid stones.
• Stones with struvite. Struvite stones can be brought on by bacterial infections. A staghorn calculus, an extremely big kidney stone that typically requires surgical removal, can develop as a result of recurrent infections.
• Stones made of cystine. Cysteine stones are caused by a hereditary disease called cystinuria. Two cysteine amino acids joined together to the chemical known as cysteine.

What are the kidney stone risk factors?

Kidney stones could perhaps be more likely to occur if you:

• Consume enough liquids.
• Eat meat and other foods high in protein.
• Eat foods heavy in sugars (fructose and sucrose) or salt.
• Take supplements containing vitamin C.
• Have kidney stones in your family's history.
• Possess an obstruction in your urinary system.
• Have surgical experience with the stomach or intestines, particularly gastric bypass.
• Take specific drugs. This includes several calcium-based antacids, antiseizure drugs, diuretics, and some
• Possess certain medical conditions.

Conditions that raise the risk of kidney stones:

Kidney stones may become more likely in you if you have certain medical conditions. Among them are:

• Fibrosis cystic.
• A hereditary condition known as cystinuria results in an accumulation of cystine.
• Diabetes.
• Gout.
• High blood pressure.
• High quantities of calcium in the urine, or hypercalciuria.
• Inflammation of the colon (IBD).
• Kidney cysts.
• Being overweight.
• Osteoporosis.
• Disease of the parathyroids.
• Hyperoxaluria primary.
• Both paraplegia and hemiplegia are types of paralysis.

Also Read: Kidney Infection (Pyelonephritis): Symptoms, Causes, Diagnosis, Treatment & Prevention

How are kidney stones diagnosed?

For the diagnosis of kidney stones, healthcare providers employ imaging, blood, and urine (pee) testing. You could require one or more of the following tests if your doctor believes you have a kidney stone based on your physical examination and symptoms:

• Urine examination. Your urine can be tested by a provider for infection symptoms, blood, and crystals that form stones.

• Imagining. The size, form, location, and quantity of stones can be seen by your healthcare professional with the use of X-rays, CT (computed tomography) scans, and ultrasound.

• Blood tests. Blood tests can be used by a physician to monitor kidney function, identify infections, and search for disorders such as elevated calcium levels or other factors that may contribute to the development of stones.

 Treatment:

Your healthcare professional will ask you to keep an eye on your symptoms until the little stone passes through your urine if it's likely to pass on its own. They may recommend drugs to assist the stone to go away on its while also keeping you comfortable.

Depending on their size, location, if they're causing infections or symptoms, and other circumstances, larger stones may require treatment. Your provider may suggest procedures to break up or remove a large stone, blockage, or stone that isn't passing on its own after a few weeks.

 

Medications:

A healthcare professional may prescribe or suggest the following medications if your kidney stone is self-passing and not infected:

Your ureter will relax as the stones pass. Tamsulosin (Flomax®) and nifedipine (Adalat® or Procardia®) are two medications that are frequently administered.
Control your nausea and vomiting.

Manage your pain. Even little stones that are self-passing can cause excruciating discomfort. To treat the pain, your doctor can offer over-the-counter (OTC) drugs or write prescriptions for them. Consult your doctor before taking ibuprofen. If you take it during a severe case of kidney stones, you may be at higher risk of kidney failure, particularly if you have underlying medical issues.

Procedures for kidney stones:

If a kidney stone becomes lodged in your urinary tract or is too big to pass naturally, your doctor might recommend surgery to break the stone up and/or remove it. The size and location of the stone are just two of many factors that determine the kind of operation they advise. Procedures for kidney stones include:

Lithotripsy with shockwave. To break up the stones from the outside of your body, a provider uses shockwaves. The fragments can more readily exit your body through your urine tract.

Ureteroscopy. A medical professional puts a scope into your ureter through your bladder and urethra. The stone can be broken apart and removed using tools the provider runs through the scope. The smaller bits are easier to pass through your urinary tract and exit your body.

Intraoperative nephrolithotomy. If your doctor feels that no other procedure can effectively treat your kidney stone, they may suggest percutaneous nephrolithotomy. A tiny incision (cut) in your back is used by your healthcare professional to place a tube straight into your kidney during a percutaneous nephrolithotomy. The stones are broken up and removed with an ultrasound probe.

Laparoscopic surgery. To remove the stone, your surgeon will make a tiny incision during laparoscopic surgery. Rarely, your doctor may need to have open surgery rather than a laparoscopy, which requires a wider incision.

Prevention:

Your risk of kidney stones might be affected by the foods and beverages you consume. Consult a dietician or your healthcare professional about methods to lower your risk. They could suggest:

• Drinking plenty of water.
• Limiting the use of animal proteins.
• Limiting sodium- and sugar-rich meals.
• Limiting oxalates-rich foods. Your doctor may advise you to stay away from foods like rhubarb, wheat bran, peanuts, tree nuts, and spinach if you have calcium oxalate stones.
• Keeping yourself at a healthy weight.
• Consuming foods high in calcium content. Foods rich in calcium can help prevent kidney stones, this may not seem possible. This isn't the case for calcium-containing antacids or supplements, which can raise your risk of kidney stones.
• Prescription medications. Your doctor may recommend kidney stone prevention drugs if dietary modifications are ineffective. The kind of stone you get will determine the kind of medication you need.

References:

• Fontenelle LF, Sarti TD. Kidney Stones: Treatment and Prevention. (https://pubmed.ncbi.nlm.nih.gov/30990297/)Am Fam Physician. 2019 Apr 15;99(8):490-496. Accessed 2/26/2024.

• Goldman L, et al., eds. Nephrolithiasis. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 20, 2020.

• What are kidney stones? American Urological Association. https://www.urologyhealth.org/urologic-conditions/kidney-stones. Accessed Jan. 20, 2020.

• Curhan GC, et al. Diagnosis and acute management of suspected nephrolithiasis in adults. https://www.uptodate.com/search/contents. Accessed Jan. 20, 2020.

• Preminger GM. Options in the management of renal and ureteral stones in adults. https://www.uptodate.com/search/contents. Accessed Jan. 20, 2020.

• Curhan GC. Nephrolithiasis. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson J, eds. Harrison’s Principles of Internal Medicine. 21st ed. McGraw Hill; 2022.

• Goldman L, et al., eds. Nephrolithiasis. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Jan. 20, 2020.