Quick Facts

Kidney Stones

Kidney Stones

Symptoms

Small stones can travel through your urinary …

Treatment

An X-ray or CT scan will reveal the location…

Prevention

Once you’ve had a kidney stone, 
you…

Doctors

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Kidney Stones

A small, hard deposit that forms in the kidneys and is often painful when passed.
Kidney stones are hard deposits of minerals and acid salts that stick together in concentrated urine. They can be painful when passing through the urinary tract, but usually don’t cause permanent damage.

Symptoms

 

Small stones can travel through your urinary system and pass out of your body in your urine without pain. Larger stones usually start to cause pain and other symptoms when they move around in your kidneys or into other parts of your urinary system and begin to block the outflow of urine.

Symptoms include:

  • Extreme pain in your side and back, below your ribs
  • Pain that spreads to your lower abdomen  and groin area
  • Pain that comes and goes and changes in intensity
  • Nausea, vomiting, fever or chills
  • Pink, red or brown urine
  • Cloudy or bad smelling urine
  • Persistent urge to urinate or urinating more than usual

Testing and Treatment

An X-ray or CT scan will reveal the location, size and number of stones, all of which will be used to determine appropriate treatment.

Small Stones: If your stone is small, your doctor may recommend you try to pass it out in your urine. To do this, you need to drink a lot of water so that your urine is almost clear. Normally, your doctor will prescribe a pain medication to help with the discomfort and a medication help your ureters (the tubes that carry urine) relax to allow the stone to pass.

Large or Complicated Stones: If your stone is too large to pass, blocking the flow of urine or causing other complications, your doctor may recommend one of these treatments.

  • Shockwave Lithotripsy (SWL): In an outpatient surgery center, your urologist uses a machine called a lithotripter to direct ultrasonic shock waves to hit the stone repeatedly until it crumbles into small particles that you pass in your urine. This is the most frequently used procedure for eliminating kidney stones.  
  • Ureteroscopy (URS):  In this procedure, your urologist passes a flexible tube with a camera through your urethra. A wisk-like basket on the end of the scope snares the stone and removes it. If the stone is too large, the urologist can use a laser inserted through the scope to break the stone apart. After a ureteroscopy, the urologist places a stent in the ureter to hold it open until the swelling subsides. The stent is removed a days later.
  • Percutaneous Nephrolithotomy (PCNL):  For large stones that can’t be effectively treated with lithotripsy or ureteroscopy, your urologist can perform a minimally-invasive surgery through a 1-centimeter incision in your back. Using a scope and special tools, the urologist can break apart the stone and suction it out.
 

Prevention

Once you’ve had a kidney stone, you are more likely to have future stones. To minimize your chances of getting additional stones, follow these guidelines.

  • Drink water. Water helps keep your urine from becoming too concentrated and forming crystals. A good rule of thumb is to drink enough water to keep your urine a faint yellow color.
  • Limit salt. Salt, which is often found in processed foods, can lead to dehydration, causing your urine to become too concentrated.
  • Avoid certain foods. For calcium stones, the most common type of kidney stones, avoid foods with high amount of oxalate including coffee, tea, chocolate, wheat bran, spinach, and strawberries.  

Medications

Changing your diet and increasing fluids may not be enough to prevent stones from forming. Your health care provider may give you medications to take to help with this. The type of stone and the urine abnormalities you have will help your health care provider decide if you need medicine and which medicine is best. Common medications include:

Thiazide diuretics are for patients who have calcium stones and high levels of calcium in their urine. Thiazides lower urine calcium by helping the kidney take calcium out of the urine and put it back in the blood stream. When taking thiazides, you need to limit how much salt you take in, as these medications work best when urine sodium is low.

Potassium citrate is for patients with calcium stones and low urinary citrate, and for those with uric acid and cystine stones. Potassium citrate makes the urine less acidic or more alkaline (basic). This helps prevent cystine and uric acid stones. It also raises the citrate level in the urine, helping to prevent calcium stones.

Allopurinol is frequently prescribed for gout, which is caused by high uric acid in the blood. Allopurinol not only lowers the level of uric acid in the blood but also in the urine, so it may also be prescribed to help prevent calcium and uric acid stones.

Acetohydroxamic acid (AHA) is for patients who produce struvite or infection stones. These stones form because of repeated urinary tract infections (UTI). AHA makes the urine unfavorable for struvite stones to form. The best way to prevent stuvite stones is to prevent repeated UTIs caused by specific types of bacteria and to completely remove the stones with surgery.

Cystine-binding thiol drugs are used only for patients who form cystine stones. These medications (d-penicillamine or tiopronin) bind to cystine in the urine and form a compound that is less likely than cystine to crystallize in the urine. This drug is used when other measures fail, such as raising fluid intake, reducing salt intake or using potassium citrate.

Vitamin supplements should be used carefully as some can increase your risk of forming kidney stones. Your health care provider and a dietitian may be good sources of information about over-the-counter nutritional supplements.

 

 

Frequently Asked Questions

Despite the fact that calcium is a major component of most kidney stones, excessive calcium intake is very rarely the cause of stone formation and limiting calcium won’t help prevent stones.

No, drinking hard water does not cause an increase in kidney stone formation. In fact, drinking plenty of water, whether hard or soft, is key to staying hydrated and preventing kidney stones.

Despite the fact that calcium is a major component of most kidney stones, excessive calcium intake is very rarely the cause of stone formation and limiting calcium won’t help prevent stones.

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