Conditions & Treatments

Kidney Stones

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OVERVIEW

Kidney stones, medically known as nephrolithiasis, are hard deposits of minerals and salts that form in the kidneys. These stones can vary in size and shape, and they can cause significant pain and discomfort as they move through the urinary tract. Kidney stones are highly prevalent in the US, with one in eleven Americans experiencing them.

At the University of Kansas Department of Urology, our expert team is dedicated to providing top-tier care. We work closely with each patient to create a customized treatment plan tailored to their specific needs. Our cutting-edge techniques and state-of-the-art diagnostics ensure precise management of kidney stones, from conservative approaches to minimally invasive procedures or surgery when necessary.

Types of Kidney Stones

  • Calcium based Stones: These are the most common type of kidney stones and are primarily composed of calcium oxalate and calcium phosphate. They are associated with high levels of calcium and sodium in the urine. High levels of oxalate is also a risk factor for formation of these stones.
  • Struvite Stones: Also called infection stones, struvite stones are typically caused by urinary tract infections (UTIs). They can grow rapidly and become quite large.
  • Uric Acid Stones: Uric acid stones form when there is an excess of uric acid in the urine. This can be a result of a diet high in purines or certain medical conditions.
  • Cystine Stones: These stones are rare and form in people with a hereditary condition called cystinuria. Cystine, an amino acid, leaks into the urine and forms crystals that can accumulate into stones.

SYMPTOMS & CAUSES

Symptoms

The symptoms of kidney stones can vary depending on their size and location within the urinary tract. Common symptoms include:

  • Severe Pain: This is often the most noticeable symptom. The pain can come in waves and may radiate from the back, down the side, and into the groin area. It’s often described as one of the most painful experiences.
  • Hematuria: Blood in the urine is a common sign, which can make the urine appear pink, red, or brown.
  • Frequent Urination: Individuals may feel the need to urinate more frequently, and the urge can be intense.
  • Painful Urination: Discomfort or a burning sensation during urination can occur.
  • Cloudy or Foul-Smelling Urine: The presence of kidney stones can affect the appearance and odor of urine.
  • Nausea and Vomiting: Some people may experience nausea and vomiting, often as a result of the severe pain.

Causes

The exact cause of kidney stones can vary, but common factors include:

  • Dehydration: Insufficient fluid intake can lead to concentrated urine, increasing the risk of stone formation.
  • Diet: A diet high in sodium and animal protein combined with low fluid intake can contribute to stone formation. Certain foods rich in oxalate, such as spinach, beets, and nuts, are rich in oxalates and may also increase the risk.
  • Family History: A family history of kidney stones can predispose an individual to develop them.
  • Medical Conditions: Some medical conditions, like gout and certain metabolic disorders, can increase the likelihood of forming kidney stones.
  • Urinary Tract Infections (UTIs): Infections that lead to the formation of struvite stones are another cause.
  • Medications: Certain medications, such as diuretics, antacids and some medications for migraines can increase the risk of stone formation.

Handling kidney stones may involve pain management, hydration, and sometimes medical procedures or surgery, depending on the size and location of the stones.

DIAGNOSIS & SCREENING

  • Medical History and Physical Examination: A doctor will typically start by taking a detailed medical history and conducting a physical examination. They will ask about your symptoms and risk factors for kidney stones.
  • Imaging Tests: Various imaging tests can help diagnose kidney stones, including:
    • Ultrasound: This non-invasive test uses sound waves to create images of the kidneys and urinary tract.
    • CT Scan: A computed tomography (CT) scan provides detailed images of the urinary system, allowing the doctor to determine the size, location, and number of stones.
    • X-ray: X-rays can detect some types of stones, particularly those made of calcium.
  • Laboratory Tests: Urine and blood tests may be conducted to check for signs of kidney stones and to evaluate kidney function. Urine tests can identify the presence of blood, crystals, or other substances that indicate stone formation.

TREATMENTS

  • Watchful Waiting: Small kidney stones that are not causing significant symptoms may pass on their own with pain management and increased fluid intake. Your doctor may recommend monitoring the stone’s progress.
  • Pain Management: Severe pain is often treated with pain relievers, such as ibuprofen or stronger prescription medications.
  • Hydration: Drinking plenty of water is crucial to help flush out kidney stones and prevent their formation. Your doctor may advise you to increase your fluid intake significantly.
  • Medical Expulsion Therapy: This involves taking medications that can help relax the muscles in the ureter, making it easier for the stone to pass.
  • Extracorporeal Shock Wave Lithotripsy (ESWL): ESWL is a non-invasive procedure that uses shock waves to break up kidney stones into smaller fragments, making them easier to pass.
  • Ureteroscopy: A thin, flexible tube with a camera is inserted into the urethra and up into the urinary tract to locate and remove or break up larger stones.
  • Percutaneous Nephrolithotomy (PCNL): For larger stones or those that cannot be treated with other methods, a surgeon may perform PCNL. This involves making a small incision in the back to access and remove the stone.
  • Surgery: In rare cases, open surgery may be necessary to remove large or complicated kidney stones.

OUTLOOK & PROGNOSIS

The outlook for kidney stones depends on various factors, including the size, type, and location of the stones, as well as individual health and treatment options. In general:

  • Small stones that pass on their own or with minimal intervention often have a good prognosis
  • Larger stones or those causing complications may require more extensive treatment but can still have a favorable outcome
  • Recurrence of kidney stones is possible, but preventive measures such as dietary changes and increased fluid intake can significantly reduce the risk

If you have a history of kidney stones or experience symptoms, it’s important to consult a healthcare professional for proper diagnosis and treatment to prevent potential complications and ensure the best possible outcome.

Prevention & Management

Preventing kidney stones and effectively managing the condition involves several key strategies:

  • Hydration: Drink plenty of water throughout the day to keep urine diluted and help prevent the formation of crystals that can lead to stones. Aim for at least 8-10 cups of water daily, or more in hot weather or if you’re physically active.
  • Dietary Changes: Consider the following dietary adjustments:
    • Reduce intake of oxalate-rich foods like spinach, beets, and nuts
    • Limit sodium (salt) intake to prevent calcium from being excreted in the urine
    • Maintain a balanced diet with adequate calcium, as low calcium intake can increase the risk of stones
  • Moderate Protein and Purine Intake: If you have a history of uric acid stones, consider reducing the consumption of foods high in purines, such as red meat and organ meats.
  • Medications: Depending on your specific risk factors and stone composition, your doctor may prescribe medications to prevent stone formation. These can include thiazide diuretics, allopurinol (for calcium oxalate stones with high uric acid in the urine), or potassium citrate (especially for uric acid stones).
  • Lifestyle Changes: Maintain a healthy weight and engage in regular physical activity. Obesity and a sedentary lifestyle can increase the risk of kidney stones.
  • Monitor Urine pH: If you’ve had recurrent stones, your doctor may recommend monitoring your urine pH and adjusting your diet or medications accordingly.
  • Address Underlying Medical Conditions: If you have conditions like hyperparathyroidism or urinary tract infections that contribute to stone formation, seek treatment to manage these conditions effectively.

CONCLUSION

Kidney stones can be a painful and uncomfortable condition, but with proper prevention and management strategies, their impact can be significantly reduced. Staying well-hydrated and making dietary adjustments are essential steps in preventing stone formation.

If you’ve experienced kidney stones or have risk factors, working closely with a healthcare professional can help you develop a personalized plan to reduce the likelihood of recurrence.

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