Kidney Stones

Kidney stones, also known as renal calculi, are hard lumps of minerals and salts that form inside your kidneys. These lumps are similar to tiny, hard pebbles.

Many things can cause kidney stones. These include what you eat, your weight, certain health problems, and some medicines or supplements. Kidney stones can form anywhere in your urinary system, from your kidneys all the way down to your bladder. They often develop when your urine becomes very concentrated. This allows the minerals in your urine to clump together and form crystals, which then stick together to create the stone.

Kidney stones can be very painful as they travel through your urinary system. However, if caught early, they usually don't cause lasting harm. Often, just taking pain relievers and drinking plenty of water is enough to help the stone pass on its own. In some cases, like when a stone gets stuck, causes an infection, or leads to other problems, surgery might be needed to remove it.

If you have a higher chance of getting kidney stones again, your doctor might recommend ways to prevent them from returning. This might involve changes to your diet, lifestyle, or medications.

Kidney stones are hard deposits that form inside your kidneys. These stones can travel down thin tubes called ureters, which carry urine from the kidneys to the bladder. When stones move through the ureters, they can cause noticeable symptoms.

Usually, you won't feel anything until a kidney stone starts to move around inside your kidney or travels into a ureter. The ureters are the pathways connecting your kidneys to your bladder.

If a stone gets stuck in a ureter, it can block the flow of urine. This blockage can cause the kidney to swell and the ureter to spasm, leading to intense pain. You might experience:

• Sharp, intense pain in your side and back, often below your ribs.
• Pain that spreads to your lower belly and groin area.
• Wave-like pain that comes and goes, changing in strength.
• Pain or burning sensation while you pee.

Other possible signs include:

• Urine that is pink, red, or brown (due to blood in the urine).
• Cloudy or smelly urine.
• Frequent urination – needing to urinate more often than usual or passing only small amounts of urine.
• Nausea and vomiting.
• Fever and chills if an infection is present.

The pain from a kidney stone might change as the stone moves through your urinary system. For example, the location of the pain or its intensity could shift as the stone travels.

See a doctor if you're concerned about any health issues.

If you're experiencing problems that are causing you worry, make an appointment with your doctor. It's important to get checked out by a medical professional if you notice anything unusual.

Get immediate medical help if you have:

• Severe pain: If the pain is so bad you can't find a comfortable position or stay still, seek immediate care. This kind of pain needs to be evaluated right away.
• Pain with nausea and vomiting: Pain combined with feeling sick to your stomach and throwing up is a sign that something might be seriously wrong. This combination needs quick attention.
• Pain with fever and chills: Pain along with a fever and shivering suggests a possible infection or other serious condition. Don't delay getting checked.
• Blood in your urine: Seeing blood in your urine could indicate a problem with your kidneys or urinary tract. This is a serious sign and needs immediate attention.
• Trouble urinating: If you're having a hard time passing urine, this could be a sign of a blockage or infection. Don't wait; get medical help right away.

If you have any of these symptoms, don't hesitate to call your doctor's office or go to the nearest emergency room. Early diagnosis and treatment are important for your health.

Kidney stones don't always have one clear cause, but several things can increase your chances of getting them.

Kidney stones happen when your urine has more substances that form crystals (like calcium, oxalate, and uric acid) than the liquid in your urine can dissolve. This, combined with a lack of substances that stop the crystals from sticking together, creates a perfect environment for stones to develop.

Figuring out what kind of kidney stone you have can help you understand why you got it and how to prevent more in the future. If you pass a stone, saving it and taking it to your doctor for testing is very helpful.

Different types of kidney stones exist, each with potential causes:

• Calcium stones: These are the most common type, often made of calcium oxalate. Your body makes oxalate every day, and you also get it from food. Many fruits, vegetables, nuts, and chocolate have a lot of oxalate. Eating too much of these foods, taking too much vitamin D, having surgery to bypass part of your intestines, or having certain health problems can all increase the amount of calcium or oxalate in your urine. Sometimes, calcium stones are made of calcium phosphate. This type is more common with conditions like renal tubular acidosis, or if you take certain medicines, like those for migraines or seizures (like topiramate).

• Struvite stones: These stones are usually linked to urinary tract infections (UTIs). They can grow quickly and be quite large, sometimes causing few noticeable problems until they get very big.

• Uric acid stones: These can form if you're not drinking enough fluids (like from chronic diarrhea or malabsorption), eat a lot of protein, have diabetes or metabolic syndrome, or have certain genetic factors.

• Cystine stones: These stones are caused by a rare inherited condition called cystinuria. This condition makes your kidneys release too much of a specific amino acid.

In summary, several factors can lead to kidney stones, from what you eat to underlying health conditions. Knowing the type of stone can point you toward the best ways to prevent future problems.

Kidney stones are painful, and some people are more likely to get them than others. Here are some factors that increase your risk:

Family History and Past Stones: If kidney stones run in your family, you might be more prone to them. Having had kidney stones before also significantly raises your chances of getting them again. This is because your body might be more susceptible to the conditions that cause stones.

Not Drinking Enough: Not getting enough water each day can lead to kidney stones. People who live in hot, dry areas or who sweat a lot need to drink even more water to stay hydrated and prevent stones. Dehydration concentrates the substances in your urine, making it easier for stones to form.

What You Eat: A diet high in protein, salt (sodium), and sugar can increase your risk of some kidney stones. Salt, in particular, plays a significant role. When you eat too much salt, your kidneys have to work harder to filter it out, and this can lead to an excess of minerals that form stones. Think of it like a clogged drain – too much stuff going through it makes it harder to function and more prone to blockages.

Weight and Body Composition: Being overweight or obese, as measured by a high body mass index (BMI), a large waist size, or recent weight gain, can also increase your risk. Excess weight can lead to changes in the way your body handles minerals, increasing the chance of stones forming.

Digestive Issues: Problems with your digestive system, such as gastric bypass surgery, inflammatory bowel disease, or chronic diarrhea, can affect how well your body absorbs calcium and water. This can cause more substances that lead to kidney stones to build up in your urine.

Other Medical Conditions: Certain medical conditions, including renal tubular acidosis, cystinuria, hyperparathyroidism, and frequent urinary tract infections (UTIs), can also increase your risk of kidney stones. These conditions can disrupt the balance of minerals in your body, making it more likely for stones to develop.

If a doctor thinks you might have kidney stones, they might order some tests to find out for sure. These tests help them understand what's happening with your kidneys and urinary system.

Blood Tests: These tests check the levels of substances in your blood, like calcium and uric acid. High levels of these substances can sometimes contribute to kidney stones. The blood tests also help your doctor see how healthy your kidneys are overall and might point to other health problems.

Urine Tests: Sometimes, a 24-hour urine collection is needed. This involves collecting all your urine for a full 24 hours. The test measures how much of certain minerals and substances you're passing in your urine. This helps determine if you're producing too many minerals that form stones, or not enough of the minerals that prevent them. Your doctor might ask you to collect urine samples over two days in a row.

Stone Analysis: If you pass any kidney stones, your doctor might ask you to urinate through a special strainer. This lets them collect the stones. A lab analysis of the stones will identify what they're made of. Knowing the type of stone helps doctors understand the cause and create a plan to prevent future stones.

Imaging Tests: Doctors use imaging to see if there are any kidney stones in your urinary tract. These tests can help find even very small stones.

• CT Scans: High-speed or dual-energy CT scans are often used. They're very good at finding small stones that other imaging tests might miss.

• X-rays: Simple abdominal X-rays are sometimes used, but they aren't as good at finding small stones as CT scans.

• Ultrasound: Ultrasound is a safe and quick test that doesn't use radiation. It's another useful tool for finding kidney stones.

Treating Kidney Stones: A Guide for Patients

Kidney stones come in different types and have various causes. Treatment depends on the stone's size, type, and whether it's causing problems like pain, bleeding, or infections.

Treating Small Stones:

Most small kidney stones can be passed without surgery. Here are some common methods:

• Increased Fluid Intake: Drinking plenty of water (about 2-3 quarts or 1.8-3.6 liters a day) is crucial. This helps dilute your urine, reducing the chance of new stones forming and making it easier for existing stones to pass. Aim for clear or nearly clear urine. Your doctor might recommend measuring your urine output to ensure you're drinking enough. This is especially important if you live in a hot climate or exercise a lot.

• Pain Relief: Small stones can be uncomfortable. Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) can help manage mild pain.

• Medication to Relax the Ureter: Your doctor might prescribe a medication called an alpha blocker. These medications relax the muscles in your urinary tract (specifically the ureter), allowing the stone to pass more easily and with less pain. Examples include tamsulosin (Flomax) and dutasteride/tamsulosin combination (Jalyn).

Treating Larger or Problematic Stones:

If a stone is too large to pass naturally, or if it's causing complications like significant bleeding, kidney damage, or ongoing urinary tract infections, more extensive treatment may be necessary. These procedures are typically only needed for larger stones or stones causing significant issues.

• Shock Wave Lithotripsy (ESWL): This procedure uses sound waves to break up larger kidney stones into smaller pieces that can be passed in your urine. It's a relatively quick procedure (about 45-60 minutes), but it can cause some discomfort. You might receive sedation or light anesthesia to make you more comfortable. Possible side effects include blood in the urine, bruising, and pain as the stone fragments pass.

• Surgery to Remove Large Stones (Percutaneous Nephrolithotomy): For very large kidney stones, a small surgical incision is made in your back. Small telescopes and instruments are inserted to remove the stone. This procedure requires general anesthesia and a hospital stay of one to two days for recovery. It's often recommended if ESWL isn't successful.

• Using a Scope to Remove Stones (Ureteroscopy): A thin, flexible tube with a camera is passed through your urethra and bladder to reach the stone in your ureter or kidney. Special tools can then either grab and remove the stone or break it into smaller pieces. A small tube (stent) might be placed in the ureter to reduce swelling and aid healing. This procedure can be done with either local or general anesthesia.

• Parathyroid Gland Surgery: In some cases, kidney stones are linked to overactive parathyroid glands, which produce too much parathyroid hormone. This can lead to high calcium levels in the body, increasing the risk of kidney stones. Surgery to remove the growth (if present) or to treat the underlying cause of the overactive glands can help prevent future stones.

Preventing Kidney Stones:

To reduce your risk of future kidney stones, consider these lifestyle changes and, if necessary, medications:

• Hydration: Drink enough fluids to produce about 2.1 quarts (2 liters) of urine daily. This is especially important if you live in a hot climate or exercise regularly. Light, clear urine is a good indicator that you're adequately hydrated.

• Diet Modifications:

  • Limit Oxalate-Rich Foods: If you tend to develop calcium oxalate stones, your doctor may advise you to limit foods like rhubarb, beets, spinach, nuts, and chocolate.
  • Low Salt and Animal Protein Diet: Reducing salt intake and choosing non-animal protein sources (like legumes) can help.
  • Calcium-Rich Foods: Continue eating calcium-rich foods unless your doctor recommends otherwise. Be careful with calcium supplements, as they might increase your risk of stones. If you take supplements, take them with meals. A low-calcium diet can actually increase the risk of stones in some people. A registered dietitian can create a personalized plan to help you reduce your risk.

• Medications: Your doctor may prescribe medications to control the levels of minerals and salts in your urine, depending on the type of stones you're prone to.

This information is not a substitute for professional medical advice. Always consult with your doctor for diagnosis and treatment of kidney stones.