Kidney Stones
Kidney stones (also called nephrolithiasis or renal calculi) are hard deposits of minerals and salts that form inside your kidneys. They can affect any part of your urinary tract, from your kidneys to your bladder. Kidney stones vary in size from tiny crystals that can only be seen with a microscope to stones as large as golf balls. They may cause excruciating pain when passing through the urinary tract, though small stones may pass without causing symptoms. Kidney stones are one of the most common urological conditions, affecting approximately 1 in 10 people at some point in their lives.
Causes
- Dehydration - Not drinking enough water leads to concentrated urine, which increases the risk of stone formation.
- Diet - Diets high in sodium, animal protein, and oxalate-rich foods (such as spinach, nuts, and chocolate) can increase stone risk in susceptible individuals.
- Family history - Having family members with kidney stones increases your risk.
- Certain medical conditions - Conditions such as urinary tract infections, inflammatory bowel disease, gout, hyperparathyroidism, and certain metabolic disorders increase kidney stone risk.
- Medications - Some medications including certain diuretics, calcium-based antacids, and some antivirals and protease inhibitors can increase stone risk.
- Obesity - Being overweight or obese increases your risk of developing kidney stones.
- Geographic and climate factors - Living in hot, dry environments where dehydration is more likely, or in regions with high mineral content in drinking water.
Signs and Symptoms
- Severe pain in the side and back, below the ribs (renal colic)
- Pain that radiates to the lower abdomen and groin
- Pain that comes in waves and fluctuates in intensity
- Pink, red, or brown urine (due to blood in urine)
- Cloudy or foul-smelling urine
- Nausea and vomiting
- Persistent urge to urinate
- Urinating more often than usual
- Burning sensation during urination
- Fever and chills (if infection is present)
- Passing small amounts of urine
Diagnosis
Medical History and Physical Examination
Your doctor will ask about your symptoms, medical history, diet, and medication use, and perform a physical examination to help diagnose kidney stones.
Urinalysis
A urine test can reveal blood in your urine and signs of infection. It may also show mineral crystals that form kidney stones or high levels of stone-forming minerals.
Blood Tests
Blood tests check for elevated levels of calcium, uric acid, and other substances that may contribute to stone formation. They also assess kidney function.
CT Scan
A non-contrast CT scan is the gold standard for diagnosing kidney stones. It can reveal the size, number, and location of stones with high accuracy.
Ultrasound
This non-invasive imaging test can identify stones in the kidneys and ureters. It's often used for pregnant women and children to avoid radiation exposure.
X-Ray (KUB)
A kidney, ureter, and bladder (KUB) X-ray can detect calcium-containing stones but may miss other types of stones.
Stone Analysis
If you pass a stone, your doctor may ask you to collect it for laboratory analysis to determine its composition, which helps guide treatment and prevention strategies.
Treatment Options
Watchful Waiting and Medical Expulsive Therapy
For small stones (less than 5mm), observation with increased fluid intake may be sufficient as many pass on their own. Medications such as alpha-blockers can relax the ureter muscles, making it easier for the stone to pass naturally.
Pain Management
Over-the-counter or prescription pain relievers may be recommended to manage the discomfort as the stone passes. NSAIDs, opioids, or combination therapy may be used depending on pain severity.
Medical Dissolution Therapy
For certain types of stones (uric acid stones), medications can sometimes dissolve the stones, eliminating the need for surgical intervention. This may include alkalinizing agents to change urine pH.
Home Remedies
Hydration
Drinking plenty of water (2-3 liters per day) helps flush out your urinary system and can assist in passing small stones. Water dilutes the substances in urine that lead to stone formation.
Lemon Juice
Citrate in lemon juice can help prevent certain types of kidney stones by binding to calcium in the urine. Try adding fresh lemon juice to water throughout the day.
Apple Cider Vinegar
Some people find that apple cider vinegar helps dissolve kidney stones due to its acetic acid content. Mix 1-2 tablespoons with water and drink throughout the day (consult your doctor first).
Herbal Teas
Certain herbal teas like dandelion, nettle, or corn silk tea may act as natural diuretics, increasing urine output and potentially helping to flush out small stones.
Dietary Modifications
Reducing salt intake, limiting animal protein, and moderating oxalate-rich foods can help prevent stone formation. The specific dietary changes needed depend on your stone type.
Preventive Care
- Stay well-hydrated by drinking at least 2-3 liters of water daily.
- Reduce sodium intake (aim for less than 2,300 mg per day).
- Limit animal protein consumption, especially red meat.
- Eat a balanced diet rich in fruits and vegetables.
- Moderate consumption of oxalate-rich foods if you have calcium oxalate stones.
- Maintain a healthy weight through diet and regular exercise.
- Consider calcium supplements only when prescribed by your doctor (taking with meals can reduce oxalate absorption).
- Follow specific dietary recommendations based on your stone type.
- Avoid vitamin C supplements if you have a history of calcium oxalate stones.
- Take medications as prescribed for underlying conditions that may contribute to stone formation.
Surgical Options
Extracorporeal Shock Wave Lithotripsy (ESWL)
A non-invasive procedure that uses shock waves to break kidney stones into small pieces that can pass more easily through the urinary tract. ESWL is typically used for stones less than 2cm in the kidney or upper ureter.
Learn More About This ProcedureUreteroscopy with Laser Lithotripsy
A minimally invasive procedure where a thin tube with a camera (ureteroscope) is passed through the urethra and bladder into the ureter. A laser is then used to break the stone into fragments that can be removed or passed naturally. This is effective for stones in the ureter or kidney.
Learn More About This ProcedurePercutaneous Nephrolithotomy (PCNL)
A surgical procedure for larger stones (>2cm) or complex stones. A small incision is made in the back, and a nephroscope is inserted directly into the kidney to remove or break up the stone. This approach is used for stones that cannot be treated with other methods.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of kidney stones, our expert team is here to help you find the right treatment approach for your specific needs.