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All About Kidney Stones

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Updated December 07, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

When people think about kidney stones, excruciating pain often comes to mind. When you have one, you wonder if it will pass it on its own or whether will need medical intervention.

Most people pass kidney stones spontaneously, but they can be intolerable. If your kidney stones are too large and don't pass, your doctor may use more aggressive treatment. Don't ever try to diagnose yourself if you have severe pain or try to mask it with a painkiller. You must see a doctor to determine the source of the pain.

What is a kidney stone?

Kidney stones develop from salt and minerals that stick together in the urine. Kidney stones are solid and can be the size of a tiny pebble or as large as a golf ball. Although they originate in the kidney, they pass out of the body through the urinary tract (which contains the ureters, bladder, and urethra). Sometimes they block the flow of urine.

What are the signs and symptoms of a kidney stone?

Discomfort

  • Severe pain in your back and side
  • Pain may spread to the pelvis, groin, or genital area
  • Intense burning when you try to urinate
  • Fever and chills

Other symptoms

Are certain people more likely to get kidney stones?

They occur more often in people who:

  • Don't drink enough water,
  • Are men,
  • Are between the ages of 30 and 60, and
  • Have a family history of kidney stones.

They are also more common in the southern United States, where it is hot and dry. This area is called the "kidney-stone belt."

What causes kidney stones?

Kidney stones form when urine is too rich with mineral, salts, and these materials clump together in the urine. Sometimes the stone passes out of the kidney into the ureter, where it gets stuck, making it extremely painful to urinate.

What types of kidney stone are there?

There are several types of kidney stones. Calcium stones are the most common type. Struvite stones contain magnesium and the waste product ammonium. They tend to result from infection. Uric acid stones occur in people with a high urine acidity. Cystine stones are rare and they tend to run in families.

How are kidney stones diagnosed?

Imaging tests, such as ultrasound, a plain abdominal x-ray, an intravenous pyelogram, retrograde pyelogram, and computed tomography (CT) scan may be used to pinpoint the size and location of your stone. These tests will be extremely helpful in determining the likelihood your stone may pass naturally with minimal intervention or require more aggressive treatment by your urologist.

How are kidney stones treated?

There are several schools of thought on kidney stone treatment. Your doctor may favor one technique over another. Sometimes, it will have to do with the size and location of the stone. A doctor's training in a specific modalities may also influence what treatment you undergo.

Conservative treatment

Since many kidney stones are small enough to pass naturally with urination, your doctor may advise you to drink a lot of water, which will help pass the stone. In some cases, you will be given painkillers to help you tolerate pain. When you are trying to pass the stone, your doctor may ask you to have a strainer ready when you go to the toilet so that the stone can be saved and its contents can be analyzed. This can help determine foods to avoid that might contribute to stone formation.

Besides drinking water, there is evidence that drinks with strong natural lemon help promote passing a stone and keeping you stone-free.

Other Treatment Strategies

  • Extracorporeal Shock Wave Lithotripsy

    Your doctor may use a technique known as extracorporeal shock wave lithotripsy or ESWL to break up a stone. A machine outside your body delivers shock waves directly to the stone, crushing them into small parts that will be eliminated naturally through your urine.


  • Percutaneous Nephrolithotomy(PCNL)

    Percutaneous (meaning through the skin) nephrolithotomy involves inserting a tube through a small incision in the skin in the back into the abdomen and kidney to help with drainage. This surgery is used when stones are too large.

    A fiberoptic camera called a nephroscope provides an accurate view of the stone's location. One advantage of the procedure over ESWL is that the entire stone removal process is done at the time of surgery.


  • Ureteroscopy (Ureteroscope)
    br>A ureteroscope is a small instrument with a long wire, a camera, and cage that collects the kidney stone. It is inserted up through the urethra, bladder, and it is then positioned in the ureter, where the stone is located. There are two techniques for removing the stone:either catching it in the cage and pulling it out, or destroying it with an instrument inserted into the ureteroscope.

What can I do to prevent getting another kidney stone?

Drink more water. If you have a history of kidney stones, you should pay particular attention to flushing out your urinary system. Without enough water, the salt and minerals are more likely to adhere to the urine, build up, and cause a stone.

Do not drink more than 1-2 cups of caffeinated beverage each day, including coffee, tea, and cola.

Change your diet.

For oxalate stones, you may be advised to restrict your intake of concentrated citrus juice, chocolate, beer, tea, vitamin C supplements, or dark green vegetables.

For calcium stones, restricting dietary salt may be especially helpful.

For uric acid stones, reducing meat, fish, and poultry intake may help to lower urine acidity.

Take prescribed medicines.

Your doctor may recommend taking diuretics, cellulose phosphate, or potassium citrate to facilitate calcium excretion for people who have had calcium stones.

Sources:

Kang DE, Sur RL, Haleblian GE, et al. Long-term lemonade based dietary manipulation in patients with hypcitraturic nephrolithiasis. J Urol 2007 177(4):1358-62.

Kidney stones. Accessed July 28, 2009 from the National Library of Medicine.

Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse. Accessed July 28, 2009.

Brikowski TH, Lotan Y, Pearl MS. Climate related increase in the prevalence of urolithiasis in the United States. Proc Natl Acad Sci 2008 105(28):9841-6.

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