Kidney Stones 101: Causes, Symptoms, and Treatment Options
Kidney stones are common in the United States, occurring in 11 percent of men and 6 percent of women. Despite being called kidney stones, they can affect any part of your urinary tract, from the kidneys to the bladder. These hard deposits of minerals and salts may cause a large amount of pain and discomfort.
If you think you have a kidney stone, you should always consult a healthcare professional. If you’re living in North Carolina or South Virginia, Granville Health System has outpatient and emergency services available to help.
What Are Kidney Stones?
Kidney stones, also known as nephrolithiasis or renal calculi, are pebble-like masses that can be as small as a grain of sand or as large as a golf ball.
How do kidney stones form?
Kidney stones begin to aggregate when the crystal-forming substances in urine become concentrated and begin to stick together. These substances, such as calcium, sodium, oxalate, uric acid, and phosphate, are normally diluted by the fluid in urine. However, if the volume of fluid is low or if there is an increased amount of minerals or salts then crystals may begin to form.
Additionally, an alteration in urine pH might induce the crystallization process. Certain substances may inhibit the formation of stones and a low concentration or lack of these substances allow the stone formation process to occur. Any one or a combination of these factors may lead to the formation of kidney stones. Stones may form quickly or, alternatively, may take months or years to develop.
Types of Kidney Stones
- Calcium-Oxalate Stones: Calcium-oxalate stones are the most common type of kidney stones. These stones form due to the presence of either too much calcium or too much oxalate in the urine. Excessive calcium results from absorbing large amounts of calcium from the intestines or bones. Other people have too much calcium in their urine because their kidneys fail to properly regulate how much calcium is released into their urine. Diseases like Crohn’s or ulcerative colitis can cause people to have an overabundance of oxalate. Finally, eating large quantities of foods containing oxalate may lead to the formation of stones. Some oxalate-rich foods are spinach, soy products, almonds, beets, and chocolate.
- Uric Acid Stones: If urine becomes saturated with uric acid then stones can form. Typically this happens to people who eat a high-protein diet or lose lots of fluid due to chronic diarrhea or malabsorption. Medical conditions like diabetes or metabolic syndrome may increase your risk of uric acid stones. The crystals that make up uric acid stones in the urine are the same crystals that form in people with gout.
- Struvite Stones: Struvite stones from after a bacterial urinary tract infection. These stones are composed of magnesium, ammonium, phosphate, and calcium. Unfortunately, struvite stones can form suddenly and become large very quickly. Repeated infections may lead to staghorn calculus, a very large and branching stone that typically needs to be removed surgically.
- Cystine Stones: Cystine stones are rare. They occur only in people who inherit a condition called cystinuria. People with this condition excrete too much of the cysteine amino acid, which can form stones.
- Pediatric Kidney Stones: Although kidney stones in children are rare, there have been more occurrences in recent years. It is thought that diets with more processed foods and less citric acid are contributing to the rise of pediatric kidney stones. Children can have all the same types of kidney stones as adults.
Symptoms of Kidney Stones
Depending on size and location, some kidney stones will cause no symptoms. Other kidney stones will cause many symptoms as they start to move around within the kidney or pass into one of the ureters (the tubes leading from the kidneys to the bladder). You may experience the following symptoms:
- Severe pain (dull or sharp) in the lower back, groin or side
- Blood in your pee
- Cloudy urine
- Foul-smelling urine
- Fever or chills
- Nausea and vomiting
- The inability to pee
- Pain or burning while urinating
Make an appointment with your doctor or go to the emergency room if you have any signs or symptoms of a kidney stone. Granville Health System has professionals willing to assist you.
Causes and Risk Factors
Often several factors lead to the development of kidney stones. The following may increase your risk of forming kidney stones:
- Dehydration: Not drinking enough fluids is the leading cause of kidney stones. People who live in dry climates or sweat a lot have a higher risk than others.
- Diet: Eating diets high in protein, sodium, and oxalate-rich foods increases your risk of kidney stones.
- Medical Conditions: Some medical conditions like diabetes, hyperthyroidism, obesity, gout, and urinary tract infections (UTIs) also increase the chances of developing kidney stones.
- Genetic Predisposition: If you or a family member has had kidney stones in the past, you are at an increased risk of developing them.
- Digestive Diseases and Surgery: Diseases and surgeries involving the stomach and intestine can increase the likelihood of developing kidney stones due to the changes in the absorption of calcium and water. This category includes gastric bypass surgery, inflammatory bowel disease, and chronic diarrhea.
- Supplements and Medications: Specific supplements like vitamin C and medications such as calcium-based antacids can increase your risk of kidney stones.
How Kidney Stones Are Diagnosed
Based on your physical exam and presentation of symptoms, a healthcare provider may use one or more of the common diagnostic tools:
- Imaging tests for kidney stones (CT scans, X-rays, and ultrasounds)
- Blood test to check for kidney function or the levels of calcium, uric acid, and electrolytes
- Urinalysis to detect blood, crystals, or other signs of infections
- Stone analysis to determine future preventative strategies
Treatment Options
Treatments for small kidney stones are limited because they often pass on their own. Most healthcare professionals recommend drinking six to eight glasses of water daily to help them pass. It is very important to manage your pain, as even small stones can be very painful. Your provider may prescribe medication for the pain or recommend over-the-counter medications like Tylenol. Ask your provider before taking ibuprofen, as it can increase the risk of kidney failure.
Larger stones require more advanced treatment options. The size and location of your stone will determine what type of procedure is needed to break up or remove the stone.
- Shock Wave Lithotripsy: This nonsurgical technique uses high-energy shockwaves to break up stones into fragments small enough to pass in the urine. Lithotripsy is typically done as an outpatient procedure that takes about 45 minutes to an hour. The recovery time is short, the patient can start walking around almost immediately after the procedure.
- Ureteroscopy: This procedure involves the healthcare provider inserting a small scope into the bladder and ureter. When a stone is present the surgeon can grab the stone using a tiny wire basket. Stones can also be broken up using a helium laser on the scope. Breaking up a stone this way is more assured than shock wave lithotripsy. However, ureteroscopy can only be used for stones closer to the bladder and not for those in the kidneys. This is an outpatient procedure with very little recovery time needed.
- Percutaneous Nephrolithotomy (PCNL): PCNL is a treatment option when other treatments cannot be used and/or for large and complex stones. This surgical procedure involves a doctor inserting instruments directly into the kidney through a tiny tube in your back. The instruments use ultrasound to break apart and remove stones. You will need a longer recovery for PCNL and usually a one to two-day hospital stay.
- Surgery: For especially large stones your doctor may need to remove the stones via laparoscopic surgery or open surgery. In laparoscopic surgery, small incisions are made and the surgeon inserts instruments to remove the stones. In rare cases, a larger incision is required, this is called open surgery. These invasive surgical methods require the longest recovery of all the treatment options.
Preventing Kidney Stones
You can prevent kidney stones by watching what you eat and drink. Ask your provider about a diet for kidney stones. Additionally, there are some medications you can be prescribed to help prevent kidney stones depending on what kind of stones you normally get. Your healthcare provider might recommend:
- Good hydration – drinking at least eight cups of water every day
- Dietary:
- Limit animal proteins and high-purine foods
- Reduce sodium and oxalate intake
- Balance calcium intake
- Increase fruit and vegetable consumption
- Limiting foods high in sugar
- Prescription Medications:
- Thiazide diuretics – lower calcium excretion
- Potassium citrate – increases levels of citrates which prevent crystal formation
- Allopurinol – lowers levels of uric acid
Complications and When to See a Doctor
Complications of kidney stones can be dangerous. If you have a kidney stone, you are at risk for:
- Kidney infections (pyelonephritis)
- Chronic kidney disease
- A urinary blockage
- Acute kidney injury (a type of reversible kidney failure)
- Frequent UTI’s
When experiencing a kidney stone, it is important to contact your doctor with any signs or symptoms that may worry you. You should seek immediate medical attention for the following:
- Persistent severe pain
- Fever
- Vomiting
- Blood in urine
Frequently Asked Questions
What are kidney stones made of?
Kidney stones are made of crystallized minerals and salts that become concentrated in your urine. They can form from substances such as calcium, sodium, oxalate, uric acid, and phosphate.
Are kidney stones genetic?
Yes. If your family members have a history of kidney stones, then you are more likely to also have a kidney stone during your lifetime. There is also an inherited condition called cystinuria that causes an excess of cysteine amino acids to form crystals.
How long does it take to pass a kidney stone?
On average, it takes about two weeks to pass a kidney stone. However, this can vary greatly depending on the size and shape of the stone.
Can kidney stones cause long-term damage?
Yes. In severe cases, kidney stones can cause long-term damage if left untreated.
How can you flush a kidney stone?
Drinking enough water, six to eight cups per day, will help your body flush out the stone.
How do you know when a kidney stone is close to passing?
You will know a kidney stone is close to passing when the intensity of the pain decreases. You may also see changes in urine color, including blood in your pee. The most accurate way to know is through imaging studies performed by your doctor.
Granville Health System: The Highest Quality of Patient Care
Kidney stones can be effectively managed and prevented. Even though most kidney stones are small and pass on their own, it is still important to have a provider follow you throughout the process. A provider can perform the appropriate tests and recommend the proper treatment.
If you live in the North Carolina or South Virginia areas and are experiencing kidney stone symptoms, don’t hesitate to contact Dr. Joseph Zola at Granville Urology Associates.
