Kidney stones are lumps that can develop in the kidneys and are usually made up of chemicals found in the urine (e.g. calcium, ammonia, uric acid and cystine). It is sometimes referred to as nephrolithiasis and it can be very painful (renal colic). They are fairly common and mostly affect people of the ages 30 to 60 years old. Men are more likely to develop kidney stones compared to women. They can be caused by many things and some can resolve without invasive treatments, by passing in the urine with the assistance of medication. Some are more serious and may require an intervention to break the stone down or remove it.
Kidney stones can be small and cause few or no problems. It can sometimes pass out in the urine with no symptoms or pain. However, renal colic can occur when slightly larger kidney stones obstruct the kidney or the ureter. If the obstruction does not resolve in a short space of time, this can cause an infection. The pain in some can be extremely painful and intense, causing sweating, nausea and pain that spreads into the back or genitals. Patients can still urinate as there will be urine in the bladder, but this may be painful and there could be blood from the damage the stone has caused to the lining of the kidney and/or ureter.
If the kidney stone begins to move down the ureter into the bladder to pass, the pain can move. It typically starts in the middle of the back on the side affected (rare that both sides are affected) and can spread across the front and into the genital area. Patients are often very agitated and struggle to sit still. If you have a fever, there may be an infection that caused the stone, or that is secondary to the presence of the stone. The doctors will perform investigations and start you on treatment for this.
There are four main types of kidney stone. Ones consisting of calcium, ammonia, uric acid and cystine. If any of these substances are present in abnormally high concentrations (e.g. too much calcium) or if you do not take in enough fluids (e.g. drinking too little water leads to a higher concentration as in dehydration), it can lead to crystal formation and over time, stones can form. Certain medications increase your risk (e.g. diuretics, which can cause dehydration).
There are several factors which increase the risk of developing kidney stones and of having recurrent episodes. These include being inactive or having reduced mobility (bed-bound), diet with high-protein and low-fibre, family history of kidney stones, recurrent kidney or urinary infections, if you experienced an episode when you were younger (e.g. before 25) and if one of your kidneys has been removed or does not work effectively. Many medications can cause stone development as well as genetic diseases, conditions causing increased levels of chemicals that can form stones and some other rarer causes.
Treatment depends on the severity of the episode. If there is no pain, then the stones can be passed normally. If there are recurrent episodes, investigations will be performed. In an acute painful (renal colic) scenario, medication will be given to reduce the pain, sickness, fever (if present) and medications to aid the passage, dissolve the stone or treatment to break up or remove the stones. Uncomplicated cases can be managed at home. Collecting the stones from the urine is a useful way to determine the cause and origin as doctors can work out the chemical that the stone is made up of.
You may be admitted to hospital if there is increased risk of complications, if you do not improve within a few hours or if you are pregnant or elderly. The treatment options for removal of a large stone causing problems is usually done by extracorporeal shock wave lithotripsy (using x-ray and/or ultrasounds to find the location and send shock waves to break the stone up). Other less common treatments can be performed such as small tubes being inserted into the ureter or by surgery (can be done openly or with a small telescopic device).
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Doctify Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.