Kidney stones are a common condition that affects millions of people worldwide. These hard deposits of minerals and salts can form in the kidneys and cause pain and discomfort. They can occur in people of all ages and genders and can be a recurrent problem for some individuals. Understanding the causes, symptoms, and treatment options for kidney stones can help you manage the condition effectively.
What are Kidney Stones?
Kidney stones are hard deposits of minerals and salts that form in the kidneys. They can range in size from a small grain of sand to a large stone the size of a golf ball. Kidney stones can cause pain and discomfort and can lead to complications such as infection or blockage of the urinary tract.
What are the different types of Kidney Stones?
Calcium Oxalate Stones
Calcium oxalate stones are the most common type of kidney stones in the UK, accounting for around 75% of all cases. They are formed when calcium combines with oxalate, a naturally occurring substance found in many foods, including spinach, rhubarb, and nuts. High levels of oxalate in the urine can lead to the formation of calcium oxalate stones. In addition, people who suffer from recurrent kidney stones often have elevated oxalate levels in their urine.
Uric Acid Stones
Uric acid stones are the second most common type of kidney stones, accounting for about 10% of cases. They are formed when the urine becomes too acidic, causing uric acid to crystallise and form stones. People who consume a diet high in purines, found in red meat and seafood, are at higher risk of developing uric acid stones.
Struvite Stones
Struvite stones, also known as infection stones, are formed due to a urinary tract infection. They are composed of magnesium ammonium phosphate and are often large and jagged. Struvite stones are more common in women than men and can lead to severe infections if left untreated.
Cystine Stones
Cystine stones are a rare type of kidney stone that occurs due to a genetic condition called cystinuria. This condition causes the kidneys to excrete too much of a specific amino acid called cystine, which can lead to the formation of stones. Cystine stones are often larger than other types of kidney stones and may require surgical removal.
What are the Causes of Kidney Stones?
There are several factors that can increase your risk of developing kidney stones. These include:
- Dehydration: Not drinking enough water can increase the concentration of minerals and salts in the urine, making it more likely that kidney stones will form.
- Family history: If a close family member has had kidney stones, you are more likely to develop them.
- Diet: Consuming a diet high in salt, sugar, and animal protein can increase your risk of developing kidney stones.
- Obesity: Being overweight or obese can increase your risk of developing kidney stones.
- Medical conditions: Certain medical conditions such as gout, urinary tract infections, and inflammatory bowel disease can increase your risk of developing kidney stones.
What are the signs and symptoms of Kidney Stones?
The symptoms of kidney stones can vary depending on the size and location of the stone. Knowing the signs and symptoms of kidney stones can help you seek medical attention and treatment promptly. Some common symptoms include:
Pain
Pain is the most common symptom of kidney stones. The pain can be severe and may come and go. It may feel like a sharp stabbing pain. The pain may start in the back or side and radiate to the abdomen or groin. The pain can also vary in intensity and may be accompanied by nausea and vomiting.
Changes in passing urine
Changes in urine can also be a sign of kidney stones. The urine may be cloudy or have a strong odour. It may also be pink, red, or brown in colour, indicating the presence of blood in the urine. Additionally, individuals may experience pain or burning during urination.
Fever and chills
In some cases, kidney stones can cause a fever and chills with uncontrollable shivers or rigors. This can indicate an infection or other complications and requires immediate medical attention.
Other symptoms
Other symptoms of kidney stones may include nausea and vomiting, diarrhoea, and difficulty finding a comfortable position due to the pain. Some individuals may also experience a metallic taste in their mouth or a feeling of pressure in the abdomen or groin.
How are Kidney Stones Diagnosed? How do you know if you have a kidney stone?
If you experience symptoms of kidney stones, your GP or urologist may perform several tests to diagnose the condition. These tests may include the following:
Medical history and physical exam
Your doctor will take your medical history and perform a physical exam. They may ask about your symptoms, including the location and severity of your pain, changes in urine, and any other symptoms you are experiencing. They may also examine your abdomen, back, and genitals for signs of tenderness or swelling.
Urinalysis
Urinalysis is a simple test involving analysing a laboratory urine sample. The test can detect the presence of blood in the urine, as well as other abnormalities such as bacteria or protein. If blood is present in the urine, it can indicate the presence of kidney stones or other underlying conditions.
Imaging tests
Imaging tests can help identify the presence of kidney stones, their size and their location. The most common imaging tests used to diagnose kidney stones are ultrasound and CT scans. These tests can provide detailed images of the kidneys and urinary tract, allowing your doctor to identify any stones or other abnormalities.
Blood tests
Blood tests can help identify any underlying medical conditions causing kidney stones. Your doctor may recommend blood tests to check your kidney function as well as to screen for conditions such as hyperparathyroidism, which can cause kidney stones.
24-hour urine collection
A 24-hour urine collection test can help identify the type of kidney stones you have. The test involves collecting all urine produced during a 24-hour period and analysing it for the presence of certain substances that can contribute to the formation of kidney stones.
What are the Treatment Options for Kidney Stones?
Treatment for kidney stones depends on the size and location of the stone and the severity of the symptoms. Some treatment options include:
- Pain management: Pain medications can help manage the pain associated with kidney stones. Your doctor may recommend over-the-counter pain medications such as ibuprofen or paracetamol to manage pain. For more severe pain, prescription pain medications may be necessary.
- Drinking plenty of fluids: Staying hydrated is an important part of kidney stone treatment. Drinking plenty of water and other fluids can help flush the stones out of your urinary tract.
- Medical therapy: Your doctor may prescribe medications such as alpha-blockers to help relax the muscles in your ureter, making it easier for the stones to pass. Additionally, medication may be used to prevent the formation of future stones.
- Extracorporeal shock wave lithotripsy (ESWL): ESWL is a non-invasive procedure that uses shock waves to break up kidney stones into smaller pieces that can be passed more easily. During the procedure, you will lie on a table while a machine delivers shock waves to your kidney stone. The procedure is usually performed under sedation.
- Surgery: In some cases, surgery may be necessary to remove the kidney stones –
- Ureteroscopy and laser lithotripsy is a minimally invasive procedure that uses a small scope to view the kidney stone and a laser to break it into smaller pieces. The procedure is performed under general anaesthesia and typically requires a short hospital stay.
- Percutaneous nephrolithotomy (PCNL) is a surgical procedure that involves making a small incision in your back to access the kidney and remove the stone. The procedure is performed under general anaesthesia and typically requires a hospital stay of 1 to 2 days.
Can you prevent Kidney Stones?
If you have a history of kidney stones or are at risk for developing them, there are several steps you can take to prevent their formation.
Stay hydrated
Staying hydrated is one of the most effective ways to prevent kidney stones. Drinking plenty of water and other fluids can help flush the stones out of your urinary tract before they have a chance to form. Your doctor may recommend drinking at least 2 to 3 litres of water per day.
Making changes to your diet can help prevent the formation of kidney stones. Your doctor may recommend reducing your intake of foods that are high in oxalates, such as spinach, rhubarb, and nuts, as well as reducing your intake of sodium and animal protein. Additionally, increasing your intake of fruits and vegetables can help prevent kidney stone formation.
Medications
Medications can help prevent the formation of kidney stones. Your doctor may prescribe medications such as thiazide diuretics or potassium citrate to help reduce the risk of stone formation.
Limit alcohol consumption
Alcohol consumption can lead to dehydration, which increases the risk of kidney stone formation. Limiting your alcohol intake can help prevent the formation of kidney stones.
Maintain a healthy weight.
Being overweight or obese can increase the risk of kidney stone formation. Maintaining a healthy weight through regular exercise and a healthy diet can help prevent the formation of kidney stones.
Regular check-ups
Regular check-ups with your doctor can help identify any underlying medical conditions that may increase the risk of kidney stones. If you have a history of kidney stones or are at risk for developing them, your doctor may recommend regular imaging tests to monitor for the presence of stones.
Conclusion
Kidney stones are a common condition that can cause pain and discomfort. Understanding the causes, symptoms, and treatment options for kidney stones can help you manage the condition effectively. If you experience symptoms of kidney stones, talk to your GP and urologist about your treatment options.
Author: Mr Neil A Haldar MBBS MD FRCS
Consultant Urological Surgeon
The Pelvic Specialists