Kidney Stones: Symptoms, Causes, Diagnosis & Treatment

Kidney stones are a common and often painful condition caused by the formation of hard deposits made of minerals and salts inside the kidneys. These solid masses can differ in size, ranging from being as small as a grain of sand to something that can be compared to a golf ball.

Several factors contribute to the development of kidney stones, including diet, excess body weight, and certain medical conditions. 

The presence of a kidney stone can lead to various symptoms, such as severe pain in the back or side, blood in the urine, and nausea.

Depending on the type of stone, treatment options may differ—some smaller stones may pass on their own, while larger stones might require a different approach, such as the use of medication or more invasive procedures. 

Preventative measures against kidney stones may involve dietary and lifestyle changes, as well as ensuring adequate fluid intake.

Symptoms

Kidney stones often go unnoticed until they cause symptoms. These symptoms, resulting from the stone’s movement or blockage, can range from mild discomfort to severe pain.

Pain

One of the most common and notable symptoms of kidney stones is pain. The pain can radiate towards the groin and may start in the side or lower back. It often starts suddenly and can fluctuate in intensity as the stone moves through the urinary tract. 

The pain may increase during urination and sometimes can be severe enough to limit daily activities.

Persistent Need to Urinate

A persistent need to urinate happens because the stone can irritate the lining of the urinary tract, sending false signals to the brain and indicating the need to empty the bladder.

Though this symptom can be associated with other conditions like urinary tract infections or an overactive bladder, if accompanied by other kidney stone symptoms, like one-sided lower back pain or bloody urine, it’s best to consult a healthcare provider promptly.

Urinating in small amounts frequently

Urinating in small amounts frequently can be a tell-tale sign of kidney stones. 

As the stone moves within the urinary tract, it can create a blockage, leading to frequent yet minimal urination because of the limited flow.

Nausea and Vomiting

Nausea and vomiting may be experienced as the body reacts to the pain and inflammation caused by the stone formation. 

The size and location of stones in the urinary tract affect the intensity experienced.

Fever and Chills

Fever and chills may accompany kidney stones if an infection is present. 

If you are experiencing fever and chills in addition to other kidney stone symptoms, it is important to seek medical attention, as this may indicate a more serious condition.

Foul-Smelling Urine

Foul-smelling or cloudy urine is another symptom of kidney stones. In some cases, the urine may also contain blood as the stone irritates the urinary tract.

Causes and Risk Factors

Kidney stone formation can be influenced by a combination of dietary, medical, and genetic factors.

Dietary Factors

Certain lifestyle factors can also contribute to the development of kidney stones. Some key factors include:

Low fluid intake: 

Low fluid intake is one of the main risk factors for kidney stone formation. 

When you don’t consume enough fluids, your urine output decreases, which increases the concentration of substances that form stones, like calcium and uric acid.

Dietary Preferences:

Diet plays a significant role in the development of kidney stones. A high intake of calcium, oxalate, and sodium can contribute to the formation of these stones. 

Kidney stone risk is also associated with high protein consumption. It is essential to maintain a balanced diet and stay adequately hydrated to lower the risks associated with these dietary factors.

Unregulated Supplement and Medication Use: 

Misuse of supplements and medications can significantly contribute to the formation of kidney stones. Substances such as high-dose vitamin C or D, laxatives, and certain diuretics can increase the concentration of stone-forming substances in the urine when not properly regulated.

Overuse of calcium-based antacids can contribute to excess calcium in the urine, which may lead to the development of kidney stones.

It’s critical to regulate supplement and medication use and always consult with a healthcare provider before starting any new regimen.

Medical Conditions

There are several medical conditions that may increase the risk of developing kidney stones. Some of these include:

Uric acid: 

Uric acid is a common cause of kidney stones, particularly in individuals with a high purine diet or conditions that increase uric acid levels, such as gout. 

The excess uric acid can crystallize and form stones in the kidneys.

Diabetes: 

People with diabetes are at an increased risk of developing kidney stones due to high blood sugar levels, which can lead to increased calcium levels in the urine.

The increased urinary concentration of substances that cause stones, including uric acid, due to insulin resistance could be a contributory factor.

Hyperparathyroidism: 

Hyperparathyroidism, a condition characterized by the overproduction of parathyroid hormone, can increase the risk of kidney stones. 

The excess hormone can cause elevated calcium levels in the bloodstream, which may result in too much calcium in the urine, promoting stone formation.

UTI and a history of kidney stones: 

Urinary tract infections (UTIs) and a history of kidney stones are both risk factors for developing new stones. 

UTIs can change the chemical makeup of urine, making it more conducive to stone formation. Similarly, a history of kidney stones increases the likelihood of future occurrences.

Genetic Factors

Genetics plays a role in the development of kidney stones, particularly in cases of cystinuria, a hereditary condition that causes cystine stones. 

Individuals with a family history of kidney stones or specific genetic factors, such as calcium oxalate stone formation, may be at a higher risk. Awareness of one’s family history can help in preventing and managing the risk factors associated with kidney stones.

Demographics

Kidney stones are more common among certain demographic groups. White men in their 30s and 40s are the most likely to develop kidney stones, although it is important to note that anyone can develop them.

While you can’t change these factors, being aware can help you take additional precautions if necessary. 

Types of Kidney Stones

There are four main types of kidney stones: Calcium Stones, Uric Acid Stones, Struvite Stones, and Cystine Stones. Each type has a different cause and may require different treatments.

Calcium Stones

Calcium, when combined with oxalate or phosphate, produces calcium stones, which is the most common type. Calcium phosphate stones are less common.

To prevent calcium stones, it’s essential to maintain a proper balance of calcium in the diet and stay well-hydrated.

Uric Acid Stones

Uric acid stones are formed when there is too much uric acid in the urine, often due to a high-protein diet, certain medications, or some genetic factors. 

These stones are more common in men and can be linked with conditions such as gout or chemotherapy treatments. 

It is advised to limit animal protein intake, drink plenty of fluids, and maintain a healthy body weight to reduce the risk of uric acid stones.

Struvite Stones

Urinary tract infections (UTIs) are associated with the presence of struvite stones. These stones form due to an increase in ammonia levels (produced by bacteria) in the urine, which leads to the formation of large crystals. 

Struvite stones are more prevalent in women, as they are more susceptible to UTIs. 

Treatment for struvite stones often involves addressing the underlying UTI with antibiotics and drinking plenty of fluids to help flush out the stones.

Cystine Stones

Cystine stones are the rarest type of kidney stones. They are caused by a genetic disorder called cystinuria, in which the body excretes excessive amounts of cystine (an amino acid) into the urine, leading to the formation of these stones. Cystine stones can be difficult to manage.

In some cases, invasive procedures may be necessary to remove the stones.

Diagnosis

To accurately diagnose kidney stones and determine their size and location, medical professionals use a combination of tests and examinations. These processes are essential to get a clear understanding of the condition and to guide decisions regarding the most effective treatment options.

Physical Exam‌

A physical examination typically kicks off the diagnosis process for kidney stones. 

During this exam, the doctor collects information about the patient’s medical history and assesses for physical symptoms of kidney stones. 

Blood Tests‌

Physicians might require blood tests to check for elevated levels of calcium or uric acid in the blood. 

This helps to monitor kidney health and determine if there are any underlying medical conditions causing the formation of kidney stones. 

Urine Tests‌

Urine tests are performed to identify the presence of dissolved minerals and salts. High levels of minerals and salts in the urine can lead to the formation of stones. 

A 24-hour urine collection test may be conducted to determine the overall volume of urine produced and to analyze the concentration of specific elements in the urine, such as calcium, oxalate, and phosphate.

Imaging Tests‌

Imaging tests play a crucial role in diagnosing kidney stones. 

X-ray

An X-ray of the abdominal region can help detect the presence and location of kidney stones. 

However, it has limitations, as it cannot visualize all types of stones, and smaller stones might go unnoticed.

Ultrasound 

Medical professionals often use an ultrasound as a non-invasive option to detect kidney stones. 

Ultrasound can identify stones of varying sizes and compositions and help physicians monitor their progress.

CT scans

A CT scan is one of the most accurate imaging tests for identifying kidney stones. It provides detailed images of the kidney and urinary tract, pinpointing the exact location and size of any kidney stones present.

The results from these tests and examinations aid in making an informed decision about the most appropriate treatment method for each individual patient.

Treatment and Management

When it comes to treating kidney stones, there are several options available depending on the size, composition, and location of the stones. 

Pain Relievers

In many cases, kidney stones can cause significant pain. Patients may be prescribed pain relievers, such as over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to manage the discomfort. 

In some cases, stronger prescription pain medications may be necessary to alleviate severe pain.

Medications

Depending on the type of kidney stone, certain medications can be prescribed to help facilitate the passage of the stone or prevent future stones from forming. These medications may include:

Calcium Channel Blockers: 

Calcium channel blockers, often used for treating high blood pressure, have also been found effective in helping pass kidney stones more quickly by relaxing the muscles in the ureter. 

This helps stones pass more easily and reduces pain.

Diuretics: 

Diuretics, also known as water pills, can help prevent certain types of kidney stones, particularly those forming from calcium. 

By increasing urine volume, they help flush out the substances that form stones, thereby reducing their concentration.

Gout Medications: 

Medications commonly used to prevent gout attacks, but it can also help prevent certain types of kidney stones. 

It works by decreasing uric acid production in the body, thereby reducing the likelihood of stone formation.

Surgical Procedures

In some cases, larger kidney stones may require more invasive treatments to remove or break up the stone. 

Lithotripsy: 

Lithotripsy is a non-invasive procedure commonly employed to break up kidney stones that are too large to pass naturally. 

It uses sound waves to generate strong vibrations that shatter the stones into tiny pieces, facilitating their exit through urine.

Ureteroscopy: 

Ureteroscopy is a minimally invasive surgery often used for medium-sized or stubborn kidney stones. 

It involves inserting a thin scope through the urinary tract to remove or disintegrate the stones.

Percutaneous nephrolithotomy: 

A more invasive surgical procedure in which a small incision is made in the back and a larger scope is inserted directly into the kidney to remove the stone(s).

Where surgical intervention is required, a temporary stent may be inserted into the ureter to help prevent damage from swelling and facilitate the passage of any remaining stone fragments.

Prevention and Alternative Treatments

While the majority of kidney stone treatments involve pain management and medical interventions, there are alternative treatment options that can be considered to help prevent their recurrence, despite some factors being uncontrollable:

Dietary Changes

Making adjustments to your diet can help prevent kidney stones from forming. It is crucial to reduce the intake of animal protein, as well as high-oxalate foods like spinach, chocolate, and nuts. Focus on consuming a balanced diet with fruits and vegetables. 

Limiting your intake of salt, sugar, and high-phosphorus foods can also be beneficial in preventing stone formation.

Fluid Intake

Staying well-hydrated is vital for preventing kidney stones. Consuming ample amounts of water assists in diluting the minerals present in urine and lessens the potential to form kidney stones.

It is recommended to consume at least 8-10 glasses of water per day or enough to maintain clear or pale yellow urine. Additionally, limiting the consumption of fluids high in sugar, such as sodas, can reduce the risk of stone formation.

Lifestyle Modifications

A few uncomplicated lifestyle modifications can considerably reduce the risk of developing kidney stones. It is essential to maintain a healthy weight since obesity can be a contributing factor to kidney stones. 

Regular exercise can further improve overall kidney health and prevent stones in the long term. 

Regular urination is also crucial as it helps flush out the minerals from the urinary system that can cause stones. Additionally, diabetes and urinary tract infections need to be controlled and properly treated, as both conditions can increase the risk of stone formation. 

Complications

By understanding the potential complications of kidney stones, you can take preventative measures and seek appropriate treatment if necessary. 

Urinary Tract Infections

Kidney stones can sometimes lead to urinary tract infections (UTIs). Damage in the lining of the tract is a risk as stones that form in the kidney travel through the urinary tract and promote a favorable environment for bacteria to breed. 

Additionally, if a stone becomes lodged it can block the flow of urine.

This can also increase the risk of UTIs. Individuals may experience a frequent urge to urinate, a burning feeling during urination, and cloudy, potent-smelling urine in cases of UTI.

Kidney Damage

In some cases, kidney stones can cause kidney damage. Large stones or multiple smaller stones can block the flow of urine, leading to a buildup of waste, which puts excess pressure on the kidneys. This can eventually result in kidney damage if not promptly treated. 

Signs of kidney damage include decreased urine output, swelling in the legs or feet, and fatigue. If you experience any of these symptoms, seek medical attention to address the issue and protect your kidney function.

Bleeding

Another complication associated with kidney stones is bleeding. As renal calculi move through the urinary tract, their sharp, irregular edges can cause small cuts and abrasions, leading to blood in the urine. This bleeding is usually not severe but can be a cause for concern, especially if it persists or worsens. 

If you notice blood in your urine or experience sharp pain while passing a stone, contact your healthcare provider to discuss further evaluation and treatment options. This can help prevent more serious complications and promote optimal urinary health.

Frequently Asked Questions

What are the common symptoms of kidney stones?

Kidney stones can cause various symptoms, including severe pain, blood in the urine, and frequent urination. In some cases, people with kidney stones may experience nausea and vomiting as well. 

It’s important to consult a healthcare professional if you suspect you have a kidney stone.

How are kidney stones diagnosed?

Routine kidney stone diagnosis normally involves blood tests, imaging studies (such as CT scans, ultrasounds, or X-rays), and urine tests. 

These diagnostic tests and procedures can help identify the presence, size, and location of kidney stones.

What factors contribute to kidney stone formation?

High levels of minerals and salts in the urine influence the formation of kidney stones. 

Factors that can contribute to kidney stone formation include diet, excess body weight, certain medical conditions, and the use of some supplements and medications.

Which foods should be avoided to prevent kidney stones?

It’s crucial to stay well-hydrated and maintain a balanced diet to prevent kidney stones. Limiting foods that are high in oxalates (such as spinach, beet greens, and nuts), sodium, and animal protein may help reduce the risk of kidney stone formation. 

Consult a healthcare professional for personalized advice on dietary changes.

How can kidney stones be treated or dissolved quickly?

Treatment for kidney stones depends on their size and type. Smaller stones may pass spontaneously with increased fluid intake, pain relief, and medications that help relax the muscles in the urinary tract. 

Larger stones may require more invasive treatments, such as extracorporeal shock wave lithotripsy (ESWL), laser lithotripsy, or surgery. Consult your healthcare provider for the most appropriate course of treatment.