What Is A Kidney Stone
Kidney stones are small, hard deposits of mineral and acid salts that form on the inner surface of the kidneys, Roger Sur, M.D., director of the Comprehensive Kidney Stone Center at UC San Diego Health, tells SELF.
True to their name, kidney stones look like little pebbles that can vary in color , texture , and size , according to the National Institute of Diabetes and Digestive and Kidney Diseases . In rare nightmare scenarios, they can even reach the size of a golf ball .
Kidney stones are made of minerals normally found in your pee, like calcium, oxalate, and phosphorus, that dont cause issues at low levels, the NIDDK explains. As these minerals start to accumulate and crystalize, they can begin to stick togetheroften when the urine becomes more concentrated, the Mayo Clinic explains, which can happen due to things like dehydration.
Risk Factors You Can’t Control
White men have a greater risk for kidney stones than other groups, starting in the 40s. Women see their risk rise in the 50s. And your odds also go up if you have a family history of kidney stones. Certain medical conditions can boost the risk — high blood pressure, gout, urinary tract infections, certain kidney conditions such as polycystic kidney disease — but treating or controlling these conditions generally helps prevent stone formation.
How Kidney Stones Are Diagnosed
There are several tools doctors can use to diagnose kidney stones, according to the NIDDK. After talking to you about your symptoms and doing a physical exam, your doctor may order these tests as well:
Urinalysis: This is a test of your pee that can show whether your urine contains high levels of minerals that form kidney stones. A urinalysis can also tell whether your pee has blood, bacteria, or white blood cells in it .
Blood tests: Your doctor may want to take a sample of your blood to test for high levels of certain minerals that can lead to kidney stones.
Abdominal X-Ray: This is a picture of your abdominal area that can potentially show the location of kidney stones in your urinary tract. One major caveat, though: Not all kidney stones can be seen on X-ray.
Computed Tomography Scan: CT scans use a combination of X-rays and computer technology to create images of your urinary tract. In some cases you might be given an injection of contrast medium, a dye or other substance that makes certain things inside your body easier to see during imaging tests.
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Kidney Stone Causes Symptoms Treatments & Prevention
Your kidneys remove waste and fluid from your blood to make urine. Sometimes, when you have too much of certain wastes and not enough fluid in your blood, these wastes can build up and stick together in your kidneys. These clumps of waste are called kidney stones.
Can Kidney Stone Symptoms Come And Go
The length of time a stone can hang around is the primary reason that a person may feel like kidney stone symptoms come and go.
Once you start feeling the pain of a kidney stone, it can take anywhere between one to four weeks for the stone to actually pass. In the meantime, the pain can seem sporadic. Here’s why:
“During a bout of kidney stones, the initial pain is typically caused by the stone making its way through your very narrow ureter tube. There can also be pain if the stone lodges itself there and blocks urine flow out of the kidney, which results in pressure buildup and painful swelling,” explains Dr. Kannady.
As your body tries to move the kidney stone through your ureter, some of your pain may also be from the waves of contractions used to force the kidney stone out. The pain may also move as the kidney stone moves along your urinary tract.
“Once the stone makes it to your bladder, the pain might subside to some degree and you may notice urinary symptoms in its place. The final push from your bladder to outside of your body can reignite sharp feelings of pain, as the stone is now passing through another narrow tube called your urethra,” says Dr. Kannady.
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Prevention Of Future Stones
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications. There is no “one-size-fits-all” diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form.
Drink enough fluids each day.
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This equals about 3 quarts . This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But it’s best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.
Knowing how much you drink during the day can help you understand how much you need to drink to produce 2.5 liters of urine. Use a household measuring cup to measure how much liquid you drink for a day or two. Drink from bottles or cans with the fluid ounces listed on the label. Keep a log, and add up the ounces at the end of the day or 24-hour period. Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces of urine daily.
Reduce the amount of salt in your diet.
Eat the recommended amount of calcium.
What Investigations May Be Advised
The investigations you may need usually depend on many different factors, such as if you have other symptoms, if you have any other illnesses or conditions and your age.
It is likely that you will need to provide a sample of urine which will be sent to the local laboratory to be tested for infection. You may have blood tests and X-rays or scans.
A cystoscopy may be performed to assess your bladder. Having a cystoscopy entails a doctor or nurse looking into your bladder with a special thin telescope called a cystoscope. The cystoscope is passed into your bladder via your outlet for your urine . A cystoscopy which is done just to look into your bladder is usually carried out under local anaesthetic.
More details about the different tests can be found in the separate individual condition leaflets, mentioned above.
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Why Do Doctors Examine The Contents Of The Stone
There are four types of stones. Studying the stone can help understand why you have it and how to reduce the risk of further stones. The most common type of stone contains calcium. Calcium is a normal part of a healthy diet. The kidney usually removes extra calcium that the body doesn’t need. Often people with stones keep too much calcium. This calcium combines with waste products like oxalate to form a stone. The most common combination is called calcium oxalate.
Less common types of stones are: Infection-related stones, containing magnesium and ammonia called struvite stones and stones formed from monosodium urate crystals, called uric acid stones, which might be related to obesity and dietary factors. The rarest type of stone is a cvstine stone that tends to run in families.
How Can Ureteral Stones Be Prevented
You will not have ureteral stones if you do not have kidney stones. If you have had a kidney stone, your doctor can help you learn how it was formed and what you can do to prevent others from forming. Your doctor may treat the stone BEFORE it moves into the ureter and causes pain.
You may be asked to change your diet in the following ways:
- Drink more fluids.
- Limit animal protein .
- Control sodium intake .
- Limit oxalate .
You may also be prescribed medications to help prevent the formation of kidney/ureteral stones.
Last reviewed by a Cleveland Clinic medical professional on 09/18/2017.
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How Are Kidney And Bladder Stones Treated
If a stone blocks urine flow and drainage of the kidney, there are a variety of possible treatments. An option that your doctor may choose is:
- Ureteral stenting or nephrostomy: A ureteral stent is a thin, flexible tube threaded into the ureter by a urologist to restore the flow of urine to the bladder from the kidney. A nephrostomy is performed by an interventional radiologist when ureteral stenting is not possible or desirable. A tube is placed through the skin on the patient’s back into the kidney and the tube is connected to an external drainage bag. The procedure is usually performed with fluoroscopy.
Diagnosis: Low Urine Ph
Citrate supplements, such as potassium citrate, will raise the pH of your urine, making stones, such as those composed of uric acid, less likely to form. If your blood potassium level is high, your doctor may prescribe sodium bicarbonate or Bicitra.
Lower protein intake
A diet high in protein will reduce urinary pH. As a general recommendation, limit your daily protein intake to 12 ounces per day of beef, poultry, fish and pork. Twelve ounces is equivalent in size to about three decks of cards. This will be plenty of protein to meet your bodys needs.
Increase fluid intake
No matter what your diagnosis, you should drink enough water to produce at least 2 liters of urine per day.
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What Questions Should I Ask My Healthcare Provider
- Do I have a kidney stone or is there another reason for my symptoms?
- What type of kidney stone do I have?
- What size is my kidney stone?
- Where is my kidney stone located?
- How many kidney stones do I have?
- Do I need treatment or will I be able to pass the kidney stone?
- Should I be tested for kidney disease?
- What changes should I make to my diet?
- What type of procedure should I have to get rid of the stones?
A note from Cleveland Clinic
Kidney stones can be frustrating at best and agonizingly painful at the worst. To stop your situation from getting worse, you should be evaluated by a healthcare provider as soon as possible. The pain can get severe, and surgery might be necessary. Remember: dont skip your prescriptions, drink lots of water and follow any dietary guidelines. Also, remember that kidney stones are a temporary condition. They wont bother you forever.
Last reviewed by a Cleveland Clinic medical professional on 05/03/2021.
Both Ct And Ultrasound Find Most Kidney Stones
Whether you have an ultrasound or a CT scan first:
- Does not affect the amount of pain you have or how quickly your pain will go away.
- Does not change the risk of having serious side effects or complications from kidney stones.
- Does not change the risk of having to go back to the emergency department or stay in the hospital.
Having an ultrasound first may help you avoid being exposed to radiation from a CT scan.
- If you have an ultrasound first, you may need a second imaging test, which may be a CT scan. But, most people who have an ultrasound first do not need a CT scan.
Note: If you and the emergency doctor decide on a CT scan, ask if it is possible to get a low-dose CT scan. Low-dose CT works as well as normal-dose CT to check for kidney stones and exposes you to less radiation.
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Treatment Of Urinary Tract Stones
Nonsteroidal anti-inflammatory drugs or opioids as needed to relieve pain
Sometimes stone removal
Small stones that are not causing symptoms, blockage of the urinary tract, or an infection usually do not need to be treated and often pass on their own. Larger stones and those that are closer to the kidney are less likely to pass on their own. Some drugs may increase the likelihood of spontaneous stone passage.
Removing A Stone With Sound Waves
Kidney stones can sometimes be broken up by sound waves produced by a lithotriptor in a procedure called extracorporeal shock wave lithotripsy .
After an ultrasound device or fluoroscope is used to locate the stone, the lithotriptor is placed against the back, and the sound waves are focused on the stone, shattering it. Then the person drinks fluids to flush the stone fragments out of the kidney, to be eliminated in the urine.
Sometimes blood appears in the urine or the abdomen is bruised after the procedure, but serious problems are rare.
A ureteroscope can be inserted into the urethra, through the bladder and up the ureter to remove small stones in the lower part of the ureter that require removal. In some instances, the ureteroscope can also be used with a device to break up stones into smaller pieces that can be removed with the ureteroscope or passed in the urine . Most commonly, holmium laser lithotripsy is used. In this procedure, a laser is used to break up the stone.
Percutaneous nephrolithotomy may be used to remove some larger kidney stones. In percutaneous nephrolithotomy, doctors make a small incision in the person’s back and then insert a telescopic viewing tube into the kidney. Doctors insert a probe through the nephroscope to break the stone into smaller pieces and then remove the pieces .
Making the urine more alkaline may sometimes gradually dissolve uric acid stones. Other types of stones cannot be dissolved this way.
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What Do Kidney Stone Symptoms Feel Like
You’re probably already aware that passing a kidney stone can be incredibly painful. Perhaps you’ve heard someone compare the pain to childbirth. Or maybe someone mentioned their experience with kidney stones completely recalibrated how they rate pain. Ouch.
But while the most-discussed kidney stone symptom is often the pain where it’s felt and how bad it can get it’s not the only symptom to be aware of.
“Kidney stones are fairly common and often painful, but they’re also treatable and even preventable,” says Dr. Chris Kannady, urologist at Houston Methodist. “If you think you might have a kidney stone, it’s important to see your doctor as soon as possible since delaying care for a kidney stone can lead to serious complications.”
But, when all you’ve heard about kidney stones is how much they hurt, how can you tell if your pain might be kidney stone pain?
What Are Kidney And Bladder Stones
Kidney or bladder stones are solid build-ups of crystals made from minerals and proteins found in urine. Bladder diverticulum, enlarged prostate, neurogenic bladder and urinary tract infection can cause an individual to have a greater chance of developing bladder stones.
If bladder stones are small enough, they can pass on their own with no noticeable symptoms. However, once they become larger, bladder stones can cause frequent urges to urinate, painful or difficult urination and hematuria.
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What Do The Results Mean
Your results will show what your kidney stone is made of. Once your health care provider has these results, he or she can recommend steps and/or medicines that may prevent you from forming more stones. The recommendations will depend on the chemical makeup of your stone.
If you have questions about your results, talk to your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
What Are The Symptoms Of Uric Acid Stones
All types of kidney stones produce similar symptoms, including one or more of the following:
- Pain in the lower back, sides, abdomen or groin; the pain is the result of irritation or blockage inside the kidneys or urinary system
- Blood in the urine
- Urine that smells bad or is cloudy during a urinary tract infection
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How Can I Prevent Kidney Stones
There are several ways to decrease your risk of kidney stones, including:
- Drink water. Drink at least six to eight 8-ounce glasses every day . Staying hydrated helps you urinate more often, which helps flush away the buildup of the substances that cause kidney stones. If you sweat a lot, be sure to drink even more.
- Limit salt. Eat less sodium. You may want to connect with a dietician for help with planning what foods you eat.
- Lose weight. If youre overweight, try to lose some pounds. Talk to your healthcare provider about an ideal weight.
- Take prescriptions. Your healthcare provider may prescribe some medications that help prevent kidney stones. The type of medication may depend on the type of stones you get.
How Common Are Uric Acid Stones
It is estimated that one in 10 people in the U.S. will have a kidney stone of one kind or another at some time in their lives. In the late 1970s, about 3.8% of the population had kidney stones, but this figure has now increased to about 8.8% of the population. Among men, the lifetime risk is about 19%; in women, it is 9%. Usually, the first incidence of kidney stones occurs after age 30. However, there are many cases that occur sooner, some in children as young as five years of age.
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