Treatment Of Kidney Stones
For smaller kidney stones, pain relievers may be the only treatment needed. On average it takes five to seven days to pass a kidney stone, says Dr. Abromowitz. It may pass sooner. And if the stone is very high in the ureter, it can take up to two weeks.
Larger stones that block urine flow or cause infection may require surgery, such as:
- Shock-wave lithotripsy, a noninvasive procedure using high-energy sound waves to break stones into fragments that pass out in the urine
- Ureteroscopy, in which an endoscope is inserted through the ureter to retrieve or break up the stone
- Percutaneous nephrolithotomy or nephrolithotripsy, used for very large or irregularly shaped stones. For both procedures, a small incision is made in the back to provide access for a nephroscope, a miniature fiberoptic camera, and other small instruments. Your doctor then either removes the stone or breaks up and removes the stone .
For ongoingprevention of recurring kidney stones, your doctor may prescribe increasing fluid intake, changing diet, controlling weight, and taking medication.
To learn more about kidney stones, talk to your doctor or health care provider or search for a provider.
What Does It Feel Like To Have A Kidney Stone
Everyone experiences kidney stones differently. Typically, kidney stones within the kidney do not cause pain.
If a stone falls onto the opening where the kidney meets the ureter or passes into the ureter, this can prevent urine from draining out of the kidney. This backing up of urine can lead to back pain just below your ribs. Sometimes the pain can be severe enough to cause nausea and vomiting.
As a stone moves, the blockage of urine may be relieved and symptoms may improve or go away. The pain may return if the stone begins to cause blockage of urine again. This changing of symptoms is called renal colic.
Blood in the urine may be a sign of kidney stones. Sometimes the blood isnt visible to the naked eye and must be detected by a urine test.
If a stone is able to pass down the ureter and close to the bladder, the pain may move to the front of the abdomen, near the pelvis.
Stones very close to the bladder can cause pain that is felt in the genitals. A stone that reaches the bladder can cause burning with urination or changes in how often or how urgently you need to urinate.
Increase Your Citric Acid Intake
Citric acid is an organic acid and a natural component of many fruits and fruit juices. An easy way to consume more citric acid is to eat more citrus fruits, such as grapefruit, oranges, lemons, or limes. Citric acid may help protect a person against kidney stones by:
- Preventing stone formation: Citric acid makes urine less favorable for the formation of stones.
- Preventing stone enlargement: Citric acid helps prevent small stones from becoming bigger stones by binding with existing calcium oxalate crystals. This can help you pass stones before they turn into larger ones.
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How Common Are Kidney Stones
Each year, more than half a million people go to emergency rooms for kidney stone problems. It is estimated that one in ten people will have a kidney stone at some time in their lives.
The prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. The prevalence of kidney stones was 10% during 20132014. The risk of kidney stones is about 11% in men and 9% in women. Other diseases such as high blood pressure, diabetes, and obesity may increase the risk for kidney stones.
What Are The Treatments For Kidney Stones
The treatment for a kidney stone depends on the size of the stone, what it is made of, whether it is causing pain and whether it is blocking your urinary tract. To answer these questions and to figure out the right treatment for you, your doctor might ask you to have a urine test, blood test, x-ray and/or CT scan. A CT scan sometimes uses contrast dye. If you have ever had a problem with contrast dye, be sure to tell your doctor about it before you have your CT scan.
If your test results show that your kidney stone is small, your doctor may tell you to take pain medicine and drink plenty of fluids to help push the stone through your urinary tract. If your kidney stone is large, or if it is blocking your urinary tract, additional treatment may be necessary.
One treatment option is shock wave lithotripsy. This treatment uses shock waves to break up the kidney stones into small pieces. After the treatment, the small pieces of the kidney stone will pass through your urinary tract and out of your body with your urine. This treatment usually takes 45 minutes to one hour and may be done under general anesthesia, which means you will be asleep and unable to feel pain.
In rare cases, a surgery called percutaneous nephrolithotomy is needed to remove a kidney stone. During the surgery, a tube will be inserted directly into your kidney to remove the stone. You will need to be in the hospital for two to three days to have and recover from this treatment.
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Kidney Stones And Your Diet
Lifestyle changes can reduce the risk of another kidney stone.
Its particularly important to drink enough throughout the day to make your urine colourless rather than yellow or brown. This will help to prevent a build-up of some of the minerals that can cause kidney stones. Aim to drink 2 to 3 litres a day. Water is a good choice, but most drinks will count. Limit alcohol as large amounts can dehydrate you. Depending on the type of stone youve had, your specialist may recommend cutting down on tea. Eating more liquid foods like soup and stew, or fruit and vegetables that contain water, can also help.
For all types of stones, try to eat less meat and fish and more fruit and vegetables. You should also cut down on your salt intake dont add extra to your food and cut down on processed and pre-prepared foods as they often have a high salt content. Losing weight can also help if youre obese or overweight. As being inactive is a risk factor for kidney stones, its a good idea to exercise more. Drink plenty to avoid getting dehydrated if you sweat a lot.
Depending on the type of stone youve had, your doctor may advise other changes to your diet, possibly including:
If you have to take calcium and vitamin D for another health condition, like osteoporosis, take supplements with meals not between them. Drink plenty to flush the calcium through your kidneys and bladder.
Medication For Kidney Stones
For most people with recurrent calcium stones, a combination of drinking enough fluids, avoiding urinary infections, and specific treatment with medications will significantly reduce or stop new stone formation.
Certain medications such as thiazide diuretics or indapamide reduce calcium excretion and decrease the chance of another calcium stone. Potassium citrate or citric juices are used to supplement thiazide treatment and are used by themselves for some conditions where the urine is too acidic.
For people who have a high level of uric acid in their urine, or who make uric acid stones, the medication allopurinol will usually stop the formation of new stones.
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What Causes Kidney Stones
Kidney stones are formed from substances in your urine. The substances that combine into stones normally pass through your urinary system. When they dont, its because there isnt enough urine volume, causing the substances to become highly concentrated and to crystalize. This is typically a result of not drinking enough water. The stone-forming substances are:
- Calcium.
- Cloudy, foul-smelling urine, fever, chills or weakness which might be a sign of a serious infection.
- Blood in the urine.
Most pediatric kidney stones remain in the kidney, but up to a third may migrate from the kidney and get stuck in a ureter. Stones that remain in the kidney, although often painless, can be the source of recurrent urinary tract infections. Those that lodge in the ureter can create severe colicky pain.
Drugs Are Better Than One
The researchers further analyzed their results, looking for a two-drug combination that might be effective at lower, safer dosages. Eventually, they found two top-performing drugs that could produce even more positive results when administered together.
One of the drugs, nifedipine, is a calcium channel blocker that doctors can use to treat high blood pressure. The other is a Rho kinase inhibitor, which can treat glaucoma.
The team then delivered various dosages of the mixture via a tubular tool called a cystoscope to ureters that had been removed from pigs.
To gauge their effectiveness at relaxing the ureter tissue, the researchers tracked the frequency and length of contractions, or cramps, associated with passing the stones.
Later tests in live, sedated pigs revealed that the drug combination could nearly eliminate these contractions.
In addition, subsequent tests found no traces of either drug in the bloodstream. The implication is that this medication remains in the ureter, reducing the risk of systemic side effects.
The researchers hope to conduct further research and development, eventually leading to trials in humans.
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What Is A Kidney Stone
A kidney stone is a hard object that is made from chemicals in the urine. There are four types of kidney stones: calcium oxalate, uric acid, struvite, and cystine. A kidney stone may be treated with shockwave lithotripsy, uteroscopy, percutaneous nephrolithomy or nephrolithotripsy. Common symptoms include severe pain in lower back, blood in your urine, nausea, vomiting, fever and chills, or urine that smells bad or looks cloudy.
Urine has various wastes dissolved in it. When there is too much waste in too little liquid, crystals begin to form. The crystals attract other elements and join together to form a solid that will get larger unless it is passed out of the body with the urine. Usually, these chemicals are eliminated in the urine by the body’s master chemist: the kidney. In most people, having enough liquid washes them out or other chemicals in urine stop a stone from forming. The stone-forming chemicals are calcium, oxalate, urate, cystine, xanthine, and phosphate.
After it is formed, the stone may stay in the kidney or travel down the urinary tract into the ureter. Sometimes, tiny stones move out of the body in the urine without causing too much pain. But stones that don’t move may cause a back-up of urine in the kidney, ureter, the bladder, or the urethra. This is what causes the pain.
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.
References
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Whats The Urinary Tract How Does It Work
Your urinary tract is vital to your body because it gets rid of waste and extra fluid. Its made up of both your kidneys, two ureters, your bladder and your urethra. Each organ has an important job :
- Kidneys: Your fist-sized, bean-shaped kidneys are located on either side of your spine, below your rib cage. Each day they filter 120 to 150 quarts of your blood to remove waste and balance fluids. Your kidneys make one to two quarts of urine every day.
- Ureters: After your kidney creates urine, the liquid travels through the tube-shaped ureter to the bladder. There is one ureter per kidney. Kidney stones can pass through the ureters or, if theyre too big, get stuck in them. You may require surgery if the stone is too large.
- Bladder: Between your hip bones is your bladder, an organ that stores urine. It stretches to hold about one and a half to two cups.
- Urethra: Like a ureter, your urethra is a tube through which urine passes. Its the final stop of the urinary tract where your urine leaves your body. This is called urination.
Treating And Preventing Kidney Stones
Most kidney stones are small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication.
Larger stones may need to be broken up using ultrasound or laser energy. Occasionally, keyhole surgery may be needed to remove very large kidney stones directly.
Read more about treating kidney stones.
It’s estimated that up to half of all people who have had kidney stones will experience them again within the following five years.
To avoid getting kidney stones, make sure you drink plenty of water every day so you don’t become dehydrated. It’s very important to keep your urine diluted to prevent waste products forming into kidney stones.
Read more about preventing kidney stones.
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Why Do I Get Kidney Stones
Kidneys are essential organs that filter out the waste traveling around the body in your bloodstream. The kidneys create urine to transport the filtered chemicals out of the body. Stones develop from buildup of mineral deposits in our urine that stick together in the kidneys. Typically, these stones develop because of a lack of water to dilute the accumulation of these minerals on the lining of our kidneys. Certain medications, medical disorders , and a family history of kidney stones can also increase your chances of suffering from them.
Because they are known to cause a great deal of pain, it is no surprise that those who suffer from kidney stones are willing to try just about anything to treat them and to prevent them from happening again. Known medicinal treatments include the use of alpha-blockers such as Flomax that relax the lining of the ureter to help stones pass more easily, and medications that treat the associated pain. Additionally, surgical procedures or other non-invasive means of surgical treatment may be prescribed to break up both calcium oxalate and uric acid kidney stones. These treatments include ureteroscopy and extracorporeal shock wave lithotripsy .
Preventative measures used to halt the formation of kidney stones include dietary and behavioral changes. These involve decreasing sodium intake, increasing water intake to stay properly hydrated, stopping excessive exercise, stopping sauna usage , and eating a diet rich in fruits and vegetables.
Extracorporeal Shock Wave Lithotripsy
This means using a machine to send shock waves from outside your body to break up the stone. Extracorporeal shock wave lithotripsy doesnt always work as well as other treatments, but it means less time in hospital and a lower risk of complications.
The shock waves break the stone into fragments small enough to be passed in your urine. You may feel some pain as the stone breaks up, so youll usually have a sedative and a painkiller. The treatment takes 30 to 60 minutes depending on how big the stone is. You need to lie as still as possible. You should be able to go home within a couple of hours.
The procedure can cause skin blistering or bruising. This should disappear after about a week. You can use skin cream to soothe your skin. You may have some pain and bleeding as you pass the stone fragments. Contact your doctor if this is severe.
You may need to have ESWL more than once to completely get rid of your kidney stones. It may not be suitable if youre pregnant, if your blood doesnt clot properly or if you get a lot of urine infections. Being obese can make it harder to target the stone. You may need to have medical expulsive therapy afterwards to get rid of any fragments.
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Surgery For Kidney Stones
Non-obstructive stones rarely cause pain. So surgery is not necessary when kidney stones are not causing any obstruction. And even if they cause pain, medications are usually sufficient. But surgery is required when there is bothersome flank pain and imaging evidence of one or more obstructive stones.
Common surgical treatments include: