Kidney Stones: What are They and How are They Treated?

The kidneys help our body filter and remove the waste it no longer needs. When the kidneys aren’t functioning properly, that waste can build up.

These buildups lead to different complications and conditions, and one of the most common are kidney stones. Kidney stones are tiny, hard deposits of minerals that form inside your kidneys over a long period of time before eventually passing through your urine. Though painful, many cases of kidney stones are harmless. In other cases, though, kidney stones can create bigger problems that require more invasive treatment.

Types of Kidney Stones

Your urine naturally contains substances that form crystals, but you have fluid in the urine that dilutes them. Kidney stones occur when there are too many crystal-forming substances or if there is not enough fluid in the urine for dilution.

There are several kinds of kidney stones that can develop from this process:

• Calcium stones: The most common type of kidney stones. These take the form of calcium oxalate or calcium phosphate, which is produced both in the body and in many common foods.
• Uric acid stones: These most often occur in people with low fluid levels or high-protein diets.
• Struvite stones: Struvite stones occur in response to a urinary tract infection or other kind of infection. These are some of the most dangerous stones because they can grow quickly and with little warning.
• Cystine stones: Caused by a hereditary disorder called cystinuria.

Symptoms

Kidney stones may not show any symptoms right away—most people only notice them when they move around or pass through the urine. Symptoms at this point include:

• Extreme pain: In the side, back, ribs, abdomen and groin. Pain will come and go, seemingly at random
• Pain during urination
• Nausea and vomiting
• Discolored or foul-smelling urine
• Frequent urination, or feeling the need to urinate often even if you don’t need to
• Fever (if infection has taken place)

If any of these symptoms become too serious, or if you can’t function in daily life without severe pain, contact your doctor right away.

Causes and Risk Factors

There’s no known direct cause of imbalanced fluid and crystal levels in the urine that leads to kidney stones, but there are several factors that have proven to put people at higher risk:

• Genetics or personal history of kidney problems
• Diet: Too much protein, sugar and especially sodium can increase calcium deposits and raise your risk
• Obesity
• Dehydration: Lowers fluid levels for dilution
• Recent surgery or digestive conditions
• Outside medical conditions: Hyperparathyroidism, renal tubular acidosis and others

 

Diagnosis

Kidney stones are diagnosed using one or more of several tests:

• Urine test: To check fluid levels and your body’s ability to break down buildups
• Blood test: To check calcium and uric acid in the blood, and monitor kidney health
• Imaging: X-rays or special forms of CT scans, sometimes ultrasounds
• Previous analysis: If you’ve previously passed kidney stones, your doctor may analyze these to figure out what’s causing them

 

Treatment and Prevention

Kidney stones can be prevented by healthy lifestyle choices and, for some people who are at higher risk, the right medications. Lifestyle changes with kidney stone prevention in mind include:

• Drinking plenty of water
• Eating fewer foods high in oxalates (e.g. potatoes, chocolate, chard, nuts, rhubarb, beets, spinach and many soy products)
• Eating a low-sodium diet
• Lowering consumption of animal protein
• Limiting calcium supplements – most calcium in food won’t increase risk of kidney stones, but additional supplements can

Medications that can help prevent kidney stones depend on the kind of kidney stones you have:

 

• Calcium stones: Diuretics or preparations containing phosphate
• Uric acid stones: Allopurinol (to reduce uric acid levels) and an alkalizing agent (to dissolve stones)
• Struvite stones: Antibiotics to help block infection
• Cystine stones: There are limited medications for cystine stones, though there are some designed to decrease the amount of cystine in urine

 

For people who do develop kidney stones, treatment depends on the size.

Small, Limited-Symptom Stones:

Treatments are limited to things like drinking water, painkillers and alpha blockers – medications to relax the muscles in your ureter and let you pass the stone.

Larger, Symptom-Causing Stones:

In these cases, stones don’t pass on their own and may cause tears, bleeding or infections if they’re forced to pass whole. Some treatments include:

• Surgery: To remove large stones that won’t break down. This may also include parathyroid gland surgery – the parathyroid is a gland that can cause kidney stones if it produces too much of a certain hormone, and removing the gland can eliminate the problem.
• Sound waves: Shock waves may be able to break the stone into smaller pieces. There can be side effects, including pain and bleeding.
• Scope: A thin tube that enters the body and removes the stone.

If you’re concerned you may have kidney stones or be developing kidney stones, speak with your doctor about steps to take.

 

Are you concerned about your kidney function? Talk with your primary care physician about seeing a nephrology specialist.

 

Sources:

“Kidney stones.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/kidney-stones/basics/definition/con-20024829

“Kidney Stones.” MedicineNet. http://www.medicinenet.com/kidney_stones/article.htm