Diseases & Conditions

Kidney Stones

Authors: Claire Yang, MD
Last updated: February 24, 2006

Overview |
Symptoms |
Causes |
Risk Factors |
Diagnosis |
Complications |
Treatment
Self-care |
Related Conditions |
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Overview

Kidney stones are mineral deposits that form in the kidney. They become a clinical problem when the stones become large enough to prevent drainage of urine from the kidney to the bladder. Occasionally, kidney stones can be a source of bacteria, causing recurrent urinary tract infections.

Symptoms

The most common symptom for kidney stone is pain in the mid-back and side (flank). This pain can radiate to the front of the body below the rib cage, and down into the groin. The pain can be so severe as to cause nausea and vomiting, and the patient cannot find a comfortable position. Persons with kidney stones may have blood in their urine, and there may be pain with urination. Urinary frequency is common.

Causes

Most causes of kidney stones are due to mild imbalances in body chemistry, resulting in the mineral deposits forming in the kidneys.

Risk Factors

Kidney stones are more common in the warmer parts of the US, particularly the Southeast and the Southwest (the "Stone Belt"). Stone disease often runs in families. Certain types of stones form in patients with neurologic diseases, who require bladder catheters.

Diagnosis

Diagnosis of kidney stones is usually straightforward. The classic history given is that of acute onset of back or flank pain, with no particular precipitating event. There may be some blood in the urine. A CT (computed tomography) scan or IVP (intravenous pyelogram) are radiologic studies that can identify a kidney stone and whether it is blocking urine drainage from the kidney to the bladder. A urine specimen and blood tests are also obtained to check for infection and kidney function.

Complications

Kidney stones that cause pain will continue to cause pain until the stone passes or is surgically removed. If the affected kidney is completely blocked for a long period of time, this condition may cause loss of kidney function. A simultaneous urinary tract infection with a kidney stone can become a life-threatening infection, if the kidney is blocked.

Treatment

Most kidney stones smaller than 5 mm can pass spontaneously. The size of the stone can be determined by a radiologic study. If the stone is too big to pass on its own, surgical treatments are available, including: ureteroscopy and laser lithotripsy, extracorporeal shock wave lithotripsy, percutaneous nephrostolithotomy, and open surgical removal.

Self-care

If a patient with a kidney stone is evaluated and found to have a stone that may pass spontaneously, the best thing a patient can do to help the stone to pass is to drink plenty of water (e.g., 8 oz. every hour while awake). Prescribed pain medications should be taken before pain gets too severe. If the patient cannot take fluids and medications because of nausea and vomiting, the patient may need to be admitted to the hospital.