Kidney Stones: Causes, Symptoms, & Treatments
At least 10% of the population has had a kidney stone, making this a condition worth learning about in case you or someone you know has symptoms. Kidney stones are common enough that most people know of someone who has had one. Part of the narrative usually includes tales of woe about the pain involved with this ailment, but fortunately, pain killers are available, and kidney stones are removable and often preventable.
What Are Kidney Stones?
As it is produced in your kidneys, urine contains crystal-forming substances, like oxalate, uric acid, and calcium. It also contains substances that prevent crystals from clumping, as well as fluid that aids in the declumping process by diluting the urine. However, sometimes there is not enough anti-clump substance or not enough diluting fluid, and kidney stones begin to form.
Some kidney stones are small and barely noticeable, and others cause enough pain to interfere with your daily life. Some stones cause no symptoms until they leave your kidney and move into your ureter, the tube that joins each kidney to your bladder, where their presence becomes noticeable. Unfortunately, once you’ve had one stone, your chances of developing another increase unless you can address the underlying cause.
Stages and Types of Kidney Stones
If you pass a kidney stone and can save it to bring to your doctor, the stone can be analyzed to determine its type.
There are five main types of kidney stones:
- Calcium oxalate stones: The most common type of stone, they form when calcium and oxalate combine in urine. They are sometimes caused by disease, but most often by diet, lifestyle, and genetic predisposition.
- Calcium phosphate stones: This type of stone results from the combination of calcium atoms and phosphoric acid. They form in urine that is too alkaline, which means it has a high pH.
- Uric acid stones: These stones form in acidic urine, which is usually found in those with diabetes, obesity, kidney disease, or gout.
- Struvite stones: A result of infections, struvite stones are made by soil bacteria that enter the urinary system after you've eaten uncooked food.
- Cystine stones: Caused by the kidney disorder cystinuria and only found in people who have this disease.
Knowing what kind of stone you have can help determine the most effective treatment, as well as help you avoid a recurrence of a future stone.
Symptoms and Causes
Kidney stones develop when there are too many crystal-forming substances in your urine and not enough diluting fluid. You may also be lacking substances in your urine that prevent crystals from sticking together.
Symptoms of kidney stones may not occur until the stone moves out of your kidney and into your ureter, the tube that connects the kidney to the bladder. At this point you may notice:
- Pain or burning during urination
- More frequent need to urinate, in smaller amounts
- Urine changes, such as cloudiness, bad smell, or discoloration (brown, red, or pink)
- Nausea and vomiting
- Lower back and side pain that eases and intensifies and may spread through abdomen
- Fever, weakness, and chills
Prevention and Risks
You can lessen your chances of developing kidney stones by reducing the crystal-forming substances in your urine. Ways to accomplish this include:
- Stay hydrated.
- Reduce your intake of salt, protein, red meat, antacids, tea, and chocolate.
- Avoid exceeding the recommended daily limit for calcium and vitamin C.
Knowing the risk factors for kidney stones can help you avoid them by changing factors over which you have some control. Risk factors include:
- Diets that are high in protein, salt, and sugar
- Family history of kidney stones
- Personal history of kidney stones
- Digestive disease
- Digestive surgery
- Medical conditions such as renal tubular acidosis and urinary tract infections
- Certain types of medications
Diagnosis and Tests
To determine if your symptoms are the result of kidney stones, your doctor will conduct a physical exam, ask questions and run tests.
Questions may be about:
- Past kidney problems
- Family history
Tests may include:
- Intravenous dye imaging
- Urine test
- Blood test
- CT scan
- Analysis of stones you have passed and collected
Treatment, Procedures, and Medication
See your family doctor if you have kidney stone symptoms that concern you. If you do have a stone that is small and presents no complications, you can be treated by your regular doctor. However, if there is a potential for problems such as bleeding or kidney damage, your doctor can refer you to a urologist (urinary tract specialist) or nephrologist (kidney specialist). If you require surgery, this can be done by a urologist with the help of an interventional radiologist.
The treatment your doctor recommends will depend on the type of kidney stone that you have.
Small stones do not require much intervention. Your doctor will likely advise plenty of fluids, a pain reliever, and possibly an alpha blocker medication (which relaxes muscles and dilates blood vessels) to help the stone pass more quickly.
If your kidney stone is larger and produces bleeding, infection, or kidney damage, your treatment will be more extensive. You may undergo one or more of the following:
- Surgery, via a small incision on your back
- Extracorporeal shock wave lithotripsy (breaking the stone with sound waves)
- Ureteroscope removal by inserting the scope through your urethra and bladder to the ureter where it locates and breaks the stone
Healthy Lifestyle Tips
Lifestyle changes can help if you have a kidney stone or may be prone to getting one. Proper diet, exercise, sleep and stress reduction techniques all contribute to better health and disease prevention, and kidney stones are no exception. Lifestyle changes to make include:
- Maintain a healthy weight.
- Stay properly hydrated.
- Replace lost fluid whenever you urinate.
Check with your doctor to see which vitamin supplements can increase kidney stones and which can help to prevent them. Vitamin B6 has been shown to be helpful, whereas vitamin C, vitamin D, fish oil and calcium supplements can sometimes cause stones.
Diet is such a significant factor in the production of kidney stones that sometimes all you need to prevent a second stone is to change what you eat. Dietary recommendations to follow include:
- Eat less salt and food containing sodium (check labels on cans and processed foods).
- Eat and drink calcium- and oxalate-containing foods together so that they bind together before they reach the kidneys, which makes it harder for stones to form. Examples of oxalate-containing foods are spinach, french fries, nuts, beets, and potato chips. If you eat foods with oxalates, have them with calcium-rich items such as milk, cheese, or broccoli.
- Eat fewer high-purine foods, which can cause uric acid stones. Examples include red meat and shellfish.
- Cut back on sugary food and drinks, and avoid high fructose corn syrup.
- Reduce alcohol consumption.
- Cut back on animal protein.
- Eat more fruits, vegetables, and whole grains.
- Drink natural fruit juices high in citrate, such as limeade and lemonade.
Once you have a proper diagnosis for the symptoms you’ve been experiencing and you begin treatment, your kidney stone will be on its way out of your life. If you have a painful stone, take heart in the knowledge that the discomfort will pass. Now that you’re armed with the knowledge of what may have caused your stone, you may be able to prevent another one from occurring.
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- Mayo Clinic: Kidney stones
- The Kidney Foundation of Canada: Kidney Stones
- Kidney Atlas: Remedies for The 5 Most Common Types of Kidney Stones
- Washington University School of Medicine in St. Louis: Surgery for Kidney Stones
- National Kidney Foundation: 6 Easy Ways to Prevent Kidney Stones
- University of Chicago: Kidney Stone Types
- Cleveland Clinic: Kidney Stones: Oxalate-Controlled Diet