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Kidney stones and stone disease
It is estimated that one in ten people will have a kidney stone at some point in their lives, and many find themselves in the emergency room when the stones become painful.
For some, it’s a single, unwelcome event — but for others, kidney stones can become a recurring problem, which may point to a broader condition known as kidney stone disease.
What is kidney stone disease?
Kidney stone disease, also called nephrolithiasis, is a condition in which hard deposits of minerals and salts form inside the kidneys.
These deposits, known as kidney stones, develop when substances such as calcium, oxalate or uric acid become concentrated in the urine and form crystals.
Kidney stones vary in size, shape and texture. A kidney stone may be as small as a grain of sand or grow much larger. Some stones remain in the kidney without causing symptoms, while others move into the ureter—the tube that carries urine from the kidney to the bladder—where they can cause significant pain or block urine flow.
Kidney stone disease can involve a single episode or recurring stones. Treatment focuses on managing the current kidney stone and understanding why it formed. Identifying the stone type and contributing factors can help your urologist recommend a personalized plan to reduce the risk of future kidney stones.
Signs and symptoms of kidney stones:
- Sharp pain in your back or lower abdomen
- Vague discomfort or dull pain, like a stomach ache that doesn’t go away
- Pain or a burning sensation while urinating with an urge to urinate more frequently, or blood in your urine
- For men, pain in your testicles
- Cloudy or foul-smelling urine
- Nausea and occasional vomiting
- Fever and chills
Kidney stones causes:
A kidney stone forms when substances in your urine become highly concentrated – which makes fluid intake one of the biggest contributing factors. If you do not drink enough water, you may put yourself at a higher risk for developing a stone.
- Exercise (too much or too little)
- Family or personal history of kidney stones
- Food with too much salt or sugar
- Infections
- Medications
- Obesity
- Weight-loss surgery
Types of kidney stones
Calcium stones
Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a substance made daily by your liver or absorbed from your diet. Certain fruits and vegetables, as well as nuts and chocolate, have high oxalate content.
Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine.
Calcium stones may also occur in the form of calcium phosphate. This type of stone is more common in metabolic conditions, such as renal tubular acidosis. It may also be associated with certain medications used to treat migraines or seizures.
Struvite stones
Struvite stones form in response to a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.
Uric acid stones
Uric acid stones can form in people who lose too much fluid because of chronic diarrhea or malabsorption, those who eat a high-protein diet, and those with diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.
Cystine stones
These stones form in people with a hereditary disorder called cystinuria that causes the kidneys to excrete too much of a specific amino acid.
Kidney stone disease diagnosis
If you are experiencing any of the symptoms and have not yet seen your doctor for a diagnosis, now is the time. At your appointment, your doctor will perform a physical exam and take a medical history, including questions about your family history of kidney stones, your diet and any gastrointestinal problems.
To complete your kidney stone diagnosis, your doctor may also perform:
- A blood test to reveal any biochemical problems that can lead to kidney stones.
- An imaging test such as an X-ray, ultrasound or CT scan to find your stone’s location and show any conditions that may have caused it to form.
- A urinalysis to determine whether you have an infection or if your urine contains substances that may form stones.
Kidney stone prevention
Drinking plenty of fluids is the best way to keep a kidney stone from forming. Your doctor may recommend you drink two to three liters of water (or other pH-neutral drinks) every day. Try to drink evenly throughout the day, monitor how much you urinate, and make sure your urine is light in color. If the weather is hot, or you exercise a lot, drink more to help balance fluid loss.
Other steps your doctor may suggest to prevent another kidney stone:
- Adapt your diet to include more vegetables, fibers and fruits while limiting animal proteins and reducing your sodium intake
- Maintain a healthy weight
- Adopt a healthier lifestyle by exercising two or three times per week and avoiding stress
- Take medicine to reduce your risk, if your doctor advises it
Kidney stone treatments
CVAC System for Kidney Stones
The only minimally invasive treatment option designed to help your doctor completely remove your kidney stones in a single procedure. Other treatments leave stone fragments inside your body, where they can regrow, require additional procedures, or cause other problems, such as urinary blockage, infection, or kidney injury. The CVAC System vacuums those fragments out, giving you more peace of mind. >Learn More
MOSES™ Laser by Lumenis
The MOSES Pulse 120H holmium laser represents a revolution in stone treatment, offering greater safety, efficacy and speed. MOSES technology provides precise fragmentation and dusting of ureteral and most renal stones, with the ideal balance of power and control for fast, safe treatment. Combined with flexible ureteroscopy, MOSES can allow physicians to treat large kidney stones on an outpatient basis—cases that once required invasive surgery and an inpatient hospital stay. >Learn More
Extracoporeal Shockwave Lithotripsy (ESWL)
ESWL utilizes an X-ray machine to locate the stone(s) within the body, and shock waves are used to break up the stone(s) into very small particles that can be passed through the urine. This procedure is the least invasive option – there are no incisions and no scopes placed into the patient’s body. ESWL, however, may not be appropriate for all patients as the shock waves may not adequately break up stones in certain cases.
Percutaneous Nephrostolithotomy (PCNL)
This is an innovative surgical treatment for patients who have large, complex kidney stones that cannot be treated successfully using other treatments. Typically, PCNL and tubeless PCNL is used to remove kidney stones that are larger than 2cm in diameter and cannot be passed through the urinary tract.