Sign In
  • ENG

Kidney stones -- causes, risk factors, symptoms, diagnosis, treatment and prevention

This summer stay away from kidney stones by learning it main causes, symptoms and prevention.

Written by Shraddha Rupavate |Updated : May 21, 2014 4:54 PM IST

Kidney stonesThe arrival of summer is an invitation to a lot of health issues, mainly kidney stones. During summer, the overall increase in humidity makes you sweat more, adding to your risk of dehydration which eventually leads to formation of stones.

Kidney stone problem is medically called nephrolithiasis. The stones are small lumps of waste products (minerals and salts) in the blood that get accumulated inside the kidneys during the process of filtration. Small stones readily get passed through the urine but when the minerals aggregate, they crystallize and become hard to form larger stones which are hard to pass through urine.

In this article, our expert Dr Avinash Ignatius, senior consultant nephrologist, discusses the risk factors, symptoms, diagnosis, treatment and prevention of kidney stones.

What are the risk factors of kidney stones?

Kidney stones occur in about 5% of the population and a person may about have about 8-10% of chances of passing a kidney stone in a lifetime.

Kidney stones are more frequent in men than women, because they have more muscle mass as compared to women. So, the daily breakdown of muscle tissues result in increased metabolic wastes and a predisposition to stone formation. Other risk factors include:

  • Family history: You are more likely to develop stones if someone in your family has had stones
  • Personal history: The risk of having a kidney stone is much higher if you have already had a stone.
  • Age: Though kidney stones can occur at any age, they are most common in adults aged 40 and above.
  • Obesity: High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones
  • Dehydration: Inadequate fluid intake will increase your risk of kidney stones. People living in hot arid regions or working in environments where they tend to sweat a lot will have a higher risk of developing stones.
  • Certain diets: Eating a diet that's high in animal protein, sodium and has low fibre content can increase your risk for kidney stones. This is especially true for a high-sodium diet. Too much sodium increases the calcium load on your kidneys, significantly increases your risk of kidney stones.
  • Existing medical conditions: Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea cause changes in the digestive process that affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine. Renal tubular acidosis, cystinuria, thyroid problem (hyperparathyroidism) and some urinary tract infections can increase stone formation

Next: Early symptoms, complications and diagnosis of kidney stones

What are the early symptoms of kidney stones?

Unfortunately, kidney stones do not cause any symptoms until they move around in your kidney or pass through your ureter, the tube connecting the kidneys and urinary bladder. In fact, small stones may pass out even without causing any symptoms. But, with larger stones, following symptoms may be seen:

  • Back and groin pain: Severe pain in the side and back, below the ribs. This pain then may move to the lower abdomen and groin as the stone passes down the ureter. The pain usually comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Nausea and vomiting
  • Persistent urge to urinate
  • Frequent urination

Can kidney stones lead to kidney failure or death?

Untreated kidney stones can significantly damage the kidneys and even lead to end stage renal disease (ESRD), requiring dialysis. But early detection and treatment may completely reverse the damage, even in those on dialysis. Unfortunately many a times, the kidney stones remain undetected for years, because minor symptoms are ignored/neglected and by the time the patient consults a doctor the damage becomes irreversible or only partially reversible.

How is the condition diagnosed?

Ultrasound of the kidney, ureter and bladder (KUB) is the most convenient and frequently used investigation to diagnose kidney stones. An X-ray KUB can further assist in diagnosis. However, in case the stones are small, the patient is obese or there is lot of gas in the abdomen, a CT scan is better method of diagnosis.

Next: Treatment of kidney stones

What are the treatment options?

Treatment is based on the size of the stones.

Smaller stones can be treated with plenty of fluids, pain medications and certain anti spasmodic drugs (pain and spasm relieving) which help in passing the stone out. But even when the symptoms disappear, it is essential to confirm whether the stone has been eliminated through an ultrasound or a CT scan.

Larger stones which do not pass out easily require medical therapy and more advanced treatments.

  • Sound waves: Depending on size and location of the stones, extracorporeal shock wave lithotripsy (ESWL) may be done. ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces, making them easier to be passed through urine. The procedure lasts for about 45 to 60 minutes. It can cause moderate pain, so it is preferably performed under sedation or light anesthesia. ESWL can also cause blood in the urine, and discomfort as the stone fragments pass through the urinary tract. Depending on the size of stones, one or more sessions may be needed.
  • Percutaneous Nephrolithotomy (PCNL): This treatment is used for very large stones or in case where ESWL is unsuccessful. The procedure involves surgically removing the stone using small telescopes and instruments that are inserted through a small incision in the back.
  • Ureteroscopic Removal: Smaller stones in the ureter or kidneys may be removed by passing a thin lighted tube (ureteroscope) equipped with a camera through the urethra and urinary bladder to the ureter. Once the stone is located, special tools can snare the stone or break it into pieces making them easier to pass through the urine. A small tube (stent) may be placed in the ureter to relieve symptoms like swelling and to promote healing.
  • Laser Lithotripsy: Some stones cannot be treated with ESWL because of their size, location, type. In such cases, uretero-scopic laser lithotripsy may be used. In this procedure, a tiny fiberoptic camera is passed into the urinary tract through the urethra to locate the stones in the bladder, kidney or ureter. Then using laser technique, larger stone are fragmented into thousands of small pieces, which are flushed out through urine.

What are the chances of recurrence of stones after treatment?

The chances of recurrence of kidney stones are quite high. More than half people, who have had a stone in the past, will develop a new stone in their lifetime.

Next: Expert tips to prevent kidney stones

Can you provide some tips to prevent kidney stones?

1. Good fluid intake: Kidney stone patients should be passing about 2.5 3.0 litres of urine a day. So, in hot climate a little higher intake of fluids is needed.

2. Less intake of oxalate-rich foods: If you tend to form calcium oxalate stones, your doctor may recommend you to restrict the intake of oxalate-rich foods like rhubarb, beets, okra (bindi), spinach (palak), Swiss chard, sweet potatoes, nuts, tea, chocolate and soy products.

3. Low salt and low animal protein: Reduce the amount of salt you eat and choose non-animal protein sources, such as legumes.

4. Do not avoid calcium-rich foods: Calcium in food doesn't have an effect on your risk of developing kidney stones. Restricting calcium rich foods can actually increase the risk of forming stones.

5. Limit calcium supplements: You should avoid taking calcium supplements, unless advised by your doctor.

Read more about causes, symptoms, diagnosis and treatment of kidney disease.

You may also like to read:

For more articles on kidney disease, do visit our kidney disease and Diseases and Conditions Section. Follow us on Facebook and Twitter for all the latest updates! For daily free health tips, sign up for our newsletter. And to join discussions on health topics of your choice, visit our forum.

Total Wellness is now just a click away.

Follow us on