Kidney stones Health Article

Symptoms

The main symptom is severe pain that starts suddenly and may go away suddenly:

• Pain may be felt in the belly area or side of the back
• Pain may move to groin area (groin pain) or testicles (testicle pain)

Other symptoms can include:

• Abnormal urine color
• Blood in the urine
• Chills
• Fever
• Nausea
• Vomiting

Signs and tests

Pain can be severe enough to need narcotic pain relievers. The belly area (abdomen) or back might feel tender to the touch.

Tests for kidney stones include:

• Analysis of the stone to show what type of stone it is
• Uric acid level
• Urinalysis to see crystals and red blood cells in urine

Stones or a blockage of the ureter can be seen on:

• Abdominal CT scan
• Abdominal/kidney MRI
• Abdominal x-rays
• Intravenous pyelogram (IVP)
• Kidney ultrasound
• Retrograde pyelogram

Tests may show high levels of calcium, oxylate, or uric acid in the urine or blood.

Treatment

The goal of treatment is to relieve symptoms and prevent further symptoms. (Kidney stones that are small enough usually pass on their own.) Treatment varies depending on the type of stone and how severe the symptoms are. People with severe symptoms might need to be hospitalized.

When the stone passes, the urine should be strained and the stone saved and tested to determine the type.

Drink at least 6 - 8 glasses of water per day to produce a large amount of urine. Some people might need to get fluids through a vein (intravenous).

Pain relievers can help control the pain of passing the stones (renal colic). For severe pain, you may need to take narcotic pain killers or nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen.

Depending on the type of stone, your doctor may prescribe medicine to decrease stone formation or help break down and remove the material that is causing the stone. Medications can include:

• Allopurinol (for uric acid stones)
• Antibiotics (for struvite stones)
• Diuretics
• Phosphate solutions
• Sodium bicarbonate or sodium citrate (which make the urine more alkaline)

Surgery is usually needed if:

• The stone is too large to pass on its own
• The stone is growing
• The stone is blocking urine flow and cuasing an infection or kidney damage

Today, most treatments are much less invasive than in the past.

• Extracorporeal shock-wave lithotripsy is used to remove stones slightly smaller than a half an inch that are located near the kidney. This method uses ultrasonic waves or shock waves to break up stones. Then, the stones leave the body in the urine.
• Percutaneous nephrolithotomy is used for large stones in or near the kidney, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with an endoscope that is inserted into the kidney through a small opening.
• Ureteroscopy may be used for stones in the lower urinary tract.
• Standard open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible.