Kidney Stones: A Common, Often Painful Complaint

The following is part 1 in a 2-part series. Part 2 will focus on advanced treatments used to break up or remove kidney stones.听
Some kidney stone sufferers, especially if they鈥檙e female, describe the pain they experience as worse than childbirth.听听
Before a stone leaves the kidney, you may not even know you have one. But once it starts its journey through the urinary tract, the pain it causes can be severe and debilitating.听
Kidney stones are fairly common, says Dr. Luay Alshara, an endourologist and robotic surgeon who serves as an associate professor of urology and an associate attending urologist at 91麻豆精品. In the United States, he says, about 1 in 10 people will experience a stone at some point in their lifetime.听
Keep reading for answers to your FAQs about kidney stones, including:听
- what they鈥檙e made of听
- who is at greatest risk for developing them听
- how they鈥檙e diagnosed听
- their symptoms听
- managing the pain they cause听
- prevention听
What are kidney stones?听
Kidney stones are hard deposits that form in the kidneys from minerals and salts in the urine. They can vary in size, from as small as a grain of sand to as large as a golf ball.听
What are they made of?听
Their composition varies, Dr. Alshara says. Here are the most common types:听
Calcium stones are the most common type of kidney stone, accounting for roughly 80 percent of cases. Calcium oxalate stones are the most common subtype. These may form when calcium combines with oxalate, a compound found in certain foods such as spinach, nuts and chocolate.听听
Uric acid stones develop when a person鈥檚 urine is too acidic, often due to:听
- a diet that includes large amounts of red meat and shellfish听
- dehydration听
- gout鈥攁n inflammatory condition in which uric acid accumulates in the joints听
Struvite stones are composed of magnesium ammonium phosphate. They鈥檙e usually caused by urinary tract infections (UTIs) that produce ammonia. Struvite stones can grow quite large, and they鈥檙e more common in women than in men.听
Who is at risk for developing stones?听
A combination of lifestyle, medical and genetic factors may heighten a person鈥檚 risk of developing kidney stones. Higher-risk individuals include the following:听
People with a family or personal history of kidney stones听
About half of those who have had one kidney stone will develop another one within 5 to 10 years.
Dehydration
People who don鈥檛 drink enough water, live in a hot, dry climate or sweat excessively are at higher risk for developing a stone.听听
People with certain dietary habits
- high salt intake
- high levels of animal protein
- high oxalate foods
- low calcium intake
People with obesity or metabolic syndrome听
- Obesity, diabetes and high blood pressure are linked to an increased risk of stones.听
- Insulin resistance, common in type 2 diabetes, can increase calcium in the urine.听
Those with certain medical conditions听
- UTIs听
- Gout听
- Hyperparathyroidism (overactive parathyroid glands)听
- Inflammatory bowel disease (IBD) or chronic diarrhea听
- Cystinuria (a rare genetic disorder)听
Sedentary individuals听
People who have had gastric bypass surgery听
- Weight-loss surgery can alter digestion and increase the absorption of oxalate, raising the risk of calcium oxalate stones.听
How do you diagnose kidney stones?听
鈥淜idney stones are often discovered during imaging tests conducted for other reasons,鈥 says Dr. Alshara. 鈥淥n the other hand, when a patient comes to us with the symptoms we associate with stones, we take a thorough history, perform a physical exam and order blood tests and imaging studies.听听
鈥淚maging is the most reliable way to confirm the presence, size and location of a kidney stone,鈥 he continues. 鈥淚n people with recurrent stones, a full metabolic evaluation is often part of the process as well,鈥 including a 24-hour urine analysis, blood tests and stone analysis.听
What are the symptoms of a kidney stone?听
Kidney stones can cause a variety of symptoms, depending on their size and location, and whether they鈥檙e obstructing your urinary tract. Symptoms can range from mild discomfort to severe, debilitating pain on your side, in the back below your ribs or in your lower abdomen. The pain may radiate to your groin as the stone moves through your urinary tract.听
Additional symptoms may include:听
- blood in the urine听
- urinary symptoms, from pain to frequency, urgency or difficulty urinating听
- nausea and vomiting听
- cloudy or foul-smelling urine听
- fever and chills听
- small stones or sand-like particles in the urine听
Seek medical attention if:听
- medication doesn鈥檛 relieve your pain听
- you have a fever and chills听
- you can鈥檛 urinate听
- you have persistent nausea and vomiting听
How do you manage the pain caused by a stone?听
Over-the-counter medications such as ibuprofen (Motrin, Advil), naproxen (Aleve) and acetaminophen (Tylenol) are the first line of defense against pain, Dr. Alshara says. 鈥However, your pain may require stronger, prescribed medications and muscle relaxants to help relax the ureter and ease the passage of a stone.听
鈥淲e also encourage patients to drink plenty of water to help flush out the urinary system,鈥 he adds. 鈥淭hat may help the stone to pass more quickly. A heating pad can also be applied to the affected side to relax the muscles and relieve pain.鈥听
If your pain is unbearable, you may need to seek emergency care.听
Prevention听
Preventing kidney stones may involve a combination of dietary changes, lifestyle modifications and, in some cases, medication鈥攅specially for people who have had prior episodes.听
鈥淭he goal is to reduce the risk factors that contribute to stone formation,鈥 Dr. Alshara says.鈥听
Here are his best recommendations:听
- Stay hydrated. Aim for at least 10 to 12 cups of water a day to keep your urine diluted.
- Make dietary changes.听
- Reduce salt intake.听
- Limit foods high in oxalate, such as spinach, rhubarb, nuts, nut butters, chocolate and tea.听
- Get enough calcium from food sources, such as dairy products and leafy greens, rather than from supplements.听
- Limit animal protein.听
- Increase citrate-rich foods. Citrate prevents stone formation by binding to calcium in the urine. Choose citrus fruits or drink lemon water.听听
- Maintain a healthy weight.听听
- Exercise regularly.听听
- Take your medications as prescribed by your doctor.听
- Undergo periodic metabolic evaluation鈥攅specially if you鈥檝e had prior episodes. Based on the results, your doctor can tailor a prevention plan to address your particular risk factors.听
Stay tuned for part 2 of this series, which will provide information about ways to break up or remove 鈥済arden variety鈥 as well as complex kidney stones.听
Take control of your kidney health. Make an appointment with a specialist by calling 646-962-9600.听