Kidney stones

Specialty of Nephrology

What are kidney stones? 

Kidney stones are solid masses that are created in the kidney due to substances in the urine. The size of stone can vary, it can be as small as a grain of sand or as big as a pearl.    

It is thought that 10 out of every 100 people will have a kidney stone at least once in their life. Kidney stones are normally able to pass through the body without the need for medical help.    

What are the symptoms?

People who have kidney stones quite often have a relative who has also had them. The most common symptoms are:

  • Back pain
  • Pain on one side of the spine and below the ribcage
  • Nausea and vomiting
  • Blood in the urine or burning
  • Frequent need to pee.

What causes it?

Kidney stones happen when there are high levels of calcium, oxalate, and phosphorus in the urine. These minerals are normally in the urine, and when present at low levels, they do not cause any issues.  

  • Calcium stones: are the most common. They form when part of the calcium not used by the bones and muscles is not eliminated through the urine and it accumulates.
  • Uric acid stones: These form when there is too much uric acid in the urine. This normally happens when too many proteins are consumed or after chemotherapy treatment.
  • Struvite stones: these are normally made of ammonia and are more common in women.
  • Cystine stones: these form due to a genetic disorder called cystinuria, although this is not very common.   

How can they be prevented?

There are many suggestions to avoid having a kidney stone:

  • Drinks lots of liquid: mainly water, 6 to 8 glasses a day ideally.
  • Have a balanced diet: reduce the amount of proteins and avoid alcohol and caffeine.
  • Diuretic medicines: such as hydrochlorothiazide, potassium citrate, or allopurinol, each according to the patient and always supervised by a urologist.   

What is the treatment?

Treatment will vary according to the size, location, and type of stone. The smallest ones are able to pass through the urinary tracts without being detected and without the need for medical treatment. For these kidney stones, the recommendation is to drink plenty of fluids and prescriptions can be made if needed for painkillers.

Bigger kidney stones, which quite often cause pain or obstruct the urinary tract, will more often than not need emergency treatment. There are different options that the urologist can choose to remove the stone or break it down:

  • Lithotripsy by shock waves: breaks down the stones in order for them to come out via the urinary tract.
  • Cystoscopy and ureteroscopy: the doctor locates the stone and can remove it or break it down into smaller pieces. After treatment, the patient can normally go straight home.  
  • Percutaneous nephrolithotomy: is used to remove the stone, or if the stone is really big, laser is used to break it down. After this treatment, the patient quite often has to stay in the hospital a few days.     

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