Updated 21 July 2021 | Approved By Dr. Umberto Russo
What are Kidney Stones?Kidney stones are hardened rock-like structures that build up in the kidneys. They are by-products that accumulate from the waste filtered by the kidney. They are often able to pass from the kidney into the main tube leading to the bladder called the ureter. They can often get stuck in the ureter as they pass from the kidney to the bladder. Other names for kidney stones are renal calculi, nephrolithiasis (stones located in the kidney) or urolithiasis (stones found in the kidneys, ureter or bladder). During their lifetime, kidney stones may occur in 15% of men and 8% of women in Australia . Usually, most stones will exit the body through the urine by itself. Although, during the stone’s passage, people can experience severe pain and the stone can get blocked somewhere along the urinary passage. General practitioners (GPs) play a crucial role in providing pain relief and monitoring the progress of kidney stones to ensure proper treatment is being received.
What Causes Kidney Stones?Kidney stones are caused by the accumulation of substances being filtered by the kidneys. As a natural cycle in the human body, the kidneys’ role is to remove waste from the blood. Examples include salt, toxins and acids. When the waste begins to group together, they become kidney stones.
How do you get kidney stones?There are several reasons why some people are more likely to get kidney stones than others. Usually, lifestyle behaviours and a person’s genetics are the main causes. Examples of these include :
- Dehydration, particularly in hotter climates.
- Hypercalcaemia, or too much calcium in the blood
- Side-effects from certain medications
- Having certain medical conditions (e.g. urinary tract infections, cancer, inflammatory bowel disease, etc.)
- Physical inactivity
Foods that cause kidney stonesAlthough more research is emerging, there is some association between the risk of kidney stones and consumption of excessive salt and meat . On the other hand, those who regularly drank water and consumed enough fruit and fibre had a lower risk of developing kidney stones .
Kidney Stone SymptomsSymptoms and signs of kidney stones will depend on the severity of the condition. Smaller stones might cause no discomfort at all, whereas larger ones are more notable. Consequently, kidney stone symptoms will vary depending on the size of the stone and the degree of blockage in the kidney/bladder.
- Kidney pain or pain felt on either side of the lower back
- Nausea and vomiting
- Hematuria or the presence of blood in the urine
- Increased frequency and urge to urinate
- Foul-smelling urine
- Cloudy urine
- Vague pain in the front of the stomach and/or abdomen
Tests and DiagnosisA diagnosis from a GP can be made after performing a thorough medical examination and appropriate testing. Examples of tests that may be requested include :
- Urine testing to assess for the presence of blood and to rule out a urinary tract infection
- CT scan and x-ray imaging
- Kidney stone ultrasound investigations for those who cannot undergo other imaging assessments.
- Kidney or renal function tests
- Analysis of kidney stones that may have already passed. Keeping a sample for your GP may help in determining the ongoing treatments required.
Kidney Stones TreatmentHow kidney stones are managed will depend on the size of the kidney. Smaller kidney stones may require conservative or no treatment at all. On the other hand, larger stones may require further treatment or a referral to a urologist.
Conservative TreatmentMost people with smaller stones may require careful monitoring from their GP. As long as there is no urinary tract infection and the pain is manageable, additional treatment is often unnecessary. To help with pain, GPs can prescribe painkillers and NSAIDs to ensure a more tolerable recovery . Straining your urine each time can identify if you are ultimately able to pass the stone in the urine without further intervention. Kidney stones that are stubborn or taking too long to pass may need a referral to a urologist from your GP.
Extracorporeal Shock-wave Lithotripsy (ESWL)ESWL is a procedure that uses shockwaves from outside the body to break up the stones into smaller fragments . Breaking up the stones makes it easier to pass through urine. However, multiple treatments may be required if the stones are still too large.
Percutaneous NephrolithotomyFor those who might not be eligible for ESWL or other medical consequences, this is another procedure to treat bigger stones (>2cm) . A small tubular instrument enters the kidney through an incision. Soundwaves are then released near the kidney stone(s) to help break it into smaller pieces.
Endoscope Kidney Stones RemovalEndoscopes can be used to help remove a kidney stone. These are long and thin tubular instruments with a light and camera attached at its end . They are inserted through an opening in the body with other attached equipment used to extract the stone from the body .
Kidney Stone SurgeryIf other treatments do not work or are not applicable, surgery may be required to remove the stone. With the aid of a general anaesthetic, access to the kidney is made through an incision to help remove the stone.
RecoveryAs noted earlier, most kidney stones will exit the body without additional treatment. During then, symptoms and pain can persist but can be managed with pain relief. Outside of uncommon complications, such as infection or stones that won’t budge, most people will make a full recovery.
How long does it take to pass a kidney stone?Typically, most stones will pass within 3-6 weeks .
How to prevent a kidney stoneAfter recovering from kidney stones, there is a 50% chance of the condition coming back . Some simple lifestyle changes can be made to help minimise this from occurring:
ComplicationsLarger stones that fail to dislodge or pass through the system can block the flow of urine. Over time, this can result in further health complications, such as :
- Extreme pain
- Kidney disease and damage
- Need for a kidney transplant
- Urinary and kidney infections
- Septicaemia or blood infections which can be fatal
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- Sewell, J., Katz, D. J., Shoshany, O., & Love, C. (2017). Urolithiasis-Ten things every general practitioner should know. Australian family physician, 46(9), 648-652.
- Littlejohns, T. J., Neal, N. L., Bradbury, K. E., Heers, H., Allen, N. E., & Turney, B. W. (2020). Fluid intake and dietary factors and the risk of incident kidney stones in UK Biobank: a population-based prospective cohort study. European urology focus, 6(4), 752-761.