Kidney stones are well known for causing excruciating pain. In surveys ranking medical conditions by how much pain they cause, kidney stones and gunshot wounds typically rank near the top of the list. But pain is just one aspect of this common medical condition. Here is a comprehensive look at eight important facts you need to know about kidney stones.
1. Cases of kidney stones have increased significantly. Developed countries in particular have seen a doubling in the prevalence of kidney stones during the past few decades. In the U.S., the prevalence of kidney stones has increased from a rate of about 5% of the population to nearly 10%. Having a family history of kidney stones increases a person’s risk for getting them. Men get kidney stones at about twice the rate as women. Infants and children get kidney stones, too.
Nutrition and lifestyle changes are believed to be the main factors causing more kidney stones. A typical diet contains a lot more processed junk foods, more preservatives and more sodium. And the increase in kidney stones is consistent with similar trends in
so-called lifestyle diseases such as high blood pressure, diabetes and obesity, each of which is a risk factor for kidney stones.
2. Dehydration encourages stones to form. Kidney stones are hard objects formed from concentrated amounts of salt, calcium and minerals that crystallize in the urine. Without enough liquid to excrete the salt, calcium and minerals out of the body through the urine, the kidney stones will grow in size. A kidney stone may remain in the kidney, where it won’t cause pain, or it can leave the kidney and move down the urinary tract into the ureter.
3. The pain moves with the kidney stone. The pain comes when the stone causes a blockage or back-up of urine in the kidney, which reacts by trying to force out the blocked urine. The pain from the kidney will be felt in the upper back, and as the stone moves down through the urinary tract, the location of the pain will move, too — lower at first and then forward toward the abdomen. The movement of the kidney stone can also cause cuts and bleeding along its path, as evidenced by the blood appearing in urine.
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4. Hydration helps prevent kidney stones, and is a treatment too. Along with healthy nutrition habits, exercise and weight control,
staying hydrated by drinking a sufficient volume of water helps prevent kidney stones from forming, and drinking water is often the most effective way to help the body excrete already-formed stones.
5. Look for these symptoms. In general, symptoms become more noticeable as the size of the kidney stone increases. The most common symptoms include:
- Severe pain that comes in waves from one or both sides of the lower back
- A stomach ache that doesn't resolve itself
- Having blood in the urine
- Having frequent urges to urinate but producing very little urine
- Nausea, vomiting
- Fever, chills
- Foul-smelling and/or cloudy urine
6. Without treatment, serious trouble may follow. The excruciating pain is usually what prompts people to seek medical treatment for suspected cases of kidney stones. Leaving the condition untreated can lead to complications such as blood in the urine and various types of urinary tract infections (UTIs). Not receiving proper treatment also puts you at greater risk for developing serious health problems later on, including
kidney failure and
chronic kidney disease (CKD).
7. Kidney stones tend to recur. Once you experience a first instance of kidney stones, your odds of having a future recurrence rise significantly. In addition to staying hydrated, your doctor can recommend changes to your diet that can help prevent kidney stones from forming.
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8. There are numerous effective treatment options. Your doctor can choose from a wide range of kidney stone treatments, up to and including surgical removal. But the overall approach taken should be conservative, meaning that if the stone is not causing a blockage of the urine flow, is not causing pain and is small in size, it should be left to come out on its own. If it causes pain during the process of coming out but is smaller than 5 mm, a conservative approach would entail helping control the pain, maintaining hydration and considering prescribing medications as well.
Other options include treatments capable of breaking the stone into smaller pieces as well as minimally invasive endoscopy techniques that determine the location of the kidney stone and effect its removal. These include:
- Cystoscopy, a minimally invasive procedure used to remove a kidney stone that is large enough that it is unlikely to clear on its own, yet not so large as to require surgical removal. The cystoscope device is inserted into the urethra. It is equipped with a tiny camera and a basket-like tool capable of grabbing the stone and holding it in the basket until the device is removed.
Kidney stones don’t affect everyone in the same way, and your symptoms may seem different from your expectations. If you are uncertain whether your symptoms are serious enough to warrant seeing a doctor, use these two simple guidelines: 1. If you have blood in your urine, see a doctor; 2. If you experience severe pain, see a doctor.
By
Dr. Tatpong Chit-ua-aree, Kidney (Nephrology) specialist, Bumrungrad International Hospital
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