Kidney Stones: Causes, Symptoms & Treatment

Kidney stones are hard crystalline deposits composed primarily of calcium oxalate, calcium phosphate, uric acid, or other minerals that form in the kidneys and urinary tract. These stones can vary in size from tiny sand-like particles to larger than a marble. While some pass without symptoms, larger stones may cause severe pain and urinary tract obstruction requiring intervention.

The incidence of kidney stones has been increasing over the past 20 years, particularly in industrialized nations.

Formation requires:

• Stone-forming substances (calcium, oxalate, urate)
• Reduced urine volume (dehydration)
• Altered urine pH
• Urinary stasis

Risk factors include:

• Male gender
• Age 30-60
• Family history
• Dehydration
• High sodium diet
• High protein diet
• Gout history
• Recurrent UTIs

Most common symptoms:

• Severe flank pain (renal colic)
• Hematuria (blood in urine)
• Dysuria
• Frequency and urgency
• Nausea and vomiting
• Pain radiating to groin

Pain intensity can be comparable to childbirth and typically comes in waves.

Diagnosis involves:

• Clinical presentation
• Urinalysis (hematuria, crystalluria)
• Imaging: CT without contrast (gold standard)
• Ultrasound
• X-ray (only for radiopaque stones)
• Urine culture

Conservative management (for small stones):

• Hydration (2-3 liters daily)
• Pain management (NSAIDs, opioids)
• Anti-emetics for nausea
• Watchful waiting for passage

Intervention for large or obstructing stones:

• Extracorporeal shock wave lithotripsy (ESWL)
• Ureteroscopy with laser lithotripsy
• Percutaneous nephrolithotomy (PCNL)

Prevention strategies include:

• Adequate hydration (maintain urine output >2 liters)
• Reduced sodium intake
• Limited animal protein
• Moderate calcium intake
• Limited high-oxalate foods
• Citrate supplementation

Seek immediate care for severe flank pain, fever with stone symptoms, or inability to urinate. Follow-up care is important for stone composition analysis and recurrence prevention.