What women should know about kidney stones

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Kidney stones can be tiny, sometimes as small as a grain of sand or rice, but they can still cause severe pain. This is because the pain is usually due to a stone blocking or stretching the ureter (the tube that carries urine from the kidney to the bladder) as it travels through the urinary tract.

Here you can find out everything you need to know about kidney stones, their causes and treatments.

What is a kidney stone?

The kidney is responsible for purifying your blood and excreting waste products through urine. If your urine contains too many minerals and salts and too little water to dissolve, they can clump together and form kidney stones.

The minerals and salts that most commonly form kidney stones are calcium, oxalate, uric acid, cystine and phosphate.

Why do kidney stones form?

Kidney stones usually arise from a combination of several factors, such as:

Diet and lifestyle: Not enough fluids, a diet high in salt or animal protein, too many sugary drinks, and too many oxalate-rich foods (such as spinach, beets, nuts, and chocolate)
Medicines and nutritional supplements: High doses of vitamin C, calcium supplements (especially when taken without food), and frequent use of laxatives and certain medications (e.g., topiramate for migraines or seizures or some HIV medications)
Certain medical disorders: Conditions such as obesity, hyperparathyroidism, chronic diarrhea or malabsorption (including inflammatory bowel disease), gout, recurrent urinary tract infections, and rare genetic disorders such as primary hyperoxaluria (which causes the body to produce too much oxalate)
The genetics: You have a family member who has had one or more kidney stones

How many types of kidney stones are there?

There are four types of kidney stones:

Calcium stones: This is the most common type of kidney stones. Many are calcium oxalate stones. Oxalate is produced by the body and is also found in some foods (e.g. spinach, nuts and chocolate). Calcium phosphate stones are less common and may be associated with certain metabolic disorders or medications (including some used to prevent migraines or seizures).
Uric acid stones: Uric acid stones can form when urine is constantly acidic. Risk factors include gout, dehydration, chronic diarrhea, diabetes, and a diet high in purines (found in foods such as organ meats and some shellfish).
Struvite calculations: Struvite stones (sometimes called infection stones) can form after a urinary tract infection caused by certain bacteria. They can quickly increase in size and become large.
Cystine calculations: Cystine stones are the product of a rare genetic disorder called cystinuria, which causes too much cystine to pass into your urine.

What are the symptoms of kidney stones?

Kidney stones can cause symptoms once they enter the ureter, the group of tubes that connect the kidneys to the bladder. One of the first symptoms is sudden, severe pain, including:

Stitching pain in the side of the chest and back, below the ribs
Pain spreading to the lower abdomen and crotch
Pain or burning when urinating

The pain may also occur intermittently and change in intensity. And as the kidney stone moves through the urinary tract, the pain can move in that direction too.

Other symptoms of a kidney stone include:

Pink, red, or brown urine
Foggy or foul-smelling urine
A constant feeling that you need to urinate, urinating more often than normal, urinating in small portions
Nausea or vomiting
Fever and chills (If you have a fever and chills, seek medical attention immediately. This could be a sign of infection.)

Do kidney stones cause complications?

Most people recover from kidney stones without long-term problems. However, sometimes they can cause complications, especially if they block the flow of urine or cause an infection. People with recurring stones may also be at higher risk of chronic kidney disease. Research has also found links between kidney stones and conditions such as high blood pressure, cardiovascular disease and lower bone density, but these links do not necessarily mean that stones directly cause these conditions.

The Are there treatments for kidney stones?

Most kidney stones are passed through urination without the need for additional action. This process can be very uncomfortable or painful. Therefore, your doctor may prescribe medication to help the stones pass more easily and relieve nausea, vomiting, and pain.

If kidney stones are too large to be removed without additional measures, you will most likely need to undergo a procedure to break them up or remove them.

Shock wave lithotripsy: Shock waves are used to break a stone into smaller pieces so they can be excreted in your urine.

Ureteroscopy: A thin ureteroscope is passed through the urethra and bladder to the ureter. A laser can crush the stone and the pieces can be removed with a small basket. Sometimes a temporary catheter is inserted to keep urine flowing while the swelling goes down.

Percutaneous nephrolithotomy: Used for larger or more complex calculations. A surgeon makes a small incision in your back and uses an endoscope to reach the kidney, break up the stone and remove the pieces.

Laparoscopic or open surgery: Surgery is currently very rare for kidney stones, but could be used in certain cases where other treatments are not an option.

This educational resource was created with support from Alnylam.

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