Kidney stones can be tiny—sometimes as small as a grain of sand or rice—but still cause severe pain. This is because the pain usually occurs when a stone blocks or stretches the ureter (the tube that carries urine from the kidney to the bladder) as it moves through the urinary tract.
Here’s what you need to know about kidney stones, what causes them, and how to treat them.
What is a kidney stone?
The kidney’s job is to clean your blood and eliminate waste products through your urine. If your urine contains too many minerals and salts and too little water to dissolve in, they can stick together and form kidney stones.
The most common minerals and salts that form kidney stones are calcium, oxalate, uric acid, cystine and phosphate.
What causes kidney stones?
Kidney stones are usually caused by a combination of several factors, such as:
- Diet and lifestyle — Drinking too little fluid, eating a diet high in salt or animal protein, drinking lots of sugary drinks, eating lots of foods high in oxalates (such as spinach, beets, nuts and chocolate).
- Medicines and nutritional supplements – High-dose vitamin C, calcium supplements (especially when taken without food), frequent use of laxatives, and certain medications (e.g., topiramate for migraines or seizures or some HIV medications)
- Certain health conditions – Conditions such as obesity, hyperparathyroidism, chronic diarrhea or malabsorption (including inflammatory bowel disease), gout, recurrent urinary tract infections, and rare genetic conditions such as primary hyperoxaluria (which causes the body to produce too much oxalate)
- genetics — A family member has one or more kidney stones
What types of kidney stones are there?
There are four types of kidney stones:
- Calcium stones — Calcium stones are 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 (such as spinach, nuts and chocolate). Calcium phosphate stones are less common and may be related to certain metabolic disorders or medications (including some medications used to prevent migraines or seizures).
- Uric acid stones — Uric acid stones can form when urine is persistently 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 stones — Struvite stones (sometimes called infection stones) can form after a urinary tract infection caused by certain bacteria. They can grow quickly and become large.
- cystine stones – Cystine stones are caused by a rare genetic condition called cystinuria, which causes too much cystine to pass into your urine.
What are symptoms of kidney stones?
Kidney stones can cause symptoms once they enter the ureters – the tubes that connect the kidneys to the bladder. One of the first symptoms is sudden, severe pain, including:
- Stitching pain in the side and back, below the ribs
- Pain spreading to the lower abdomen and groin
- Pain or burning when urinating
The pain may also come and go, changing the way in which it hurts. And as the kidney stone moves through the urinary tract, the pain may move with it.
Other symptoms of a kidney stone include:
- Pink, red, or brown urine
- Cloudy or foul-smelling urine
- A constant feeling that you need to urinate, urinating more often than usual, or urinating in small amounts
- Nausea or vomiting
- Fever and chills (If you experience fever and chills, seek medical attention immediately. This may be a sign of infection.)
Do kidney stones cause complications?
Most people recover from kidney stones without lasting problems. But sometimes they can cause complications, especially if they block the flow of urine or lead to 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 don’t necessarily mean that stones directly cause them
What are Kidney Stone Treatments?
Most kidney stones go away on their own when you urinate. This process can be very uncomfortable or painful. Therefore, your doctor may prescribe medication to make it easier to pass the stones and relieve nausea, vomiting and pain.
If the kidney stones are too large to pass on their own, you will likely need a procedure to break them up or remove them.
Shock wave lithotripsy – Uses sound waves to break a stone into smaller pieces so they can be excreted in urine.
Ureteroscopy — A thin scope is inserted through the urethra and bladder into the ureter. A laser can crush the stone and the pieces can be removed with a small basket. Sometimes a temporary stent is inserted to keep urine flowing while the swelling goes down.
Percutaneous nephrolithotomy — Used for larger or complex stones. A surgeon makes a small incision in your back and uses a scope to reach the kidney, break up the stone and remove pieces.
Laparoscopic or open surgery — Surgery for kidney stones is rarely required these days, but can be performed in selected cases when other treatments are not an option.
This educational resource was created with support from Alnylam.
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