Kidney stones

Kidney stones - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Kidney stones Kidney stones About kidney stones Symptoms of kidney stones Causes of kidney stones Diagnosing kidney stones Treating kidney stones Preventing kidney stones About kidney stones Kidney stones can develop in one or both kidneys and most often affect people aged 30 to 60. Theyrequite common, with around 3 in 20 men and up to 2 in 20 women developing them at some stage of their lives. The medicalterm for kidney stones is nephrolithiasis, and ifthey cause severe pain its known as renal colic. Symptoms of kidney stones Small kidney stones maygo undetected and be passed out painlessly in the urine.But its fairly common for a stone to block part of the urinary system, such as the: ureter  the tube connecting the kidney to the bladder urethra  the tube urine passes through on its way out of the body A blockage can cause severe pain in the abdomen or groin and sometimes causes a urinary tract infection(UTI) . Read more about the symptoms of kidney stones . What causes kidney stones? The waste products in the blood can occasionally form crystals that collect inside the kidneys. Over time, the crystals may build up to form a hard stone-like lump. This is more likely to happen if you dont drink enough fluids, if youre takingsome types ofmedication,or if you havea medical conditionthat raises the levels of certain substances in your urine. Read more about the causes of kidney stones . After a kidney stone has formed,your bodywill try to pass itout when you go to the toilet (in the urine). This meansit will often travel through the urinary system (the kidneys, kidney tubes and bladder). Treating and preventing kidney stones Most kidney stonesare small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication. Larger stones may need to be broken up using ultrasound orlaser energy. Occasionally, keyhole surgery may be needed to remove very large kidney stones directly. Read more about treating kidney stones . Its estimated thatup tohalf of all people who have had kidney stones will experience them again within the following 5 years. To avoid getting kidney stones, make sure you drink plenty of water every dayso you dont become dehydrated . Its very important to keep your urine diluted (clear) to prevent waste products forming into kidney stones. Read more about preventing kidney stones . Symptoms of kidney stones Very small kidney stones are unlikely to cause many symptoms. It may even go undetected and pass out painlessly when you urinate. Symptoms usually occur if the kidney stone: gets stuck in your kidney starts to travel down the ureter (the tube that attaches each kidney to the bladder) the ureter is narrow and kidney stones cancause pain as they try to pass through causes an infection In these cases, the symptoms of kidney stones can include: a persistent ache in the lower back,which is sometimes also felt in the groin men may have pain in theirtesticles and scrotum periods of intense pain in the back or side of your abdomen, or occasionally in your groin, whichmay last for minutes or hours feeling restless and unable to lie still nausea (feeling sick) needing to urinate more often than normal pain when you urinate (dysuria) blood in your urine (haematuria)  thismay be caused by the stone scratching the kidney or ureter Blocked ureter and kidney infection A kidney stone that blocks the ureter can lead to a kidney infection. This is because waste products are unable to pass the blockage, which may cause a build-up of bacteria. The symptoms of a kidney infection are similar to symptoms ofkidney stones, but may also include: a high temperature (fever) of 38C (100.4F) or over chills and shivering feeling very weak or tired diarrhoea cloudy and bad-smelling urine Read more about kidney infections . Causes of kidney stones Kidney stones are usually formed following a build-up of certain chemicals in the body. This build-upmay be any of the following: calcium ammonia uric acid a waste product produced when the body breaks down food to use as energy cysteine an amino acid that helps to build protein Certain medical conditions can lead to an unusually high level of these substances in your urine. Youre alsomore likely to develop kidney stones if you dont drink enough fluids. Recurrent kidney stones Some people are particularly likely to keepon developing kidney stones, including people who: eat a high-protein, low-fibre diet areinactive or bed-bound have a family history of kidney stones have had several kidney or urinary infections have had a kidney stone before, particularly if it was before you were 25 have only one fully working kidney have had an intestinal bypass (surgery on your digestive system), or a condition affecting the small intestine, such as Crohns disease Medication Theres evidence to suggest that certain medications may increase your risk of developing recurrent kidney stones. These include: aspirin antacids diuretics (used to reduce fluid build-up) certain antibiotics certain antiretroviral medication(used to treat HIV ) certain anti-epileptic medication Types of kidney stones Kidney stones can develop for a number of reasons. Calcium stones Calcium stones are the most common type of kidney stone and form if theres too much calcium in the urine, which can be due to: an inheritedcondition called hypercalcuria, which leads tolarge amounts of calcium in urine an overactive parathyroid gland (the parathyroid glands help to regulate the amount of calcium in your body) kidney disease a rare condition called sarcoidosis some cancers Calcium stones are usually either large and smooth or spiky and rough. Struvite stones Struvite stones are often caused by infections, and they most commonly occur after a urinary tract infection thats lasted a long time. Struvite stones are more common in women than men. Uric acid stones Uric acid stones can form if theres a large amount of acid in your urine. They may be caused by: eating a high-protein diet that includes lots of meat a conditionsuch as gout that prevents the body breaking down certain chemicals an inherited condition that causes higher than normal levels of acid in the body chemotherapy Cystine stones Cystine stones are the rarest type of kidney stone. Theyre caused by an inherited condition called cystinuria, which affects the amount of acid that is passed in your urine. Diagnosing kidney stones Your GP will usually be able to diagnose kidney stones from your symptoms and medical history. It will be particularly easy if youve had kidney stones before. You may be given tests, including: urine tests to check for infections and pieces of stones an examination of any stones that you pass in your urine blood tests to check that your kidneys are working properly, and to also check the levels of substances that could cause kidney stones, such as calcium You can collecta kidney stone by urinating through some gauze or a stocking. Having a kidney stone to analyse will make a diagnosis easier, and may help your GP determine which treatment method will be of most benefit to you. If you have severe pain that isnt controlled by painkillers, or if you have a high temperature as well as pain, you may be referred to a urologist (a specialist in treating urinary problems). Imaging tests If yourereferred to hospital for an imaging test,a number of different techniques may be used. Imaging tests can help confirm the diagnosis, or identify precisely where a kidney stone is. These testsinclude: a computerised tomography (CT) scan  where a series of X-rays at slightly different angles are taken and a computer is used to put the images together X-ray  an imaging technique that uses high-energyradiation to highlight abnormalities in body tissue an ultrasound scan uses high-frequency sound waves to create an image of the inside of your body an intravenous urogram (IVU) or intravenous pyelogram (IVP)  a dye that shows up on X-ray is injected into a vein in your arm; the X-ray image highlights any blockages as the kidneys filter the dye out of your blood and into yoururine CT scans are now often used because theyre thought to be more accurate. IVUs were previously the preferred imaging method. The imaging technique you have may depend on whats availableat your local hospital. Treating kidney stones Most kidney stones are small enough (less than 4mm in diameter) to be passed out in your urine and can probably be treated at home. But even small kidney stones can be painful, although thisusually only lasts a couple of days and disappears when the stone has been passed. Medication If you are in severe pain, your GP can give you pain relief by injection. A second dose can be given after half an hour if youre still experiencing pain. Medication can also be injected to treat the symptoms of nausea (feeling sick) and vomiting. This is called an anti-emetic (anti-sickness) medication. You may also be given a prescription for painkillers, anti-emetics, or both, to take at home. Self care You may be advised to wait until you pass your kidney stone when you go to the toilet, and to try to collect it from your urine. You can do this by filtering your urine through gauze or a stocking. Give the stone to your GP so that they can have it analysed to help determine any further treatment you may need. You should drink enough water to make your urine colourless. If your urine is yellow or brown, youre not drinking enough. Admission to hospital If your kidney stone has moved into your ureter (the tube that carries waste products from the kidneys to the bladder), and its causing severe pain, your GP may admit you to hospital for treatment. This may be necessary if: youre at an increased risk of your kidneys failing(for example, because you only have one kidney) your symptoms dont improve within an hour of being given painkillers or anti-sickness medication youredehydrated and vomiting too much to keep fluids down youre pregnant youre over 60 years of age Treating large kidney stones If a kidney stone is too big to be passed naturally 6mm to 7mm(about 0.23in to 0.27in)in diameter or larger  you may need treatment to remove it another way. This could include: extracorporeal shock wave lithotripsy (ESWL) ureteroscopy percutaneous nephrolithotomy (PCNL) open surgery The type of treatment you have will depend on the size and location of your stones. Extracorporealshock wave lithotripsy (ESWL) ESWL is the most common way of treating kidney stones that cant be passed in the urine. It involves using ultrasound (high-frequency sound waves) to pinpoint where a kidney stone is. Ultrasound shock waves are then sent to the stone from a machine to break it into smaller pieces, so it can be passed in your urine. ESWL can be an uncomfortable form of treatment, so its usually carried out after giving painkilling medication. You may need more than one session of ESWL to successfully treat your kidney stones. ESWL is up to 99% effective for stones up to 20mm (0.8in) in diameter. Ureteroscopy If a kidney stone is stuck in the ureter, you may need to have a ureteroscopy, which is also sometimes known as retrograde intrarenal surgery (RIRS). Itinvolves passing a long, thin telescope called a ureteroscope through your urethra (the tubeurine passes through on its way out of the body) andinto your bladder. Its then passed up into your ureter to where the stone is stuck. The surgeon may either try togently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so that it can be passed naturally in your urine. Ureteroscopy is carried out under general anaesthetic (where youre unconscious), so you shouldnt drive or operate machinery for up to 48 hours after the procedure. For stones up to 15mm (0.6in), a ureteroscopy is effective in 50% to 80% of cases. Aplastic tube called a stent may need to betemporarily inserted inside you to allow the stone fragments to drain into the bladder. Percutaneous nephrolithotomy (PCNL) PCNL is an alternative procedure that may be used for larger stones. It may also be usedif ESWL isnt suitable for example, because the person being treated is obese. PCNL involves using a thin telescopic instrument called a nephroscope. A small incision is made in your back and the nephroscope is passed through it and into your kidney. The stone is either pulled out or broken into smaller pieces using a laser or pneumatic energy. PCNL is always carried out under general anaesthetic,so you shouldnt drive or operate machinery for up to 48 hours after the procedure. PCNL is 86% effective for stones that are 21mm to 30mm (0.8in to 1.2in) in diameter. Open surgery Nowadays, open surgery for kidney stones is rare. Less than 1% of cases require this type of surgery. Its only usually used if theres a very large stone or abnormal anatomy. During open surgery, an incision will be made in your back so that your surgeon is able to access your ureter and kidney. The kidney stone can then be removed. Treating uric acid stones If you have a uric acid stone, you may be advised to drink around 3 litres (just over 5 pints) of water each day to try to dissolve it. Uric acid stones are much softer than other types of kidney stone, and they can be made smaller if theyre exposed to alkaline fluids. Youmay need to take some medication to make your urine more alkaline before the uric acid stone starts to dissolve. Complications of treatment Complications can occur following the treatment of large kidney stones. Your surgeon should explain these to you before you have the procedure. Possible complications will depend on the type of treatment you have and the size and position of your stones.Complications could include: sepsis  an infection that spreads through the blood, causing symptoms throughout the whole body a blocked ureter caused by stonefragments; the ureter is the tube that attaches the kidney to the bladder an injury to the ureter a urinary tract infection bleeding during surgery pain Its estimated that 5% to 9% of people may experience complications after having a ureteroscopy. Preventing kidney stones The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated. Keeping your urine diluted helps to stop waste products getting too concentrated and forming stones. You can tell how diluted your urine is by looking at its colour. The darker your urine is, the more concentrated it is. Your urine is usually a dark yellow colour in the morning because it contains a build-up of waste products that your body has produced overnight. Drinks such as tea, coffee and fruit juice can count towards your fluid intake, but water is the healthiest option and is best for preventing kidney stones developing. You should also make sure you drink more when its hot or when youre exercising, to replenish fluids lost through sweating. Read more about preventing dehydration . Diet If your kidney stone is caused by too much calcium, you may be advised to reduce the amount of oxalates in your diet. Oxalates prevent calcium being absorbed by your body, and can accumulate in your kidney to form a stone. Foods that contain oxalates include: beetroot asparagus rhubarb chocolate berries leeks parsley celery almonds, peanuts and cashew nuts soy products grains, such as oatmeal, wheat germ and wholewheat Dont reduce the amount of calcium in your diet unless your GP advises you to. This is because calcium is very important for maintaining healthy bones and teeth. To avoid developing a uric acid stone, you should reduce the amount of meat, poultry and fish in your diet. You may also be prescribed medication to change the levels of acid or alkaline in your urine. Medication If you have a kidney stone, medication will usually be prescribed for pain relief or to prevent infections developing. However, some medication may need to be reviewed by your GP if its thought to be causing your kidney stone. The type of medication your GP prescribes will depend on the type of kidney stone you have. For example, if you have: calcium stones you may be prescribed adiuretic medication if they are caused by hypercalcuria (an inherited condition) struvite stones you may be prescribed antibiotics to help prevent a urinary tract infection or kidney infection , which are the main causes of struvite stones uric acid stones  you may be prescribed allopurinol (a medication used to lower uric acid levels) and medication to help alkalise your urine cystine stones  you may be prescribed medication to lower levels of cystine inyour urine Source: NHS 24 - Opens in new browser window Last updated: 01 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. 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