There is no indication for IM medications in treating renal colic. IV fluids should be used to maintain hydration. However, the use of large volumes of fluid is controversial and may increase pain in the patient with an obstructed ureter by increasing hydrostatic pressure behind the stone. The majority of stones will pass spontaneously within 48 hours. Renal injury from obstruction generally does not occur for at least 72 hours.
Hospital admission is required.
If parenteral analgesics are required, if persistent vomiting prevents adequate oral hydration, if pyelonephritis is suspected, or if patient has elevated BUN and creatinine, oliguria or anuria. All urine should be strained, and any stones found brought for analysis. All patients with kidney stones should increase their daily fluid intake regardless of the composition of the stones. Analysis of the stones may identify specific preventive measures. There is good evidence that reducing the dietary intake of animal protein can reduce stone formation.