- Dehydration: Not drinking enough water is a leading cause, as it reduces urine volume and allows stone-forming substances to become more concentrated.
- Diet:
- High sodium intake: Can increase the amount of calcium in your urine.
- High animal protein intake: Can increase uric acid levels and reduce citrate, which helps prevent stones.
- High oxalate foods: Foods like spinach, chocolate, nuts, and tea are high in oxalate, which can bind with calcium to form stones.
- Obesity: Higher body mass index (BMI) has been linked to an increased risk of kidney stones.
- Digestive Diseases and Surgery: Conditions like Crohn's disease, ulcerative colitis, or gastric bypass surgery can affect calcium and water absorption, increasing stone risk.
- Medical Conditions:
- Hyperparathyroidism: Leads to high calcium levels in the blood and urine.
- Renal tubular acidosis: A condition in which the kidneys fail to excrete acids into the urine, leading to an overly alkaline urine and the formation of calcium phosphate stones.
- Cystinuria: A rare genetic disorder that causes the amino acid cystine to leak into the urine, forming cystine stones.
- Urinary tract infections (UTIs): Some UTIs can produce struvite stones.
- Gout: Can lead to higher uric acid levels, increasing the risk of uric acid stones.
- Certain Medications: Diuretics, some anti-seizure medications, and calcium-based antacids can increase stone risk.
- Family History: If someone in your family has had kidney stones, you're more likely to develop them.
- Supplements: High doses of Vitamin C and Vitamin D supplements can increase the risk of certain types of stones.
- Severe Pain in the Side and Back: Below the ribs (renal colic). This pain may radiate to the lower abdomen and groin.
- Pain That Comes in Waves: And fluctuates in intensity.
- Pain or Burning Sensation During Urination.
- Pink, Red, or Brown Urine: Due to blood in the urine (hematuria).
- Cloudy or Foul-Smelling Urine.
- Nausea and Vomiting.
- Persistent Need to Urinate.
- Urinating More Often Than Usual.
- Fever and Chills: If an infection is present.
- Small Amount of Urine: Or difficulty urinating.
- Medical History and Physical Exam: The doctor will ask about your symptoms, diet, fluid intake, and any family history of kidney stones. A physical exam may reveal tenderness in the back or abdomen.
- Urine Tests:
- Urinalysis: To check for blood, infection, and levels of stone-forming substances.
- 24-hour urine collection: To measure the volume of urine and the levels of minerals and salts that form stones.
- Blood Tests: To check kidney function and levels of calcium, phosphorus, uric acid, and electrolytes.
- Imaging Tests:
- X-ray (Kidneys, Ureters, and Bladder - KUB): Can detect some types of kidney stones.
- CT Scan (Computed Tomography): Often the preferred imaging test for kidney stones, as it can detect even small stones and show their precise location.
- Ultrasound: A non-invasive test that can identify kidney stones, especially in pregnant women or those who need to avoid radiation.
- Intravenous Pyelogram (IVP): Involves injecting a dye into a vein and taking X-rays to visualize the urinary tract and identify obstructions. Less commonly used now with the advent of CT scans.
- Stone Analysis: If you pass a stone, it will be collected and analyzed to determine its composition. This helps in understanding the cause and guiding preventive measures.
- Conservative Management (for small stones):
- Drink Plenty of Water: 2 to 3 quarts (1.8 to 3.6 liters) of water a day to help flush out the stone.
- Pain Relievers: Over-the-counter pain medications (e.g., ibuprofen, naproxen) or prescription pain relievers.
- Alpha-Blockers: Medications like tamsulosin (Flomax) can relax the muscles in your ureter, making it easier for the stone to pass.
- Medical Procedures (for larger or problematic stones):
- Extracorporeal Shock Wave Lithotripsy (ESWL): Uses sound waves to break the stones into tiny pieces that can then be passed in the urine.
- Ureteroscopy: A thin, lighted scope (ureteroscope) is passed through the urethra and bladder into the ureter to locate and remove or break up the stone with a laser.
- Percutaneous Nephrolithotomy (PCNL): For very large or complex stones. A small incision is made in the back or side, and a scope is inserted directly into the kidney to remove the stone.
- Parathyroid Gland Surgery: If kidney stones are caused by an overactive parathyroid gland, surgical removal of the affected gland may be recommended.
- Dietary and Lifestyle Changes (for prevention):
- Increase Fluid Intake: Especially water, to produce at least 2 liters of urine daily.
- Reduce Sodium Intake: Avoid high-sodium processed foods.
- Limit Animal Protein: Especially red meat.
- Moderate Oxalate Intake: If you form calcium oxalate stones, your doctor may advise reducing high-oxalate foods.
- Maintain a Healthy Weight.
- Medications (to prevent future stones, based on stone type):
- Thiazide diuretics: For calcium stones.
- Allopurinol: For uric acid stones.
- Sodium bicarbonate or potassium citrate: To make urine less acidic.
- D-penicillamine or tiopronin: For cystine stones.