Kidney Stone Disease

What are kidney stones?

Also called renal stone disease, kidney stones form when one or more solid deposits of mineral and acid salts build up inside the kidneys. While some stones can be as small as a grain of sand, others can grow to the size of a pea or even a golf ball. As they grow, it becomes more difficult for them to pass through your urinary system on their own.

There are different types of kidney stones named for the substances that form them. Identifying your kidney stone type is important to determining the cause of your stone and preventing future stones. The most common types of kidney stones are:

• Calcium-oxalate and calcium phosphate stones
• Uric acid stones
• Struvite stones
• Cystine stones

Stones are relatively common, as more than one million Americans are hospitalized every year with this condition, and approximately 10 percent of people in the United States will have a kidney stone sometime in their life. In addition, stone recurrence is very common. Up to 50% of people who have had a kidney stone will experience another stone in their lifetime.

Kidney stone symptoms

Very small kidney stones may not cause noticeable symptoms or pain. However, stones larger than three or four 3-4 millimeters in size, about the size of the head of a match, can cause a lot of discomfort. At this size, a stone can block urine flow when it enters the ureter and cause rapid kidney swelling (hydronephrosis) and mild to severe pain. Some people describe kidney stone pain as worse than childbirth labor. The pain often begins suddenly and comes in waves. It can come and go as the body tries to get rid of the stone.

The most common kidney stone symptoms include:

• Flank pain (pain in the side)
• Groin pain
• Nausea and vomiting
• A feeling of an intense need to urinate
• Blood in the urine
• Abnormal urine color or appearance

If you experience a fever or chills with any of the above symptoms, talk to a doctor right away to rule out an infection.

Causes of kidney stones

There are many reasons why kidney stones form. That’s why it’s necessary to seek care from a multidisciplinary team that will evaluate your risk factors and determine the root cause of your stone.

You may be more likely to form a kidney stone if you:

• Have a personal history of stones
• Have a family history of kidney stones
• Don’t drink enough fluids
• Eat excessive amounts of salt

• Have a history of gastric bypass surgery

• Have certain medical conditions, such as Crohn's disease or ulcerative colitis

Kidney stone prevention

Our kidney stone experts evaluate your medical history and personal risk factors for stone recurrence, which helps us tailor a plan to prevent future kidney stones. Using a multidisciplinary approach, we work closely with other specialists to help prevent stone formation. For example, some patients benefit from collaboration with our dietitians, who can help patients adopt dietary changes that may help to prevent stone formation.

Testing for kidney stones

We also perform a comprehensive evaluation, which aids in determining the right steps for prevention. These tests may include one or more of the following:

• Urinalysis
• Stone analysis (especially important for the first stone)
• Blood studies (evaluate calcium, phosphate, uric acid, electrolytes, creatinine)
• 24-hour urine collection (to evaluate urinary risk factors) on current diet and then repeat if needed on a stone diet to reduce abnormal findings
• Additional imaging to evaluate for stone recurrence during routine follow-up.

Kidney stone treatment

We offer the full spectrum of medical and surgical treatment options. Your treatment will vary depending on several factors, including:

• Stone size
• Location
• Composition
• Urinary tract anatomy
• Associated symptoms

Medical support to help the stone pass

Many renal stones are small enough to pass naturally without the need for surgery. Medical support such as medication and hydration can help to move the stone out of the urinary tract. After a stone passes, we analyze it to determine the cause and individualize a prevention plan.

Some medications have been shown to improve the chance that a stone will pass. The most common medication prescribed for this reason is Flomax (tamsulosin). Tamsulosin has been shown to improve the chance that certain stones will pass. If you are struggling with pain, or if nausea or vomiting are preventing hydration, talk to your doctor about your options. And, if you develop a fever while trying to pass a stone, seek immediate medical evaluation.

Minimally-invasive kidney stone treatments

You may need further treatment if:

• The stone causes too much pain.
• Even with time the stone does not pass.
• The stone is too large to pass spontaneously.
• The stone is causing severe blockage to the kidney, increasing your risk of kidney damage.

• If the stone is found in conjunction with a urinary tract infection.

Our kidney stone experts offer several minimally-invasive surgical options to break up or remove larger stones, including: