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Kidney Stones

The kidneys, ureters, bladder, and urethra make up the human urinary tract system. The kidneys are two bean-shaped organs below the ribs in your back that filter blood and create urine. They keep a stable balance of salts and substances in the blood by removing extra water and waste from the blood to form urine.

After urine is created, it is carried from the kidneys to the bladder through narrow tubes called ureters. The bladder then stores the urine until it is emptied out of the body through the urethra.

When crystals form in the urine, usually from built-up excess chemicals, they are called kidney stones. There are several reasons for stone formation, but the main one is dehydration (from not drinking enough water).

Some kidney stones may be as small as a grain of sand and pass on their own, while others can grow significantly larger and get stuck, causing obstruction in urine flow that can cause the build-up of urine and swelling of the kidney(s). When this occurs, you may require medical treatment to prevent kidney damage.

Some stones may stay put in the kidney and never be a bother or they may pass out of the body without the need for intervention. Others can cause severe pain if they become trapped in one of the ureters (the narrow tubes that carry urine from the kidneys to the bladder). There are four types of kidney stones: uric acid stones, struvite stones, cysteine stones, and calcium stones.

Symptoms of Kidney Stones

You may not experience symptoms of a kidney stone until it moves to the ureter or moves about the kidney. When symptoms develop, you may experience:

  • Sudden, intense pain in your back, often radiating to your abdomen and groin. The pain may come in waves or get worse and then better.
  • Frequency urinating
  • Persistent urge to urinate
  • Pain when urinating
  • Blood in your urine
  • Cloudy or foul-smelling urine
  • Nausea and/or vomiting
  • Fever and chills if an infection is present (this may be a medical emergency if the stone is blocking the ureter)

Causes of Kidney Stones

Certain circumstances may increase your risk of developing kidney stones:

  • Not being hydrated: When you do not have enough fluid in your body, typically from not drinking enough water, your urine can become concentrated with crystal-forming substances that clump together and form stones. Having adequate fluid in your body helps prevent formation of these crystals.
  • Tendency to form stones: Your urine may not contact substances that can prevent crystals from clumping together, which creates a better environment for stones to form.
  • Eating a high protein or high salt diet
  • Having an enlarged prostate
  • Having untreated gout, which can cause the formation of uric stones
  • Having an endocrine disorder, such as hyperparathyroidism, that can increase concentration of calcium in your urine, causing stones to form

Risk Factors for Kidney Stones

  • Being over 40, although kidney stones may develop at any age
  • Personal or family background. If you or a member of your family has already had kidney stones, your risk is higher.
  • Obesity. Increased body mass index (BMI) and larger waist size have been linked to increased risk of kidney stones.
  • Being male, although women do develop kidney stones, but not as frequently
  • Inactive lifestyle or prolonged bed rest
  • Dehydration
  • Eating a diet high in salt, oxalate, and / or animal protein
  • Taking certain medications. Some diuretics or calcium-based antacids may increase the risk of kidney stone formation, as well as calcium and vitamin C supplements.

Diagnosing Kidney Stones

If a kidney stone is suspected, in addition to a detailed medical history and a physical, the following tests or procedures may be performed:

  • Blood tests to check and monitor kidney function, as well as to see if there is an excess of certain substances in your blood
  • Urine tests to check for infection. A 24-hour urine collection may also help detect if too many stone-forming substances or too few stone-preventing minerals are in your urine
  • Imaging studies, which may include:
    • X-ray to determine if there is a visible stone
    • Ultrasound to see if there are any obvious stone or blockage causing kidney swelling
    • CT scan, which may identify size and location of stones to diagnose and determine the best course of treatment

Treatment for Kidney Stones

For small stones with minimal or no symptoms, a conservative wait-and-see approach may be taken to allow to the stone to pass naturally. If this is the case, you may be required to drink plenty of water to help flush out the stone, as well as take certain medications for pain relief or to help pass the stone.

For larger or symptomatic kidney stones, a more invasive approach may be taken. These approaches include:

  • Extracorporal shock wave lithotripsy is a procedure where sound waves create strong vibrations that break up stones into small pieces that can pass in your urine.
  • Ureteroscopy (URS), with or without laser lithotripsy, is a procedure in which a scope with a camera attached passes through the urethra and into the ureter. Once the stone is identified, it is either removed or broken up into smaller pieces. A temporary tube (stent) may be placed at that time to promote healing and decrease swelling, and will likely be removed 1 to 3 weeks after the procedure. Either general or local anesthesia may be used.
  • Percutaneous nephrolithotomy is a surgery done under general anesthesia for very large kidney stones. An incision is made through your back and small cameras and tools are used to remove the stone(s).

Preventing Kidney Stones

A combination of lifestyle changes and medication may be used to prevent stones from recurring. Lifestyle changes include:

  • Eating a normal but not excessive amount of calcium-rich foods
  • Avoiding calcium and vitamin C supplements
  • Drinking at least 2 to 2.5 liters of water throughout the day. You may need to drink more than this amount if you exercise often or live in warm/hot climates. Consult your doctor.
  • Eating a balanced nutritional diet low in salt and animal protein. The daily recommended portion of meat, chicken, or fish is the size of your palm; don’t exceed that amount.
  • Avoiding fast food, canned food, frozen food, and luncheon meats
  • Eliminating sodas from your diet, particularly colas
  • Losing weight and exercising. A decrease in waist size can also help reduce your risk of stones.

Diet and lifestyle changes can significantly decrease your chances of producing kidney stones. Medication may be prescribed, particularly if your stones are persistent and recurrent.

Miami urologist Dr. Marvin Bondhus treats men and women with kidney stones from throughout Miami-Dade County. For a consultation, call (305) 661-9692 or use our secure online appointment request form.