Renal Stones (Kidney Stones)

Overview

Renal stones, also known as kidney stones, are a condition that affects the kidneys and urinary tract. They result from the accumulation of salts and minerals in a specific area, where continued deposition leads to stone formation. Kidney stones vary in type depending on their chemical composition, with calcium oxalate stones being the most common.

Symptoms depend on the size and location of the stone. Some stones are small and cause no symptoms, while others may obstruct the urinary tract and cause severe flank or abdominal pain. Treatment varies according to the condition and may include medications, increased fluid intake, stone fragmentation procedures, or surgery. Identifying the underlying cause is a crucial part of treatment to prevent recurrence, usually through specialized urine tests.

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Symptoms

Some kidney stones cause no symptoms or only mild discomfort, such as intermittent flank pain.

More severe symptoms may include:

• Severe flank pain

• Abdominal pain that may radiate to the buttock or groin

• Blood in the urine (hematuria)

• Passage of stones or stone fragments during urination

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Causes

Dehydration is the primary cause of kidney stone formation, as it increases the concentration of salts in the urine.

Other contributing factors depend on the stone type and include:

• Calcium oxalate stones: dietary factors and gastrointestinal disorders

• Calcium phosphate stones: use of phosphate-rich medications, especially in patients with kidney disease

• Uric acid stones: gout

• Cystine stones: genetic causes

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Diagnosis

Diagnosis is based on medical history and physical examination. Doctors may order laboratory blood and urine tests. Imaging studies of the urinary tract are often required, such as:

• Ultrasound

• Computed tomography (CT scan)

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Treatment

Treatment depends on the stone’s size and location and may include:

Medical Treatment

• Drinking large amounts of water

• Medications to help pass the stone through the urinary tract

Surgical Treatment

• Shock wave lithotripsy

• Surgical procedures to remove the stone

Preventive Treatment

• Measures to reduce the risk of future stone formation

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Living with Kidney Stones

General Advice:

• Pain and fever: Pain can be severe and may require injectable pain relief. NSAIDs should be avoided in patients with impaired kidney function.

• Fluid intake: Drink 3–4 liters of water daily, or more if needed, to increase urine output.

• Increase fluid intake during periods of fluid loss, such as heavy sweating or vomiting.

• If a stone passes in the urine, keep it and bring it to the doctor for laboratory analysis to determine its type.

• Dietary advice: A general kidney stone diet is usually recommended. Additional dietary modifications may be made once the stone type and cause are identified.

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Recovery Rates

Recovery depends on the size of the stone. Small stones often pass spontaneously, leading to full recovery. Larger stones usually require medical intervention, such as lithotripsy or surgery.

Even after successful treatment of the first stone, recurrence is possible and may cause severe pain.

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Sick Leave

Medical leave may be granted in cases of severe pain or following procedures to remove kidney stones.

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When to Visit the Hospital

Kidney stone pain is often severe. Patients are advised to visit the emergency department for evaluation and confirmation of diagnosis. Pain typically occurs suddenly in the abdomen or flank, is intense and continuous, and may be associated with urinary symptoms such as bleeding or frequent urination.

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Medical Specialists

• Urologist: for stone fragmentation or surgical removal

• Nephrologist: to identify the cause of stone formation and manage preventive medical treatment

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Questions to Ask Your Doctor

• Has the type of kidney stone been identified?

• Are there specific dietary or fluid intake recommendations?

• Should I make changes to my diet?

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Prevention

• Drink at least 3 liters of water daily, or more if needed, to ensure adequate urine output.

• Certain medications can prevent salt deposition and stone formation. The choice of medication depends on the stone type. Consult a nephrologist to determine the most appropriate preventive treatment.