Kidney Stones

ExitCare ImageKidney stones (urolithiasis) are deposits that form inside your kidneys. The intense pain is caused by the stone moving through the urinary tract. When the stone moves, the ureter goes into spasm around the stone. The stone is usually passed in the urine.

CAUSES

  • A disorder that makes certain neck glands produce too much parathyroid hormone (primary hyperparathyroidism).

  • A buildup of uric acid crystals, similar to gout in your joints.

  • Narrowing (stricture) of the ureter.

  • A kidney obstruction present at birth (congenital obstruction).

  • Previous surgery on the kidney or ureters.

  • Numerous kidney infections.

SYMPTOMS

  • Feeling sick to your stomach (nauseous).

  • Throwing up (vomiting).

  • Blood in the urine (hematuria).

  • Pain that usually spreads (radiates) to the groin.

  • Frequency or urgency of urination.

DIAGNOSIS

  • Taking a history and physical exam.

  • Blood or urine tests.

  • CT scan.

  • Occasionally, an examination of the inside of the urinary bladder (cystoscopy) is performed.

TREATMENT

  • Observation.

  • Increasing your fluid intake.

  • Extracorporeal shock wave lithotripsy—This is a noninvasive procedure that uses shock waves to break up kidney stones.

  • Surgery may be needed if you have severe pain or persistent obstruction. There are various surgical procedures. Most of the procedures are performed with the use of small instruments. Only small incisions are needed to accommodate these instruments, so recovery time is minimized.

The size, location, and chemical composition are all important variables that will determine the proper choice of action for you. Talk to your health care provider to better understand your situation so that you will minimize the risk of injury to yourself and your kidney.

HOME CARE INSTRUCTIONS

  • Drink enough water and fluids to keep your urine clear or pale yellow. This will help you to pass the stone or stone fragments.

  • Strain all urine through the provided strainer. Keep all particulate matter and stones for your health care provider to see. The stone causing the pain may be as small as a grain of salt. It is very important to use the strainer each and every time you pass your urine. The collection of your stone will allow your health care provider to analyze it and verify that a stone has actually passed. The stone analysis will often identify what you can do to reduce the incidence of recurrences.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your health care provider.

  • Make a follow-up appointment with your health care provider as directed.

  • Get follow-up X-rays if required. The absence of pain does not always mean that the stone has passed. It may have only stopped moving. If the urine remains completely obstructed, it can cause loss of kidney function or even complete destruction of the kidney. It is your responsibility to make sure X-rays and follow-ups are completed. Ultrasounds of the kidney can show blockages and the status of the kidney. Ultrasounds are not associated with any radiation and can be performed easily in a matter of minutes.

SEEK MEDICAL CARE IF:

  • You experience pain that is progressive and unresponsive to any pain medicine you have been prescribed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Pain cannot be controlled with the prescribed medicine.

  • You have a fever or shaking chills.

  • The severity or intensity of pain increases over 18 hours and is not relieved by pain medicine.

  • You develop a new onset of abdominal pain.

  • You feel faint or pass out.

  • You are unable to urinate.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.