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Kidney Stones (Renal Calculi)


Kidney stones are crystal of minerals and salts present in urine that stick together to form stones. A single stone or multiple stones can be present in the kidney, or in the ureters. These stones may then pass into the bladder and then be expelled into the environment. The formation of stones is known as urolithiasis. The stones start out as very tiny deposits that accumulate, increase in size and harden over time. Low volume of urine and increase in the stone-forming substances within the urine causes the stones to grow.

Kidney Stone Symptoms

Symptoms of kidney stones appear once the stones become lodged somewhere in the urinary tract. Very small stones can easily get flushed out of the body, however, when the stones grow and start to move down the ureters towards the urinary bladder, it obstructs the flow of urine and suddenly causes symptoms of the disease. The symptoms include :

  • Severe pain, which is felt in the back, sides and lower abdomen. This pain can subside as suddenly as it appears. It is referred to as renal colic.
  • Abnormal color of the urine.
  • Blood in the urine.
  • Frequent urge to urinate.

Sometimes kidney stones are accompanied by infection of the urinary tract and additional symptoms such as chills and fever may be present. Nausea is a symptom that is seen with urinary tract infections and with severe kidney stone pain. Vomiting is rare but may occur.


Several types of kidney stones can be formed such as calcium stones, struvite stones, uric acid or cystine stones. Different types of kidney stones may arise with different causes.

  • Dehydration. Inadequate fluid intake and excessive loss of fluid can essentially ‘concentrate’ the urine thereby allowing certain constituents to precipitate. The sediment can then grow into kidney stones.
  • A diet rich in proteins, salts and sugar increases probability of forming kidney stones.
  • Some medications such as some common antibiotics (like cetriaxone, ciprofloxacin), indinavir prescribed to HIV patients and medicines prescribed for gout can affect the normal balance of minerals and increases the chances of kidney stone formation
  • Genetic predisposition seems to be an important factor in the formation of certain types of kidney stones.
  • Hypercalciuria is a condition where the level of calcium in the urine is higher than normal. Since most stones are deposits of calcium, people with hypercalciuria are at a greater risk of developing kidney stones. Increase in calcium levels can also be caused by excess hormone secreted by the parathyroid gland – hyperparathyroidism.
  • Certain other illnesses such as cystic fibrosis, renal tubular acidosis inflammatory bowel disease, are associated with kidney stone formation.


When the stones are small, a high fluid intake helps to expedite the movement of these stones out of the urinary tract. This can be accompanied by pain relief medication to manage pain from stones that “graze” the walls of the urinary trac. An additional medicine, alpha-blockers, which helps to relax the muscles of the ureters and pass the stone easily can be prescribed by the doctor.

When the stones are larger treatment for depends on the type and composition of the stones. Depending upon the type of stones, medicines are prescribed to break up the stones so that they can pass out easily. Medicines such as allopurinol (for uric acid stones), antibiotics (for struvite stones), diuretics or phosphate solution may be used.

However, larger stones may require more invasive methods. The stones can be “blasted” with ultrasound in a procedure known as lithotripsy and the fragments either pass out or are dissolved. Open surgery for kidneys stones is rare but may be considered for abnormally larger stones.

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