What Is It?
Kidney stones, also referred to as “nephrolithiasis”, are quite common among men, women, and to a lesser extent, children.
Kidney stones are more common in the Southern United States due to warmer climates and the propensity for dehydration.
Substances in urine, such as calcium, oxalate, cystine or uric acid, form “crystals” in the kidney which can ultimately grow in size to form a kidney stone.
Stones can also develop in the bladder (bladder stones) and are usually seen in men who have difficultly urinating due to an enlarged prostate obstructing the flow of urine.
Symptoms of Kidney Stones
When a kidney stone forms, it may travel from the kidney down the “ureter”, the tiny tube that carries urine from the kidney to the bladder. When this happens, excruciating flank or back pain ensues. The pain varies in severity from individual to individual; however, most rate the pain as a 10/10 – the worst possible pain.
Pain may be accompanied by nausea, vomiting, hematuria (blood in the urine), as well as fever.
Evaluation and Treatment
Individuals who are suspected of having kidney stones undergo a urinalysis and urine culture. These lab tests often demonstrate “microscopic hematuria” (blood in the urine that is seen with a microscope).
The decision to treat an individual conservatively or with surgery to remove the stone is based on the size of the stone and its location within the urinary system. In general, stones less than 5 millimeters in size have a 50% chance of passing out of the body with conservative therapy alone.
When an individual has a fever, and a stone is obstructing the urinary system, surgery is advised to allow elimination of the obstruction that allows the individual to improve clinically. The stone is then removed several days later after the individual is clinically stable.
It is important to undergo a thorough metabolic evaluation following the diagnosis of kidney stones. Dietary modification, including increase in fluid intake to prevent dehydration, is important in the management and prevention of kidney stones.
A 24-hour urine test may be performed that allows the physician to better understand a specific individual’s risk of stone formation, and aid in future therapy to prevent kidney stones.