What are kidney stones?

Kidney stones are small hard stones that

form in the kidney and sometimes move
into the ureter, the tube that leads from the
kidney to the bladder.
They can be as small as a grain of sand or as
large as a golf ball. They can occur singly or
in multiple numbers. They are also referred
to as renal calculi or urinary calculi.
How are they formed?
A stone usually begins as a tiny sand-like
speck of material in the kidney. Minerals in
the urine, especially calcium, then build on
the speck in a similar way to that in which a
pearl grows in an oyster shell.
Most are flushed out but some can remain
and grow over many years. Excessive
amounts of uric acid or minerals in the
urine, such as calcium and oxalate, make
stone formation likely. Concentrated urine,
such as occurs in people who only drink
small amounts of fluid, is also a risk factor.
Who gets kidney stones?
Anyone can get them. They have been
found in Egyptian mummies from 6000
years ago and about one person in every 400
has kidney stone-related problems. Males
are three times more likely to get them and
people are most often affected between the
ages of 20 and 50, with a peak age of about
30.
Risk factors include pregnancy, low-fibre
diet, hot climates, inadequate fluid intake
and kidney infections.
What are the symptoms?
There may be no symptoms, especially with
tiny stones that flush out or with large stones
that are too big to pass.
However, when small stones pass into the
ureter, excruciating pain called renal colic
usually develops.
Renal colic usually comes on suddenly and
lasts until the stone is passed into the blad-
der which can take a few hours (usually less
than eight hours). Other symptoms include
vomiting and small amounts of blood in the
urine.
What causes the pain?
The pain of ureteric colic is caused by
movement of the stone, which stretches the
ureter and causes intense spasm.
What is the treatment?
The treatment of severe renal colic is a pain-
killing injection which can be a strong nar-
cotic or one of the anti-inflammatory drugs.
An anti-inflammatory drug, in the form of
tablets or suppositories, may be prescribed
after the attack settles.
The urine is tested and X-rays are taken to
find any stones and to check the structure of
the urinary tract.
What are the risks?
Although most stones either remain in the
kidneys, causing no harm, or pass in the
urine, some may get stuck in the ureter and
require a procedure to be removed. Some
kidney stones may lead to infection. Large
troublesome stones may require shattering
with special shock waves called lithotripsy.
How can kidney stones be pre-
vented?
Prevention applies mainly to those who
have had an attack, especially recurrent
attacks. Your doctor will organise tests to
see if you have too much calcium or other
substances in your blood or urine and if so
advise accordingly.
Dietary advice includes the fol-
lowing:
Drink at least 2L of water every day.
Reduce your animal protein consumption
restrict yourself to one major meat
meal a day.
Have a high-fibre diet plenty of vegeta-
bles and fruit.
Depending on the type of stone, other
dietary restrictions may be required, such
as reducing uric acid-containing foods
including beer, red meat, red wine and
organ meats (brain, kidney, liver, sweet-
bread) or reducing oxalate-containing
foods, especially chocolate, rhubarb, vita-
min C tablets, tea, coffee and cola drinks.
PATIENT INFORMATION
Kidney stones
AUTHOR: PROFESSOR JOHN MURTAGH
Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes.
Kidney
Pain felt in back
and abdomen
Pain
referred
to groin
Bladder
Stone in
ureter