Kidney Stones

Dr. Rajalakshmi VK (AIIMS)MBBS

November 08, 2018

June 04, 2022

Kidney Stones
Kidney Stones


Our kidneys are the foundation of cleansing the body of toxins and waste products. However, the development of small hardened structures in one or both the kidneys makes this process very discomforting and unpleasant. Kidney stones are generally more painful than they are serious. A condition that is seen more in the male population than in females, kidney stones are small, pebble-like hard growths in one or both kidneys. They vary in size, nature, colour and type. They develop due to the deposition of certain minerals. This deposition is the result of elevated levels of calcium, uric acid, or struvite or due to a condition called cystinuria (the leakage of cystine acid in the urine).

The most common visible changes are in the colour and odour of urine along with the need to urinate frequently, passing only small quantities each time. Additionally, pain in the lower back, lower belly, sides and groin may be experienced. Apart from elevated levels of acids and minerals in the body, other medical conditions, such as hyperparathyroidism, kidney ailments, digestive disorders and urinary tract infections (UTIs) also pose the individual at a higher risk of developing kidney stones. Diagnosis of kidney stones is established based on the individual’s medical history, a complete physical examination, blood and urine tests, X-rays, ultrasonography and CT scans.

Treatment depends on the size of the stone and may vary from simply waiting for it to pass in the urine to sound wave therapy using scopes that disintegrates the stone or even surgery. Prevention mainly revolves around drinking plenty of water, modifying the diet to avoid foods that cause mineral residues and lowering salt intake. Although there is a risk of relapse, the prognosis is generally good because kidney stones can be treated effectively if there is no hereditary influence. Complications, such as kidney damage or infection, UTI, obstructions in the ureter or kidneys and blood in urine may arise from kidney stones. 

What is a Kidney stone

Stones in the kidney are medically referred to as a nephrolith or renal calculi. They are also called urinary stones. Kidney stones may be found in one or both kidneys, and are best described as small, stone-like structures. They are usually composed of certain minerals and can vary in size and colour. Most kidney stones, especially those that are smaller, pass through the urine and resolve without treatment. Some may get lodged or stuck on the way, causing pain and bleeding. 

Over the past decades, the incidence of kidney stones among people has been increasing. While it is seen more commonly in men than in women, the number of women affected by kidney stones is also rising at present.

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Types of Kidney stones

Kidney stones can be of different kinds, depending on how they look, their composition and location. Stones may sometimes be as small as a particle of sand, while the larger ones may be pea-sized. In some rare cases, they may grow to the size of golf balls or obstruct half the kidney. The colour of these stones usually ranges from pale yellow to darkish brown. Kidney stones are often round and smooth, except for some that may be irregular and jagged. The most common types of kidney stones by composition include:

  • Calcium stones
    Calcium is essential for the teeth and bones. The body’s natural mechanism is to flush out all the extra calcium, which is not being used by the body. When there is an excess of calcium or hindrance in calcium metabolism, calcium tends to fuse with other waste products and form stones. The most commonly occurring kidney stones are calcium phosphate and calcium oxalate stones.
  • Uric acid stones
    When there is an unusually high uric acid level in the blood, it also starts getting excreted in large amounts in the urine and there is a higher tendency for uric acid stones to form. Among others, a diet rich in meat and fish, which are high in protein, contributes to high uric acid levels.
  • Struvite stones
    These stones are usually the result of a severe urinary tract infection and occur after or during the ailment. This is because the urine becomes alkaline in nature due to the infection. As a result, magnesium ammonium phosphate is formed, which accumulates in the kidneys in the form of stones. They have a tendency to increase in size very rapidly.
  • Cystine stones
    A hereditary condition called cystinuria is responsible for these kinds of stones. In this condition, amino acids, especially cystine start to leak from the kidneys and pass into the urine, causing the formation of these stones.

Kidney stones symptoms

Kidney stones, especially in the initial stages, do not really present many symptoms. It is only later when the stone either starts to move around or goes through into the ureter that obvious discomfort and symptoms start to appear. Some of the symptoms are:

  • Discolouration of the urine to a red, pink or dark brown colour.
  • Intense urge to pass urine every now and then.
  • Peculiar odour in urine.
  • Passing only small amounts of urine each time.
  • Pain experienced in the urethra while urinating. (Read more - Painful urination causes)
  • Nausea and vomiting.
  • Pain in the lower back and sides.
  • Pain in the groin region and lower belly.

Pain can sometimes be felt in spurts or waves, and the location of the pain may also change as the stone travels from one part of the urinary system to the other. Severe, continuous pain is a medical emergency and should be immediately attended to. 

Kidney stones causes & risk factors


Urine comprises several minerals including calcium, phosphorus and oxalate. These are routinely eliminated from the body and are usually found only in small quantities. When levels exceed what the body is capable of passing out, these residual minerals usually come together, crystallise and form stones in the kidneys.

Risk Factors

Numerous factors place an individual at the risk of developing kidney stones. In most cases, it is a combination of two or more factors that may rise to kidney stones. Some risk factors include:

  • Medical conditions
    There are several medical conditions, which can increase the risk of developing kidney stones, such as:
    • Cystic kidney disease
      A disease that is characterised by the formation of fluid-filled sacs in the kidneys. These may hinder efficient filtration by the kidneys.
    • Cystinuria
      A genetic condition where the excess of an amino acid called cystine is passed in the urine.
    • Surgery
      A gastrointestinal surgery due to digestive disorders may hamper calcium absorption.
    • Disorders of the digestive system
      Irritable bowel syndrome or other chronic bowel-related disorders.
    • Recurrent urinary tract infections
      Recurrent infections of the urinary tract reduce the acidity of the urine and prevent the dissolution of salts in water.
    • Hyperparathyroidism  
      A disorder of parathyroid glands hampers calcium metabolism and leads to excessive calcium level in the blood.
    • Blockage in the urinary tract
      Certain birth defects of the urinary bladder or kidney may hamper the passing of urine.
    • Gout
      Gout is a condition characterized by excess uric acid levels in the blood.
    • Hypercalciuria  
      Elevated calcium levels found in urine.
    • Hyperoxaluria  
      Elevated oxalate levels in the urine.
    • Hyperuricosuria  
      Elevation of uric acid levels in the urine.
    • Renal tubular acidosis  
      A tendency of the urine to remain acidic because kidneys can’t remove the excess acids.
  • Medications
    Certain medications may also aid in the formation of kidney stones.
    • Antacids, which are calcium based.
    • Anti-seizure medication.
    • Some medications that are used to treat HIV infection.
    • Diuretics (medications that excrete excess water from the body)
  • Others
    There may also be more generalised factors, which place an individual at greater risk. These are:
    • A family history of kidney stones or high uric acid levels.
    • Diet high in sugar, protein and salt.
    • Obesity.
    • Dehydration.

Prevention of Kidney stones

The key to preventing kidney stones lies in making simple dietary and lifestyle changes. Different kinds of precautions need to be exercised for different types of kidney stones. However, there are some general rules that can aid in the prevention of kidney stones. These are:

  • Drink plenty of water (2-3 litres) unless you are suffering from a kidney disorder.
  • Avoiding nuts, spinach and rhubarb if you are prone to developing oxalate stones.
  • If you have a history of having uric acid stones, reduce the intake of protein-rich foods, which produce uric acid on breakdown e.g., meat, fishes, pulses, dairy, fermented foods and others.
  • Lowering the intake of salt and processed foods.

Diagnosis of Kidney stones

Diagnostic tests for kidney stones are fairly simple and begin with a consultation to help the doctor understand the nature of the problem and symptoms, and also the medical history. After checking for the role of heredity and a physical examination, some simple tests may be advised, such as:

  • Blood samples to check for the levels of minerals and salts in the body.
  • Urine tests may show the presence of blood in the urine along with the levels of minerals and uric acid. Urine samples also help reveal the presence of bacteria and levels of white blood cells, which indicate infections.
  • X-ray of the abdomen usually helps to determine the location of the stones; however, all stones may not show up on an X-ray.
  • CT scans are more accurate in revealing the location, size and impression of kidney stones. They also help reveal how the stones impact other organs.

Kidney Stone treatment

The course of treatment for kidney stones differs based on how large and impacting the stone is. Most doctors prefer adopting a more conservative approach, allowing the stones to be passed naturally in the urine. The treatment options employed for kidney stones are:

For small kidney stones

These are much easier to eliminate. Doctors usually suggest drinking plenty of fluids to help the stones get flushed out in the urine. They may aid the process by prescribing a mild painkiller to suppress the pain, or a muscle relaxant to help the stone pass more effortlessly.

For larger stones

Some medical procedures may be required to treat larger kidney stones:

  • Medications
    Medication is suggested depending on the nature of the stone formed and the severity of the condition. These medications help in dissolving the salts of the stone and reduce its size. Over a period of time, the stone may get small enough to be easily passed in the urine.
  • Surgery
    Using small telescopic instruments called laparoscopes that are inserted into the kidneys through the back, doctors surgically remove kidney stones after administering anaesthesia to the person undergoing surgery. This procedure, called percutaneous nephrolithotomy, requires admission and stay in the hospital for a few days.
  • Scopes
    These are used when the stones are lodged in the kidney or ureter. A thin lit tube is passed through the urethra to the ureter to locate the stone, which may then either be removed or broken down. Most procedures of this nature use local anaesthesia and are performed as outpatient procedures.
  • Shock-wave therapy
    Shock waves are sometimes passed through the skin to break down or fragment the kidney stones so that they may then be flushed out in the urine. This is a procedure that lasts for about an hour and can cause some pain. Following the procedure, there may also be some discomfort, bruising or bleeding.

Doctors usually recommend collecting the stone that has been passed to examine its nature. It also helps decide the next course of treatment and take lifestyle measures that help prevent them from forming again.

Lifestyle management

The harsh reality about kidney stones is that the chances of them recurring are unusually high. This means that not only is treatment crucial, but also the time when it is sought and the choices we make following the episode. In managing and maintaining a lifestyle following recovery, here are some things that you will need to factor in:

  • Consumption of plenty of fluids, chiefly water.
  • Modification of diet to avoid foods that contribute to the development of the kind of kidney stones previously formed.
  • Managing and maintaining weight appropriate for height and age.
  • Regular health and blood check-ups to watch the mineral and uric acid levels in the blood and urine.
  • Being health conscious and maintaining personal hygiene to prevent UTIs, which may be contracted more easily once you have had kidney stones.

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Kidney Stone prognosis and complications


When given timely and proper attention, kidney stones can be treated effectively without causing too much trouble or complication. The prognosis of kidney stones is mostly good, however, it is unpredictable in certain cases and usually involves:

  • A tendency of the kidney stone to relapse. However, given the peculiarity of the discomfort and pain experienced, it becomes easy for the patient to identify and seek treatment almost immediately.
  • In those who have a family history of kidney stones, the chances of occurrence are much higher. Watching for signs and taking more preventive measures can be useful.


Although it seems like a relatively harmless and less damaging condition, there are several complications that can arise because of kidney stones, such as

  • Recurring episodes of stones in the kidney or urethra.
  • Increased chances of contracting UTI.
  • Blockages in the ureter, which may lead to obstruction and bleeding that may also be seen in the urine.
  • Kidney scarring or damage caused due to compromised functioning.


  1. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Definition & Facts for Kidney Stones
  2. U.S. Department of Health and Human Services. Chapter 9: Urinary tract stones. In: Litwin MS, Saigal CS, eds.Urinary Tract Stones
  3. Urology Care Foundation [Internet]. USA: American urological association; What are kidney stones?
  4. Sylvia C. McKean, John J. Ross, Daniel D. Dressler, Danielle B. Scheurer. Principles and Practice of Hospital Medicine. Second edition New-Delhi: ACP Publications; copyright © 2012.
  5. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Eating, Diet, & Nutrition for Kidney Stones
  6. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Diagnosis of Kidney Stones
  7. National Kidney foundation [Internet]. New York: National Kidney Foundation; Kidney Stone Treatment: Shock Wave Lithotripsy
  8. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Kidney Stones

Doctors for Kidney Stones

Dr. Anvesh Parmar Dr. Anvesh Parmar Nephrology
12 Years of Experience
DR. SUDHA C P DR. SUDHA C P Nephrology
36 Years of Experience
Dr. Mohammed A Rafey Dr. Mohammed A Rafey Nephrology
25 Years of Experience
Dr. Soundararajan Periyasamy Dr. Soundararajan Periyasamy Nephrology
30 Years of Experience
Consult a Doctor

Medicines for Kidney Stones

Medicines listed below are available for Kidney Stones. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Lab Tests recommended for Kidney Stones

Number of tests are available for Kidney Stones. We have listed commonly prescribed tests below: