Kidney stones - Diagnosis and treatment (2022)

Diagnosis

If your doctor suspects that you have a kidney stone, you may have diagnostic tests and procedures, such as:

  • Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
  • Urine testing. The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.
  • Imaging. Imaging tests may show kidney stones in your urinary tract. High-speed or dual energy computerized tomography (CT) may reveal even tiny stones. Simple abdominal X-rays are used less frequently because this kind of imaging test can miss small kidney stones.

    Ultrasound, a noninvasive test that is quick and easy to perform, is another imaging option to diagnose kidney stones.

  • Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.

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More Information

  • Kidney stones care at Mayo Clinic
  • Computerized tomography (CT) urogram
  • CT scan
  • Intravenous pyelogram
  • Ultrasound
  • Urinalysis

Treatment

Treatment for kidney stones varies, depending on the type of stone and the cause.

Small stones with minimal symptoms

Most small kidney stones won't require invasive treatment. You may be able to pass a small stone by:

  • Drinking water. Drinking as much as 2 to 3 quarts (1.8 to 3.6 liters) a day will keep your urine dilute and may prevent stones from forming. Unless your doctor tells you otherwise, drink enough fluid — ideally mostly water — to produce clear or nearly clear urine.
  • Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
  • Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain. Examples of alpha blockers include tamsulosin (Flomax) and the drug combination dutasteride and tamsulosin (Jalyn).

Large stones and those that cause symptoms

Parathyroid glands

Kidney stones - Diagnosis and treatment (1)

Parathyroid glands

The parathyroid glands lie behind the thyroid. They produce parathyroid hormone, which plays a role in regulating the body's blood level of calcium and phosphorus.

(Video) Kidney Stones (Nephrolithiasis) Signs & Symptoms | & Why They Occur

Kidney stones that are too large to pass on their own or cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment. Procedures may include:

  • Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).

    ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.

    ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

  • Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back.

    You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL is unsuccessful.

  • Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.

    Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.

    (Video) Kidney stones - Diagnosis and Treatment

  • Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result.

    Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that's causing your parathyroid gland to overproduce the hormone.

Prevention

Prevention of kidney stones may include a combination of lifestyle changes and medications.

Lifestyle changes

You may reduce your risk of kidney stones if you:

  • Drink water throughout the day. For people with a history of kidney stones, doctors usually recommend drinking enough fluids to pass about 2.1 quarts (2 liters) of urine a day. Your doctor may ask that you measure your urine output to make sure that you're drinking enough water.

    If you live in a hot, dry climate or you exercise frequently, you may need to drink even more water to produce enough urine. If your urine is light and clear, you're likely drinking enough water.

  • Eat fewer oxalate-rich foods. If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate, black pepper and soy products.
  • Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose nonanimal protein sources, such as legumes. Consider using a salt substitute, such as Mrs. Dash.
  • Continue eating calcium-rich foods, but use caution with calcium supplements. Calcium in food doesn't have an effect on your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise.

    Ask your doctor before taking calcium supplements, as these have been linked to increased risk of kidney stones. You may reduce the risk by taking supplements with meals. Diets low in calcium can increase kidney stone formation in some people.

    Ask your doctor for a referral to a dietitian who can help you develop an eating plan that reduces your risk of kidney stones.

Medications

Medications can control the amount of minerals and salts in the urine and may be helpful in people who form certain kinds of stones. The type of medication your doctor prescribes will depend on the kind of kidney stones you have. Here are some examples:

  • Calcium stones. To help prevent calcium stones from forming, your doctor may prescribe a thiazide diuretic or a phosphate-containing preparation.
  • Uric acid stones. Your doctor may prescribe allopurinol (Zyloprim, Aloprim) to reduce uric acid levels in your blood and urine and a medicine to keep your urine alkaline. In some cases, allopurinol and an alkalizing agent may dissolve the uric acid stones.
  • Struvite stones. To prevent struvite stones, your doctor may recommend strategies to keep your urine free of bacteria that cause infection, including drinking fluids to maintain good urine flow and frequent voiding. In rare cases long-term use of antibiotics in small or intermittent doses may help achieve this goal. For instance, your doctor may recommend an antibiotic before and for a while after surgery to treat your kidney stones.
  • Cystine stones. Along with suggesting a diet lower in salt and protein, your doctor may recommend that you drink more fluids so that you produce a lot more urine,. If that alone doesn't help, your doctor may also prescribe a medication that increases the solubility of cystine in your urine.

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(Video) 1st Sign of a Kidney Stone: Do This – Kidney Stone Remedies – Dr.Berg

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(Video) Kidney Stones 101: Causes, Symptoms & Remedies – Dr.Berg

More Information

  • Kidney stones care at Mayo Clinic
  • Percutaneous nephrolithotomy

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Preparing for your appointment

Small kidney stones that don't block your kidney or cause other problems can be treated by your family doctor. But if you have a large kidney stone and experience severe pain or kidney problems, your doctor may refer you to a doctor who treats problems in the urinary tract (urologist or nephrologist).

What you can do

To prepare for your appointment:

  • Ask if there's anything you need to do before your appointment, such as limit your diet.
  • Write down your symptoms, including any that seem unrelated to kidney stones.
  • Keep track of how much you drink and urinate during a 24-hour period.
  • Make a list of all medications, vitamins or other supplements that you take.
  • Take a family member or friend along, if possible, to help you remember what you discuss with your doctor.
  • Write down questions to ask your doctor.

For kidney stones, some basic questions include:

  • Do I have a kidney stone?
  • What size is the kidney stone?
  • Where is the kidney stone located?
  • What type of kidney stone do I have?
  • Will I need medication to treat my condition?
  • Will I need surgery or another procedure?
  • What's the chance that I'll develop another kidney stone?
  • How can I prevent kidney stones in the future?
  • I have other health conditions. How can I best manage them together?
  • Do I need to follow any restrictions?
  • Should I see a specialist? If so, does insurance typically cover the services of a specialist?
  • Is there a generic alternative to the medicine you're prescribing?
  • Do you have any educational material that I can take with me? What websites do you recommend?
  • Do I need a follow-up visit?

Besides the questions you prepare in advance, don't hesitate to ask any other questions during your appointment as they occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did your symptoms begin?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has anyone else in your family had kidney stones?

By Mayo Clinic Staff

(Video) কিডনিতে স্টোন: কারণ, লক্ষণ ও চিকিৎসা | Kidney Stones Symptoms | Causes | Treatment | Prevention

FAQs

What is the best diagnostic test for kidney stones? ›

Urinalysis. Urinalysis involves a health care professional testing your urine sample. You will collect a urine sample at a doctor's office or at a lab, and a health care professional will test the sample. Urinalysis can show whether your urine has blood in it and minerals that can form kidney stones.

What is the gold standard for diagnosing kidney stones? ›

At present, computed tomography (CT) is the gold standard for a patient suspected to have stone disease. However, CT scan is associated with the hazards of radiation and high cost. Ultrasonography (US) is cheap and also devoid of any radiation hazard to the patient.

Which treatment is better for kidney stone? ›

Percutaneous nephrolithotomy (PCNL)

Percutaneous Lithotripsy (PCNL) is the best treatment for large stones in the kidney.

What size of kidney stone requires surgery? ›

Surgical treatment is usually recommended for stones 0.5 centimeters in size and larger, as well as for patients who fail conservative management. The procedures used today to remove stones are minimally invasive and highly effective.

How does a urologist check for kidney stones? ›

Your urologist will conduct an imaging test to diagnose your specific type of kidney stones and to determine the exact cause(s) of the stone. This examination may include the following: Some type of imaging such as an X-ray, CT scan or ultrasound. Urine analysis and/or basic blood work.

Can kidney stones be cured completely? ›

Most kidney stones can be treated without surgery. Ninety per cent of stones pass by themselves within three to six weeks. In this situation, the only treatment required is pain relief. However, pain can be so severe that hospital admission and very strong pain-relieving medication may be needed.

What is the fastest way to dissolve a kidney stone? ›

Apple cider vinegar as kidney stones remedy

If you're looking to dissolve kidney stones fast, you can rely on apple cider vinegar. Made from fermenting apples and endowed with phosphoric, citric and acetic acids, apple cider vinegar makes urine acidic and helps to dissolve most types of kidney stones quickly.

Is CT scan necessary for kidney stone? ›

To diagnose painful kidney stones in hospital emergency rooms, CT scans are no better than less-often-used ultrasound exams, according to a clinical study conducted at 15 medical centers.

Do kidney stones always show on CT scan? ›

They can find some stones, but little ones might not show up. CT scans. A more in-depth type of scan is called computed tomography, or CT scan. A CT scan is a special kind of X-ray.

Can you see kidney stones on ultrasound? ›

Calculi (stones) of the kidneys and ureters may be detected by ultrasound. A kidney ultrasound may be performed to assist in placement of needles used to biopsy (obtain a tissue sample) the kidneys , to drain fluid from a cyst or abscess, or to place a drainage tube.

How long is kidney stone surgery? ›

The procedure, which is done under general anesthesia, takes about 1.5 hours. You'll typically return home the same day. Percutaneous nephrolithotomy: Your doctor makes a small incision in your back and guides a thin, flexible tube called an endoscope to your kidney to break up and remove the stone.

What are the first signs of kidney disease? ›

Generally, earlier stages are known as 1 to 3. And as kidney disease progresses, you may notice the following symptoms. Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little.

Is surgery necessary for kidney stones? ›

Kidney stones often pass on their own without any medical intervention. However, surgery may become necessary to break up or remove some stones. Those reasons include when the stone: Is too large to pass on its own.

What is the largest size kidney stone that can be passed? ›

Between 4 mm and 6 mm, only 60 percent will pass without medical intervention, and on average take 45 days to exit your body naturally. Anything bigger than 6 mm will almost always need medical care to help remove the stone.

What size of kidney stone is too big to pass? ›

Kidney stones that are larger than 5 mm are often too large to pass through the ureter spontaneously. Oftentimes, treatment is needed. Bottom line, the larger the stone, the less likely it will pass on its own.

What happens if you can't pass a kidney stone? ›

Sometimes, tiny stones move out of the body in the urine without causing too much pain. But stones that don't move may cause a back-up of urine in the kidney, ureter, the bladder, or the urethra. This is what causes the pain.

What does a urologist do on the first visit for kidney stones? ›

Typically, a urologist or nephrologist will conduct some sort of imaging during the appointment, whether that be a CT scan, X-ray or ultrasound. Typically, Dr. Calle says, there should be a urine analysis and basic blood work.

Are there medications to dissolve kidney stones? ›

Uric acid stones are the only type of kidney stones that can sometimes be dissolved with the help of medication. Alkaline citrate salts or sodium bicarbonate are considered for this purpose, and sometimes allopurinol.

Which injection is used for kidney stone pain? ›

If the stone is causing severe pain, the urologist may choose to prescribe a narcotic. Providers may also inject patients with Ketorolac (Toradol), a more powerful anti-inflammatory medication.

Can kidney stones not show on CT scan? ›

They can find some stones, but little ones might not show up. CT scans. A more in-depth type of scan is called computed tomography, or CT scan. A CT scan is a special kind of X-ray.

Can ultrasound Miss kidney stones? ›

A renal ultrasound might show a kidney stone and kidney obstruction, but the ultrasound can miss a ureteral stone. A plain X-ray of the abdomen (called a “KUB”, short for kidneys, ureters, and bladder film) can show larger stones, but it will often miss small stones.

Do kidney stones show up on CT scan? ›

Two imaging tests to check for kidney stones are a CT scan and an ultrasound. If the first imaging test is not clear, you may need a second test. In the past, a CT scan was often used as the first imaging test to check for kidney stones.

Can you see kidney stones on ultrasound? ›

Calculi (stones) of the kidneys and ureters may be detected by ultrasound. A kidney ultrasound may be performed to assist in placement of needles used to biopsy (obtain a tissue sample) the kidneys , to drain fluid from a cyst or abscess, or to place a drainage tube.

What can be mistaken for kidney stones? ›

Patients who have kidney stones may experience blood in the urine (hematuria), foul-smelling urine, abdominal or pelvic pain, and frequent urination.
...
Conditions that can be mistaken for kidney stones, sharing similar symptoms:
  • Appendicitis or lower back pain.
  • Urinary tract infection (UTI)
  • Stomach flu or virus.

Which is more accurate ultrasound or CT scan? ›

Conclusion. CT misses fewer cases than ultrasound, but both ultrasound and CT can reliably detect common diagnoses causing acute abdominal pain. Ultrasound sensitivity was largely not influenced by patient characteristics and reader experience.

Which is better ultrasound or CT scan? ›

Image Detection

Ultrasounds are routinely used in prenatal care and other procedures such as the removal of gall stones or kidney stones. CT scans are better used for detecting certain cancer tumors or other abnormalities within the body.

Is a CT scan or ultrasound better for kidney stones? ›

To diagnose painful kidney stones in hospital emergency rooms, CT scans are no better than less-often-used ultrasound exams, according to a clinical study conducted at 15 medical centers. Unlike ultrasound, CT exposes patients to significant amounts of radiation.

How does a doctor treat kidney stones? ›

The doctor uses a thin viewing tool, called a nephroscope, to locate and remove the kidney stone. The doctor inserts the tool directly into your kidney through a small cut made in your back. For larger kidney stones, the doctor also may use a laser to break the kidney stones into smaller pieces.

How accurate are CT scans for kidney stone size? ›

Noncontrast spiral computerized tomography (CT) can detect up to 95% of the renal, ureteric and bladder stones, especially those with calcium composition, and considered nowadays one of the most accurate methods for detecting undetectable stones by other modalities.

Will a urine test show kidney stones? ›

You may be given tests, including: urine tests to check for infections and pieces of stones. an examination of any stones that you pass in your pee. blood tests to check that your kidneys are working properly and also check the levels of substances that could cause kidney stones, such as calcium.

What foods cause kidney stones? ›

Avoid stone-forming foods: Beets, chocolate, spinach, rhubarb, tea, and most nuts are rich in oxalate, which can contribute to kidney stones. If you suffer from stones, your doctor may advise you to avoid these foods or to consume them in smaller amounts.

Can an xray show a kidney stone? ›

X-Ray for Kidney Stones

X-rays are used less frequently than CT scans because they can miss small kidney stones. However, your doctor might recommend an x-ray first to look for large kidney stones or the presence of many stones. During an x-ray for kidney stones, you will either lie on a table or stand.

Videos

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2. Kidney stone diagnosis, signs, symptoms, and causes | National Kidney Foundation
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4. Kidney Stones class 10 | Causes, Symptoms & Treatment: (Lithotripsy) @Study point with rs
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5. Urinary/Kidney Stones - Overview (signs and symptoms, risk factors, pathophysiology, treatment)
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