Kidney Stones: What to Know About This Common Condition

They’re common, incredibly painful and send more than one million Americans to the emergency room each year. They’re kidney stones – and their prevalence is on the rise due to a mix of suspected risk factors such as obesity, diabetes and even climate change.

Jose Salvado, MD, a urologist at the University Hospitals Stone Center, shares common facts about kidney stones, prevention tips and new treatment innovations.

What Are Kidney Stones?

Kidney stones are hard, stone-like deposits of materials like calcium that form inside the kidneys when the urine becomes concentrated. They can be as small as a grain of sand or as large as a marble.

Sometimes these crystallized stones stay in the kidney and cause no symptoms. Other times, they travel into the ureter (the tube between the kidney and bladder), causing intense pain and potential complications. In addition to pain, kidney stones may cause blood in the urine, cloudy or smelly urine, fever, chills, frequent urination, and nausea and vomiting.

What Causes Kidney Stones?

Kidney stones are very common, especially in adults. About one in ten people will experience a kidney stone at some point in their lives. They tend to be more common in men than women and the risk increases with age. However, kidney stones have been rising in recent years among women and even children.

Though genetics can play a role in kidney stone risk, lifestyle factors are more often the culprit. “Kidney stones are more common in the Northern Hemisphere, most likely related to diets with high consumption of salt and meat, and low consumption of water,” says Dr. Salvado. Certain medical conditions – such as gout, urinary tract infections and inflammatory bowel disease – are also linked to an increased risk of stones.

What to Expect from Treatment

Kidney stone treatment depends on the size, type and location of the stone. “Our goal in determining treatment is to choose the procedure with the best stone-free rate – or how much stone can we ultimately get out with the approach we choose,” says Dr. Salvado.

For larger stones, treatment options typically include:

• Shock wave lithotripsy. A noninvasive procedure that uses high-energy sound waves, known as shock waves, to break stones into tiny pieces that can be passed through the urine.
• Ureteroscopy. An endoscopic procedure where a thin scope is inserted from the ureter to the kidney to break up the stone with a laser.
• Percutaneous nephrolithotomy. Surgical removal for very large or complex stones, which involves puncturing the kidney to create space for the stone to pass.

“Since the full surgery involves greater risk, more than 80 percent of our patients are treated with ureteroscopy,” adds Dr. Salvado.

Regardless of the procedure used, around half of patients will require a stent running from the kidney to the bladder to allow the fragments of the stone to pass. For those patients, a new stent developed at University Hospitals offers relief from the typical discomfort and complications associated with stents. “Often after surgery, patients would be in more pain from the stent than from the stone removal itself,” Dr. Salvado explains. “This new stent we are using significantly reduces the urine reflux associated with pain after surgery.”

Preventing Kidney Stones Before They Form

The good news is that many kidney stones can be prevented with lifestyle changes. Patients typically undergo a full evaluation, including a 24-hour urine test and blood work, to identify underlying factors that caused their stone.

In general, Dr. Salvado recommends the following best practices to reduce the risk of kidney stones:

• Drink plenty of water, aiming for at least two to three liters per day.
• Try to eat less meat from animal sources.
• Limit sodium, since high salt intake increases calcium in your urine.
• Eat more food containing citrate, such as lemon, pineapple and pomegranate.
• Cut back on oxalate-rich foods, such as spinach, soy and beets and if you’re prone to oxalate stones.
• Stay active, since obesity increases the risk of stone formation.

If you’ve had a kidney stone before or think you might be dealing with one now, talk to your healthcare provider. “Early treatment can help prevent complications and keep you stone-free in the future,” adds Dr. Salvado.

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The experienced urology team at University Hospitals works together to create a personalized care plan for every patient to relieve symptoms and prevent recurrence of kidney stones.