Kidney Stones
Published: 10 May 2022
Published: 10 May 2022
Kidney stones are one of the most common urinary tract disorders, affecting between 4 and 8% of the Australian population at any given time (Kidney Health Australia 2020).
Kidney stones, also known as renal calculi, are crystallised masses formed by salts in the urine (Better Health Channel 2018).
They range in size from as small as a grain of sand to more than 20 mm, and in some cases, may even be as large as a golf ball (Leslie et al. 2022; Healthdirect 2020).
Kidney stones are typically yellow or brown in colour and can be smooth or jagged (Queensland Health 2017).
About 1 in 10 men and 1 in 35 women will develop a kidney stone during their lifetime (Better Health Channel 2018).
Kidney stones occur when waste products in the urine clump together into hard crystals (Kidney Health Australia 2020).
This can occur for a variety of reasons, including:
(Leslie et al. 2022)
There are four types of kidney stones:
(Better Health Channel 2018; Leslie et al. 2022; NKF 2021a, 2022)
Kidney stones typically become painful if they pass into the ureter (the tubes connecting the kidneys and bladder) and cause irritation or blockage. While this can cause severe pain, most kidney stones can pass through the body without causing damage to the internal structures (Mayo Clinic 2020; NKF 2022).
Despite this, many people with kidney stones experience no symptoms (Better Health Channel 2018).
As a general rule, the larger the kidney stone, the more likely it is to cause symptoms (NKF 2022).
Possible symptoms include:
(NKF 2022; Better Health Channel 2018; Mayo Clinic 2020)
Signs of systemic infection include fever, chills and sweating. This can be potentially life-threatening (Leslie et al. 2022).
Kidney stones have the potential to cause long-term kidney damage. They may also increase the risk of urinary or kidney infection, which could potentially lead to sepsis (Better Health Channel 2018; NHS 2019).
Those who have had one kidney stone are also at increased risk of developing another one in the future. The likelihood of experiencing a second kidney stone within five to seven years is 50% (NKF 2022).
Diagnosis will involve:
(NKF 2022)
In most cases, kidney stones can be treated non-surgically. About 90% of stones smaller than 5 mm will pass on their own within three to six weeks (Better Health Channel 2018; Leslie et al. 2022). The patient might also be prescribed medical expulsion therapy to increase the likelihood of the stone passing spontaneously (Leslie et al. 2022; Kidney Stone Melbourne 2017).
While small stones can usually be left to pass on their own without any issues, the patient may require analgesia for pain relief and, potentially, intravenous hydration and anti-emetic medicines (Leslie et al. 2022).
The patient may also be advised to increase their fluid intake (Better Health Channel 2018).
If the stone is too large or is obstructing urine flow, or the patient is displaying signs of infection, surgical intervention will be required (NKF 2022). There are several methods of surgical removal, including:
(Better Health Channel 2018; NKF 2021b, 2022)
The stone should be collected and analysed after it has been passed in order to determine its cause. The patient may also be advised to collect their urine for the next 24 hours so that it can be tested for calcium and uric acid levels, as well as undergo blood tests for calcium, phosphorus and uric acid. This will enable a treatment plan to be prescribed that will hopefully prevent the development of future kidney stones (NKF 2022; Leslie et al. 2022).
Urgent intervention is required in the following situations:
(Leslie et al. 2022)
The risk of kidney stones can be reduced by:
Question 1 of 1
What is the most common type of kidney stone?