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What are Kidney Stones?

Kidney stones are also known as Renal Calculus and can develop in 1 or both kidneys and most often affect people aged 30 to 60. They're quite common, with around 2 in 10 people affected. Kidney stones are located in the kidneys or in the ureter, the ureter is the tube that connects the kidneys to your bladder. They can be extremely painful, and can lead to kidney infections or the kidney not working properly if left untreated.

The kidneys

The kidneys are 2 bean-shaped organs that are roughly 10cm (4 inches) in length.

They're located towards the back of the abdomen on either side of the spine.

The kidneys remove waste products from the blood. The clean blood is then transferred back into the body and the waste products are passed out of the body when you pee.


Symptoms of kidney stones

Very small kidney stones are unlikely to cause many symptoms. They may even go undetected and pass out painlessly when you urinate. Larger kidney stones can cause symptoms, including:

  • pain in the side of your tummy (abdomen) or groin – men may have pain in their testicles

  • a high temperature

  • feeling sweaty

  • severe pain that comes and goes

  • feeling sick or vomiting

  • blood in your urine

  • urine infection


Blocked ureter and kidney infection


A kidney stone that blocks the ureter, the tube that connects your kidney to your bladder, can cause a kidney infection.



This is because waste products are not able to pass the blockage, which may cause a build-up of bacteria. The symptoms of a kidney infection are similar to symptoms of kidney stones, but may also include:

  • High temperature

  • chills and shivering

  • feeling very weak or tired

  • bad-smelling and cloudy urine


When to get urgent medical help

You should contact a GP or NHS 111 immediately if:

  • you're in severe pain

  • you have a high temperature

  • you have an episode of shivering or shaking

  • you have blood in your urine


Our specialists provide a fast diagnosis and easy access to appointments.


What causes kidney stones?

Waste products in the blood can occasionally form crystals that collect inside the kidneys.

Over time, the crystals may build up to form a hard stone-like lump.

This is more likely to happen if you:

  • do not drink enough fluids

  • are taking some types of medication

  • have a medical condition that raises the levels of certain substances in your urine therapy for the best results.


Your GP will usually be able to diagnose kidney stones from your symptoms and medical history.

It'll be particularly easy if you have had kidney stones before. 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

You may be told what equipment you'll need to collect a kidney stone. Having a kidney stone to analyse will make a diagnosis easier, and may help your GP determine which treatment method will be of most benefit to you.

If you're in severe pain

If you have severe pain that could be caused by kidney stones, your GP should refer you to hospital for an urgent scan:

  • Adults should be offered an X-ray, Ultrasound or a CT scan

  • Pregnant women should be offered an ultrasound scan

  • Children and younger people under 16 should be offered an ultrasound – if the ultrasound does not find anything, a low-dose non-contrast CT scan may be considered


Treating small kidney stones

Small kidney stones may cause pain until you pass them, which usually takes 1 or 2 days.

A GP may recommend a non-steroidal anti-inflammatory drug (NSAIDs) to help with pain.

To ease your symptoms, a GP might also recommend:

  • drinking plenty of fluids throughout the day

  • anti-sickness medicine

  • alpha-blockers (medicines to help stones pass)

You might be advised to drink up to 3 litres (5.2 pints) of fluid throughout the day, every day, until the stones have cleared. To help your stones pass:

  • drink water, but drinks like tea and coffee also count

  • add fresh lemon juice to your water

  • avoid fizzy drinks

  • do not eat too much salt

Make sure you're drinking enough fluid. If your pee is dark, it means you're not drinking enough. Your pee should be pale in colour. You may be advised to continue drinking this much fluid to prevent new stones forming. If your kidney stones are causing severe pain, your GP may send you to hospital for tests and treatment.

Treating large kidney stones

If your kidney stones are too big to be passed naturally, they're usually removed by surgery.

Surgery for treating kidney stones

The main types of surgery for removing kidney stones are:

  • Shockwave lithotripsy (SWL)

  • ureteroscopy

  • percutaneous nephrolithotomy (PCNL)

Your type of surgery will depend on the size and location of your stones.

Shock wave lithotripsy (SWL)

SWL involves using ultrasound (high-frequency sound waves) to pinpoint where a kidney stone is. Shockwaves are then sent to the stone from a machine to break it into smaller pieces so it can be passed in your urine. SWL can be an uncomfortable form of treatment, so it's usually carried out after giving painkilling medication. You may need more than 1 session of SWL to successfully treat your kidney stones.



Ureteroscopy

Ureteroscopy involves passing a long, thin telescope called a ureteroscope through the tube urine passes through on its way out of the body (the urethra) and into your bladder.

It's then passed up into your ureter, which connects your bladder to your kidney.

The surgeon may either try to gently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so it can be passed naturally in your urine.

Ureteroscopy is carried out under general anaesthetic, where you're asleep.

Percutaneous nephrolithotomy (PCNL)

PCNL involves using a thin telescopic instrument called a nephroscope.

A small cut (incision) is made in your back and the nephroscope is passed through it and into your kidney. The stone is either pulled out or broken into smaller pieces using a laser or pneumatic energy. PCNL is always carried out under general anaesthetic.

Complications of treatment

Complications can occur after the treatment of large kidney stones. Your surgeon should explain these to you before you have the procedure. Possible complications will depend on the type of treatment you have and the size and position of your stones. Complications could include:

  • sepsis, an infection that spreads through the blood, causing symptoms throughout the whole body

  • a blocked ureter caused by stone fragments (the ureter is the tube that attaches the kidney to the bladder)

  • an injury to the ureter

  • a urinary tract infection (UTI)

  • bleeding during surgery

  • pain


Prevention

The best way to prevent kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated.


To prevent stones returning, you should aim to drink up to 3 litres (5.2 pints) of fluid throughout the day, every day.

You're advised to:

  • drink water, but drinks like tea and coffee also count

  • add fresh lemon juice to your water

  • avoid fizzy drinks

  • do not eat too much salt

Keeping your urine clear helps to stop waste products getting too concentrated and forming stones. You can tell how diluted your urine is by looking at its colour. The darker your urine is, the more concentrated it is. Your urine is usually a dark yellow colour in the morning because it contains a build-up of waste products that your body's produced overnight. Drinks like tea, coffee and fruit juice can count towards your fluid intake, but water is the healthiest option and is best for preventing kidney stones developing. You should also make sure you drink more when it's hot or when you're exercising to replace fluids lost through sweating. Depending on the type of stones you have, your doctor may advise you to cut down on certain types of food. But do not make any changes to your diet without speaking to your doctor first.


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