Special Services

Recognizing the Symptoms and Signs of a Kidney Stone

Kidney stones are known to cause severe pain. Symptoms of kidney stones may not occur until the stone begins to move down the ureters. This severe pain is called renal colic. You may have pain on one side of your back or abdomen. In men, pain may radiate to the groin area. The pain of renal colic comes and goes, but can be intense. People with renal colic tend to be restless.

• Blood in the urine (red, pink, or brown urine)
• Vomiting
• Nausea
• Discolored or foul-smelling urine.
• Chills
• Fever
• Frequent need to urinate
• Urinating small amounts of urine

In the case of a small kidney stone, you may not have any pain or symptoms as the stone passes through your urinary tract.

Stones don’t always stay in the kidney. Sometimes, they pass from the kidney into the ureters. Ureters are small and delicate, and the stones may be too large to pass smoothly down the ureter to the bladder. Passage of stones down the ureter can cause spasms and irritation of the ureters as they pass, which causes blood to appear in the urine. Sometimes stones block the flow of urine. This is called a urinary obstruction. Urinary obstructions can lead to kidney infection (pyelonephritis) and kidney damage.

Diagnosis of kidney stones requires a complete health history assessment and a physical exam. Other tests include:

• blood tests for calcium, phosphorus, uric acid, and electrolytes
• Blood urea nitrogen (BUN) and creatinine to assess kidney functioning
• Urinalysis to check for crystals, bacteria, blood, and white cells
• Examination of passed stones to determine type.

• Abdominal X-rays
• Intravenous pyelogram (IVP)
• Retrograde pyelogram
• Ultrasound of the kidney (this is the preferred study)
• MRI of the abdomen and kidneystrasound of the kidney (this is the preferred study)
• Abdominal CT scan

Treatment is tailored according to the type of stone. Urine can be strained and stones collected for evaluation. Drinking six to eight glasses of water a day increases urine flow. People who are dehydrated or have severe nausea and vomiting may need intravenous fluids. Other treatment options include:

Pain relief may require narcotic medications. The presence of infection requires treatment with antibiotics. Other medications include:

• allopurinol for uric acid stones
• Diuretics
• Sodium bicarbonate or sodium citrate
• Phosphorus solutions

Extracorporeal shock wave lithotripsy uses sound waves to break up large stones so they can more easily pass down the ureters into your bladder. This procedure can be uncomfortable and may require light anesthesia. It can cause bruising on the abdomen and back and bleeding around the kidney and nearby organs.

Stones are removed through a small incision in your back and may be needed when:

• the stone causes obstruction and infection or is damaging the kidneys
• the stone has grown too large to pass
• pain cannot be controlled

When a stone is stuck in the ureter or bladder, your doctor may use an instrument called a ureteroscope to remove it. A small wire with a camera attached is inserted into the urethra and passed into the bladder. A small cage is used to snag the stone and remove it. The stone is then sent to the laboratory for analysis.

Proper hydration is a key preventive measure. Doctor recommends drinking up to 12 glasses of water daily. Drinking more fluids increases the amount of urine you pass, which helps flush the kidneys. Doctor recommends passing 2.5 liters of urine a day. You can substitute some glasses of water with ginger ale, lemon-lime soda, and fruit juice. Eating oxalate-rich foods in moderation and reducing your intake of salt and animal proteins can also lower your risk of kidney stones. Your doctor may prescribe medications to help prevent the formation of calcium and uric acid stones. If you’ve had a kidney stone, or you’re at risk for a kidney stone, speak with your doctor and discuss the best methods of prevention