Kidney stones – incidence and treatments

Who gets kidney stones?

The peak onset of kidney stones is at 35-45 years old but really anyone can get them. If you have a family history of kidney stones it can almost double your chances of getting one.

Why do we get them?

Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid — than the fluid in your urine can dilute. Sometimes, your urine may lack substances that stop crystals sticking together. If these two situations happen together it is the perfect environment for a stone to form.

Some medications and some other medical conditions can make the formation of kidney stones more likely. If you have previously had a kidney stone it can increase your chances of getting another (recurrent kidney stones).

How are they diagnosed?

If your doctor suspects you have a kidney stone they may conduct a couple of tests:

Urine test to check for infections and pieces of stone

  • Examination of any stones passed

  • A blood test to check kidney function

If you’re referred to a specialist (urologist) because of the pain they may do further tests. These might include:

  • CT scan: this is a series of x-rays to build a picture

  • Ultrasound: uses sound waves to create an image of the inside of the body

Generally, the imaging and diagnostic method are tailored to the individual patient.

How do we treat them?

Often kidney stones are small enough (less than 4mm wide) for you to pass them in your urine (although this can still be painful) so your doctor may prescribe some pain killers. The pain usually lasts a couple of days and once the stone is passed will disappear.

You may be admitted to hospital if you’re in severe pain or you’re at higher risk (over 60, pregnant, dehydrated or symptoms aren’t improving following pain relief).

Larger kidney stones, 6-7mm or larger, are too big to pass naturally so you may need alternative treatment to remove it. This could include:

  • ESWL – extracorporeal shock wave lithotripsy: this involves using ultrasound to pinpoint the stone before ultrasound shockwaves are directed at the stone to break it up into smaller pieces to be passed naturally. Depending on the stone this can be done in one session or multiple sessions.

  • Ureteroscopy – this involves passing a ureteroscope (long thin telescope-like camera) from the urethra into the bladder and along the ureter to reach the stone. The surgeon may then remove the stone with another instrument or use laser to break the stone into smaller piece to pass naturally.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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