Kidney stones are hard masses formed from the crystallization of substances within your kidney and urinary system, including calcium, oxalate, uric acid, and cysteine. They can form anywhere along the urinary system and can vary in size and composition, with larger kidney stones causing extreme pain1.
Although kidney stone prevalence differs depending on an individual’s location, worldwide prevalence is rising2. In the US, the overall prevalence has now reached over 10 percent3. Various demographic factors can increase the risk of developing a kidney stone, with the highest prevalence (19.7 percent) occurring in males over 80 years old2.
This article will discuss symptoms of kidney stones, including what kidney stones feel like and what can mimic kidney stone pain, in addition to causes, treatment options, and how to prevent kidney stones.
Kidney Stone Symptoms, Signs & Appearance
Common symptoms
If kidney stones are small, they are able to pass through the urinary system and out of the body in urine without causing any symptoms. However, stones larger than 4 mm will cause symptoms, with increasing severity the larger the stone.
The most common symptom of kidney stones is pain extending from your groin to your side, lower back, and belly. The pain can appear as an underlying dull pain or can be sharp and severe, often progressing in waves1. Other common symptoms include blood in urine and pain when urinating. Urinary tract infections, appendicitis, and musculoskeletal strain/injury can mimic kidney stone pain, causing potential misdiagnoses.
Severe symptoms
Kidney stones, particularly large ones, can cause complications and associated symptoms. Signs of kidney stone complications can include:
- Fever and chills – could be a sign of a kidney infection1.
- Cloudy and bad-smelling urine – could also be a sign of a kidney infection4.
- Nausea and vomiting – could be a sign of kidney swelling due to urine not emptying from the body properly5.
- Inability to urinate – could be a sign of urinary blockage1.
Kidney stones in women and men
The symptoms of kidney stones in men and women can differ. Men may experience testicular and groin pain due to adjacent or linked nerve pathways4. Women may experience pelvic pain, resulting in the first signs of kidney stones being initially misdiagnosed as menstrual pain.
Kidney stones in pregnancy
Pregnancy increases the risk of developing kidney stones6. Symptom overlap between kidney stones and pregnancy-related conditions, such as preterm labor or gynecological conditions, can result in a delayed diagnosis6.
Urinary Tract Infection vs Kidney Stones
Overlapping symptoms between urinary tract infections (UTIs) and kidney stones can lead to misdiagnosis. Both may include a burning feeling when urinating, increased frequency of needing to urinate, blood in the urine, cloudy urine, and pelvic pain. The conditions can be distinguished through the location and intensity of the pain.
Bladder Stones vs Kidney Stones
Bladder stones are similar crystalized masses to kidney stones. However, they form in the bladder rather than the kidney. Bladder stones present with pain in the lower abdomen, whereas kidney stone pain is more common in the lower back or side7.
Gallstones vs Kidney Stones
Gallstones are formed in the gallbladder and may result in severe pain and nausea/vomiting. However, this pain will develop in the top right of the abdomen – potentially spreading to the shoulder – so distinguishing the pain from kidney stone pain8.
Urgent Care for Kidney Stones
Individuals should seek emergency care for kidney stones if presenting with the following symptoms4:
- In severe pain
- High temperature
- Shivering or shaking episodes
- Blood in the urine
Underlying medical conditions
Certain medical conditions can increase risk factors for kidney stones:
- Diabetes
- Cystic fibrosis
- Gout
- High blood pressure
- Obesity
Role of dehydration
Failing to drink enough fluids results in a high concentration of substances within the urine. This can cause the substances to crystallize into kidney stones9.
Impact of infections
Repeated UTIs contribute to the formation of kidney stones, potentially through the presence of certain bacteria promoting the crystallization of substances in the urine10.
Other risk factors
Kidney stones are partially genetic. Therefore, a family history of kidney stones can increase an individual’s risk. Specific medications can also contribute to the risk of developing kidney stones. In addition, lifestyle factors, such as sedentary behavior and poor diet, can increase the risk of developing kidney stones11.
Diagnosis of Kidney Stones
Physical examination
Your medical professional may physically examine you to evaluate where the pain is coming from. Diseases with similar symptoms may present with pain in slightly different locations – kidney stones will cause pain in the lower back and sides.
Imaging tests: ultrasound, CT scans, MRI
To definitively diagnose a kidney stone, medical professionals will carry out imaging of the urinary system. The gold standard kidney stone diagnosis method is a CT scan12. However, other imaging methods may be carried out, including ultrasound or magnetic resonance imaging (MRI)13.
Additional diagnostic tests
A urine sample may be taken to assess the levels of substances within the urine which could cause kidney stones. Blood tests may also be used to check kidney function12.
Treatment Options for Kidney Stones
Kidney stone size and treatment
- 1-5 mm – with extra hydration, these should pass on their own14.
- 5-10 mm – medical expulsive therapy with alpha-blockers may be used15.
- 10-20 mm – extracorporeal shock wave lithotripsy (ESWL)15.
- 20-40+ mm – ureteroscopy or percutaneous nephrolithotripsy15.
Non-invasive techniques
Improving hydration will increase urine output, aiding in the flushing out of small kidney stones14. Alpha-blocker medication may be recommended for slightly larger kidney stones. These work by relaxing muscles in the urinary system, making it easier to pass the stones14.
Minimally invasive procedures
Mid-sized kidney stones may require breaking up to be able to pass out of the body – extracorporeal shock wave lithotripsy can be used to transmit shock waves to the stone through the skin15.
Surgical interventions
Large stones will require surgical interventions to break up the stones. These may include a ureteroscopy, where a tube is inserted up the urethra, allowing the surgeon to view the stones and use a power source (such as a laser) inserted via the tube to break up the stones. A percutaneous nephrolithotripsy involves the surgeon accessing the kidney stones through a small incision in the back15.
Medications and pain management
Over-the-counter medications, such as ibuprofen and paracetamol, may be used to help manage the pain from kidney stones.
Preventing Kidney Stones
Lifestyle modifications
Drinking plenty of fluids can lower your risk of developing kidney stones by diluting urine and keeping minerals at a low concentration, decreasing the possibility of their crystallization16. Maintaining a healthy weight may also help to prevent kidney stones.
Dietary changes
Diets may be implemented by health professionals specific to the type of kidney stone. For example, individuals who have developed uric acid stones should decrease their intake of red meat, as it contains compounds that increase the production of uric acid16. In general, you should aim to eat a healthy, low-salt diet and drink plenty of fluid16.
Addressing underlying health issues
Kidney stones may result from underlying health conditions. Managing these conditions – for example, treating repeated UTIs quickly or keeping blood sugar under control – will help to reduce your risk of developing kidney stones.
Conclusion
Kidney stones are hard, crystalized masses formed in the urinary system, which cause severe pain, commonly in the lower back or side, when passing out of the body. Individuals are at an increased risk of developing kidney stones if they experience dehydration, repeated UTIs, have a family history of stones, or have other medical conditions. Kidney stones often pass out of the body without intervention. However, larger stones may require surgical procedures. You should implement preventive measures to reduce your risk of developing kidney stones.
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FAQ
Q: Are kidney stones genetic?
A: Kidney stones mostly arise from a combination of genetic and environmental conditions, although some specific genetic conditions can increase their risk17.
Q: How long do kidney stones last?
A: This depends on the size of the stone and its location within the urinary system. Most pass naturally within 3 weeks1.
Q: What do kidney stones feel like?
A: Kidney stones cause severe pain, generally in the lower back or side, which comes in waves.
Q: What do kidney stones look like in the toilet?
A: Kidney stones often appear as irregularly shaped ‘rocks’ which sink to the bottom of the toilet bowl. Their color can vary from yellow-brown to brown-black.
Q: Can kidney stones cause constipation?
A: Yes, occasionally, kidney stones can affect bowel movements.
Q: Can stress cause kidney stones?
A: Not directly; however, stress can lead to hormonal changes and behavioral changes (such as dehydration), which may increase the risk of kidney stones18.
Q: What foods cause kidney stones?
A: Consuming a diet high in protein, salt, and sugar, and low in fiber can increase the risk of kidney stones11.
Q: Does coffee cause kidney stones?
A: No, coffee actually decreases the risk of kidney stones19.
Q: Does tea cause kidney stones?
A: This depends on the type of tea. Green tea has protective effects. However, black tea and iced tea may increase the risk20,21.
Q: Does alcohol cause kidney stones?
A: There is limited evidence that alcohol causes kidney stones; however, heavy drinking may indirectly promote kidney stones by increasing the risk of other diseases22.
Q: Does soda cause kidney stones?
A: Yes, drinking soda increases the risk of developing kidney stones23.
Q: Can creatine cause kidney stones?
A: No, there is no link between creatine and kidney stones24.
Q: Can collagen cause kidney stones?
A: Yes, excessive collagen supplementation may increase the risk of kidney stones25.
Q: Does sparkling water cause kidney stones?
A: Unflavored and unsweetened sparkling water does not affect the risk of kidney stones; however, added sugar or artificial sweeteners may increase the risk23.
