What are Kidney Stones?
Kidney stones (also called renal stones, nephrolithiasis or urolithiasis) are hard deposits of minerals and salts that form inside the kidneys. They can vary in size — from tiny grains that pass unnoticed in the urine to larger stones that stay in the kidney or become lodged in the ureter (the tube connecting the kidney to the bladder). When a stone blocks the flow of urine, it can cause severe pain, infection and, if not treated, damage to the kidney over time.
Stones can occur at any age, but are most common between 30 and 60 years of age and are seen more often in men. Once a person has had a stone, the chance of another stone in the future is higher, so ongoing preventive care is important.
Types of Kidney Stones
Symptoms of Kidney Stones
Small stones sitting quietly in the kidney may not cause any symptoms and are sometimes discovered by chance during a scan. Symptoms usually appear when a stone moves or blocks urine flow. Common features include:
- Severe pain in the flank or lower back — often called renal colic — that may come in waves and radiate to the lower abdomen or groin
- Blood in the urine (pink, red or brownish urine)
- Nausea and vomiting during a pain episode
- Burning or painful urination
- Increased frequency or urgency of urination
- Cloudy or foul-smelling urine, especially if infection is present
- Fever and chills — a warning sign of infection with obstruction
Causes and Risk Factors
Kidney stones develop when the urine becomes concentrated and certain minerals crystallise and clump together. Contributing factors often include:
- Inadequate water intake, especially in hot climates or with physical work
- High salt, high animal protein or high oxalate diet
- Obesity and metabolic conditions such as diabetes
- Recurrent urinary tract infections
- Family history of stone disease
- Certain medical conditions (for example, hyperparathyroidism, gout) and some medications
- Anatomical problems of the kidney or ureter that slow urinary drainage
When to See a Doctor
Please arrange evaluation if you have suspected stone symptoms such as flank pain, blood in the urine or repeated urinary infections. Some situations require urgent care:
Emergency signs: Fever with flank pain, uncontrollable vomiting, inability to pass urine, severe pain not relieved by medication, or symptoms in a patient with a single functioning kidney — these need immediate hospital evaluation.
Diagnosis
Assessment usually begins with a detailed history and clinical examination. Investigations that may be advised include:
- Urine routine and culture — to look for blood, crystals and infection
- Blood tests — kidney function, calcium, uric acid and infection markers
- Ultrasound of the abdomen and pelvis — usually the first imaging test
- Non-contrast CT scan (CT KUB) — provides accurate information about stone size, number and location
- X-ray KUB — helpful for follow-up of radio-opaque stones
Treatment Options
Treatment depends on the size, number, location and composition of the stone, the presence of obstruction or infection and the patient's overall health. Broadly, options fall into conservative and procedural categories.
Conservative treatment
Small stones — usually less than 5–6 mm — may pass on their own with adequate hydration, pain relief and medication that helps the ureter relax (medical expulsive therapy). Regular follow-up with imaging is advised to ensure the stone is progressing and not causing obstruction.
ESWL (Extracorporeal Shock Wave Lithotripsy)
ESWL uses focused shock waves delivered from outside the body to break selected stones into small fragments that can then pass in the urine. It is a non-surgical option suitable for certain stone sizes and locations; more than one session may be needed depending on the stone.
URS (Ureteroscopy) with laser
A thin scope is passed through the natural urinary passage up to the stone. The stone is either removed directly or broken with a laser. URS is often chosen for stones in the ureter and lower urinary tract.
RIRS (Retrograde Intra-Renal Surgery)
RIRS uses a flexible scope through the natural passage to reach stones inside the kidney and treat them with a laser. It may be an option for selected renal stones.
PCNL (Percutaneous Nephrolithotomy)
For large kidney stones, PCNL involves making a small track through the skin of the back directly into the kidney to remove the stone. It is often preferred for larger or complex renal stones.
Open or laparoscopic surgery
In selected complex situations, open or laparoscopic surgery may still be considered. Your surgeon will discuss the most appropriate option depending on your condition.
Recovery
Recovery varies with the type of procedure and individual factors. Many patients undergoing endoscopic procedures such as URS or ESWL are able to return home the same day or the next day and resume routine activity within a short time. PCNL usually requires a short hospital stay. A temporary ureteric stent may be placed after some procedures and is removed later in the OPD. Your surgeon will guide you individually about medications, fluid intake, follow-up imaging and stent removal.
Prevention of Kidney Stones
Long-term prevention is an important part of care, especially in patients who have already had a stone. General measures often include:
- Drink adequate water throughout the day so that the urine remains pale in colour
- Reduce excess salt and animal protein in the diet
- Include a balanced amount of dietary calcium; do not restrict calcium without medical advice
- Limit foods very high in oxalate if advised (for example, excessive spinach, beetroot)
- Maintain a healthy weight and treat conditions such as diabetes and gout
- Consider stone analysis after a passed or removed stone to guide specific dietary changes
Frequently Asked Questions
What are kidney stones?
Kidney stones are hard deposits of minerals and salts that form inside the kidneys. They may stay silent, cause severe colicky pain, or block urine flow.
What are the symptoms of a kidney stone?
Severe flank pain that may radiate to the groin, blood in urine, nausea, vomiting and painful or frequent urination are common features.
Do all kidney stones need surgery?
No. Small stones often pass with hydration and medication. Larger stones, obstruction or infection usually need a procedure such as ESWL, URS or PCNL.
What is the difference between ESWL, URS and PCNL?
ESWL breaks selected stones using shock waves from outside the body. URS uses a scope through the natural passage. PCNL is used for large renal stones through a small track in the back.
When should I go to the emergency for a kidney stone?
Please seek urgent care for fever with pain, uncontrollable vomiting, inability to pass urine, or severe pain not relieved by medication.
How can I prevent kidney stones from coming back?
Drink plenty of water, reduce salt and excess protein, maintain a healthy weight and follow specific dietary advice based on stone analysis and your surgeon's guidance.
Is kidney stone surgery covered by mediclaim?
Procedures such as ESWL, URS and PCNL are generally covered under most health insurance policies. Madhav Hospital offers mediclaim / insurance facility — please confirm coverage with your insurer.
Consult Dr. Bhavesh Panchal for Kidney Stone Evaluation
Get a proper evaluation and discuss appropriate treatment options for your stone at Madhav Hospital, Thakkarbapanagar, Ahmedabad.