Living with kidney stone

Overview

A kidney stone is a hard, solid piece of material that forms in your kidney from substances in your urine, like calcium, oxalate, or uric acid. Stones can be as small as a grain of sand or as large as a golf ball. They may stay in your kidney or travel down the urinary tract. Many kidney stones pass on their own, but some can cause severe pain and need medical treatment.

Yes, kidney stones are very common. Around 1 in 10 people will have a kidney stone at some point in their life. They are becoming more common worldwide, especially in adults aged 30 to 50.

Anyone can get a kidney stone, but they are more likely in men than in women. Other factors that increase your risk include being overweight, living in a hot climate, not drinking enough fluids, and eating a diet high in salt or animal protein. People with certain medical conditions, such as diabetes, high blood pressure, or gout, also have a higher risk.

Symptoms

Common symptoms

• Intense, sharp pain in your side or back, below the ribs
• Pain that spreads to your lower belly or groin
• Pain that comes in waves and changes in intensity
• Pain when urinating
• Pink, red, or brown blood in your urine
• Cloudy or foul-smelling urine
• Feeling the constant need to urinate
• Urinating more often than usual
• Nausea and vomiting
• Fever and chills, if there is an infection

Symptoms in children

• Unexplained fussiness or crying in young children
• Pain in the belly or side (a child may say their tummy hurts)
• Pain or burning when urinating
• Frequent urination or trouble urinating
• Blood in the urine
• Nausea or vomiting
• A fever, if a urinary tract infection is also present

Symptoms in older adults

• Less specific pain, which may be dull or hard to describe
• Sudden confusion or agitation, especially if infection is present
• Pain in the lower belly rather than the side
• General weakness or being unusually tired
• Difficulty urinating or inability to urinate
• Fever or low body temperature with chills

Causes

Main causes

• Not drinking enough water, which makes your urine more concentrated and allows minerals to clump together
• High levels of certain minerals in your urine, like calcium, oxalate, or uric acid
• Too much salt (sodium) in your diet, which increases the amount of calcium your kidneys filter
• Eating a diet high in oxalate-rich foods (such as spinach, nuts, or chocolate) without enough calcium
• Recurrent urinary tract infections, which can lead to a type of stone called a struvite stone
• Certain medical conditions like gout, inflammatory bowel disease, or renal tubular acidosis

Risk factors

• A personal or family history of kidney stones
• Dehydration, especially in hot climates or with heavy exercise
• Obesity or having a high body mass index (BMI)
• A diet high in salt, sugar, or animal protein
• Not getting enough dietary calcium (even though calcium is in stones, eating calcium-rich foods can help prevent them)
• Taking certain supplements or medications, such as high-dose vitamin C, calcium supplements, or some diuretics
• Having a urinary tract infection or a structural problem in your urinary tract
• Having gastric bypass surgery or other digestive issues that affect mineral absorption

When to see a doctor

See a doctor urgently if:

• You have sudden, severe pain in your side or back that does not go away
• You have a fever or chills with your pain
• You cannot urinate or you see blood in your urine
• You feel nauseous and cannot keep down fluids

Book a routine appointment if:

• You have persistent or intermittent pain that worries you
• You notice blood in your urine even without pain
• You have had a kidney stone before and want to prevent another one
• You have a family history of kidney stones and want to discuss your risk

Diagnosis

Your doctor will ask about your symptoms, medical history, and any family history of stones. They will do a physical exam and likely order tests to confirm whether you have a stone, find its size and location, and check for any complications.

Tests that may be done

• Urine tests to check for blood, minerals, infection, or small stones that have passed
• Blood tests to measure kidney function and levels of calcium, uric acid, and other substances
• Imaging tests, such as a CT scan, ultrasound, or X-ray, to see the stone's size, shape, and position
• If you pass a stone, you may be asked to catch it in a strainer so it can be sent to a lab for analysis

What to expect at your appointment

The most common test used by emergency doctors is a CT scan, because it gives a clear picture of your kidneys and urinary tract. It is quick and painless. In some cases, you may have an ultrasound instead, especially if you are pregnant or need to avoid radiation. Your doctor will explain the results and talk about the best treatment plan for you.

Treatment

Treatment for kidney stones depends on the stone's size, location, and whether it is causing symptoms. Many small stones pass on their own with plenty of fluids and pain relief. Larger stones, stones that block urine flow, or stones that cause infection may need medical or surgical treatment.

Self-care at home

• Drink plenty of water — aim for enough to keep your urine pale and clear (around 2 to 3 litres a day, if your doctor advises)
• Take over-the-counter pain relief such as paracetamol or ibuprofen, as approved by your doctor or pharmacist — this can help manage mild pain while the stone passes
• Move around gently — a stone may pass faster with normal activity, but avoid intense exercise that causes pain
• Use a urine strainer if your doctor gives you one, to catch the stone for testing
• Track your symptoms and contact your doctor if pain gets worse or you develop a fever

Medical treatments

If a stone is not passing on its own, your doctor may recommend a class of medicine that helps relax the muscles in your urinary tract, which can help the stone move through more easily. This approach is called medical expulsive therapy. You may also receive prescription pain relief if over-the-counter options are not enough. Always follow your doctor's guidance on medicines, and do not take any medication without checking with them first.

When is surgery considered?

Surgery may be needed if the stone is very large, blocks urine flow, causes infection, or fails to pass after a reasonable time. Common procedures include using shock waves to break the stone into small pieces (lithotripsy), using a thin tube to remove the stone (ureteroscopy), or a minor keyhole operation through your back (percutaneous nephrolithotomy). These are routine and performed by specialist urologists. Your doctor will explain which option is best for you.

Living with this condition

While you are passing a kidney stone, you may have days of pain and discomfort. Rest as much as you can, use heating pads or warm baths to relax cramped muscles, and sip water regularly. Most stones pass within a few days to a few weeks. Keep in touch with your doctor so they know how you are doing.

Lifestyle tips

• Drink plenty of fluids throughout the day, especially water, to keep your urine diluted
• Reduce salt in your diet — choose fresh foods over processed or packaged ones
• Keep eating calcium-rich foods (like milk, yogurt, and cheese) unless your doctor tells you otherwise
• Limit foods high in oxalate, such as spinach, rhubarb, beets, nuts, and chocolate, if your doctor suggests
• Maintain a healthy weight and stay physically active
• Limit sugary drinks and drinks sweetened with high-fructose corn syrup

Diet and exercise

A balanced diet is key to managing kidney stones. Include plenty of fruits, vegetables, whole grains, and lean proteins. Stay within a healthy weight for your body, and aim for regular, moderate exercise. Avoid crash diets or very high-protein low-carb diets, which can increase stone risk. Your doctor or a dietitian can help you create a meal plan that fits your needs.

Mental health and emotional wellbeing

Living with kidney stones can be stressful, especially if you have repeated stones or severe pain. The worry of when the next attack might happen can cause anxiety. It is normal to feel frustrated or scared. Talk to your doctor about your emotional health, and ask for support if you need it. Your daily life matters, and you deserve help for all aspects of your health.

Prevention

For most people, kidney stones can be prevented or made less likely. The most important step is to drink enough fluids, especially water, to keep your urine clear and dilute. Eating a balanced diet, reducing salt, and maintaining a healthy weight also help. If you have had a stone, your doctor may order urine and blood tests to learn what caused it, so you can get specific dietary advice to reduce your risk of another one.

Screening programmes

If you have a history of kidney stones, your doctor may suggest periodic urine or blood tests to monitor your mineral levels. Imaging tests are not usually needed for routine screening unless you have symptoms. Talk to your doctor about a follow-up plan that is right for you.

Complications

If left untreated

• A stone can block the flow of urine from your kidney, causing urine to back up and damage your kidney or lead to permanent kidney malfunction
• A urinary tract infection can develop behind the blockage and spread to your kidneys or bloodstream, which can be life-threatening
• Large or irregular stones may not pass on their own and can cause repeated severe pain
• Kidney stones can come back in the future, especially if risk factors remain

Long-term outlook

The outlook for most people with kidney stones is good. With proper care, most stones pass or are treated without lasting harm. Even if you have more than one stone, steps are available to lower your risk. Your healthcare team can help you manage the condition, and many people return to their normal lives within a week or two of passing a stone.

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