kidney stone risk reduction

Overview

Kidney stones are small, hard deposits that form in the kidneys when minerals and salts in your urine stick together. They can cause severe pain when they travel through the urinary tract, but many stones pass on their own with plenty of fluids and pain relief.

Yes. Kidney stones are very common. In recent years, about 1 in 11 people will have a kidney stone at some point in their life.

Kidney stones affect people of all ages, but they are more common in adults, especially men. People with a family history of stones, chronic dehydration, or certain medical conditions such as obesity and diabetes are at higher risk.

Symptoms

Common symptoms

• Severe pain in the side and back, below the ribs
• Pain that spreads to the lower belly and groin
• Painful or burning feeling when urinating
• Pink, red, or brown urine (blood in urine)
• Cloudy or strong-smelling urine
• Feeling sick to the stomach or throwing up

Symptoms in children

• Belly pain that does not get better
• Blood in the urine (red or pink urine)
• Crying or fussiness in younger children
• Needing to pass urine often or with pain

Symptoms in older adults

• Pain may be less specific, such as general belly discomfort
• New confusion or unusual sleepiness
• Fever and chills may be the only symptom of a urinary infection with a stone
• Difficulty passing urine or only passing small amounts

Causes

Main causes

• Not drinking enough fluids, causing concentrated urine
• A diet high in salt (sodium) and certain foods that promote crystal formation
• Obesity and metabolic conditions such as diabetes or gout
• Urinary tract infections or urinary blockage

Risk factors

• Having had a kidney stone before
• A family history of kidney stones
• Living in a hot, dry climate or working in a hot environment
• Taking some medicines or supplements that increase stone risk
• Not eating enough calcium-rich foods (which is different from taking too much calcium supplementation)

When to see a doctor

See a doctor urgently if:

• Severe pain that comes on suddenly and will not ease
• Fever and chills with back or side pain
• Vomiting that will not stop
• No urine output for many hours

Book a routine appointment if:

• You have had a kidney stone and need a plan to prevent another one
• You have blood in your urine that is not going away
• Your doctor wants to do tests to find out why you form stones

Diagnosis

Your doctor will ask about your symptoms, examine you, and usually order imaging tests to see the stone and check for blockage. Urine and blood tests help find the cause.

Tests that may be done

• CT scan (a special X-ray that shows stones in the kidney and urinary tract)
• Ultrasound of the kidneys and bladder
• Urine test to check for infection or tiny stones
• Blood tests to look for kidney function and levels of minerals

What to expect at your appointment

You may be asked to collect your urine for 24 hours to measure how much stone-forming material you make. 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.

Treatment

Treatment for kidney stones depends on the size, location, and type of stone, as well as your symptoms. Many small stones pass on their own with fluids and pain relief. Larger stones or stones that cause blockage or infection may need a procedure.

Self-care at home

• Drink 2 to 3 liters of fluid a day (enough to keep your urine light yellow)
• Take over-the-counter pain relief as directed by your pharmacist or doctor
• Pass urine through a strainer to catch any stone fragments for testing
• Move around gently; walking can help a small stone move along

Medical treatments

Your doctor may prescribe medicines to help relax the tube between your kidney and bladder (ureter) so a stone can pass more easily. They may also give you stronger pain relief. If you have a type of stone that is caused by infection, you may receive antibiotics. For people who have multiple stones, medicines may be used to change the chemistry of the urine to prevent future stones.

When is surgery considered?

Surgery is needed when a stone is too large to pass, is blocking urine flow, or is causing persistent infection. Common procedures include shock wave therapy that breaks the stone into small pieces, or a thin instrument passed through the urinary passage to remove or break up the stone.

Living with this condition

If you have had a kidney stone, your goal is to prevent another one. The most important habit is drinking enough water every day. Keep a water bottle with you and set reminders if needed.

Lifestyle tips

• Drink plenty of fluids throughout the day, especially water
• Limit salty foods and avoid adding extra salt at the table
• Eat a balanced diet that includes foods with calcium (like milk, yogurt, or leafy greens)
• Avoid very high doses of vitamin C supplements, which can increase stone risk in some people

Diet and exercise

Eat a diet rich in fruits, vegetables, and whole grains. Reduce foods high in oxalates, such as spinach, rhubarb, beets, and nuts, if your doctor recommends it. Regular physical activity helps maintain a healthy weight and reduces stone risk.

Mental health and emotional wellbeing

Having a kidney stone can be stressful. The pain is intense, and worrying about it coming back is normal. It may help to talk to your family or friends, and your healthcare team can answer your questions and reassure you.

Prevention

Many kidney stones can be prevented by drinking enough fluids and making simple dietary changes. If you know what type of stone you had, your doctor can give you specific advice to prevent another one.

Screening programmes

After your first stone, your doctor may recommend a 24-hour urine collection and blood tests to look for risk factors. If you have repeated stones, ongoing monitoring and preventive medicines may be offered.

Complications

If left untreated

• A stone that blocks urine flow can cause severe pain and kidney damage
• Urinary tract infection that spreads to the kidney or bloodstream (sepsis)
• Long-term kidney damage if blockage is not relieved

Long-term outlook

The outlook is good. Most kidney stones pass or are treated successfully without permanent harm. With the right diet, hydration, and medical follow-up, you can greatly lower your risk of having another stone.

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