Kidney Stones

Kidney stones are a relatively common health condition that can cause severe pain and other ongoing symptoms that impact quality of life. However, with the right care, most patients make a full recovery. Houston Methodists team of leading urologists offers comprehensive care for kidney stones, from accurate diagnosis to the latest minimally invasive treatment options. Whether you’re managing your first stone or dealing with a recurring condition, our specialists will guide you through every step of kidney stone care.

What Are Kidney Stones?

When high levels of certain substances, such as calcium, occur in the urine, a solid kidney stone may form. Kidney stones vary in size from a grain of sand to a golf ball, and may remain in the kidney or travel down the urinary tract. A small stone may pass on its own, with little or no pain, whereas a larger stone may lodge along the urinary track, blocking the flow of urine and causing severe pain or blood in the urine.

 

There are several different types of kidney stones, categorized by the material that makes up their composition. These include:

 

• Calcium stones: These are the most common type of kidney stones and are made up of calcium deposits that occur when calcium binds with oxalate (calcium oxalate stones) or phosphate (calcium phosphate stones) contained in the urine.
• Cystine stones: These stones are rare and are caused by a hereditary disorder known as cystinuria.
• Struvite stones: These stones are not common, but are typically found in people who are more prone to urinary tract infections (UTIs), due to the presence of certain types of bacteria.
• Uric acid stones: These are more common in men or in people who eat animal-based diets that are excessively high in protein.

Why Choose Houston Methodist for Kidney Stone Care

When it comes to kidney stone treatment, experience and expertise matter. Houston Methodist’s team of nationally recognized urologist brings together advanced diagnostic tools, the latest minimally invasive surgical techniques and a patient-centered approach to deliver outstanding care. From your initial consultation throughout your recovery, our specialists work closely with you to develop a personalized treatment plan that addresses your needs today and your long-term urological health.

Common Causes of Kidney Stones

Kidney stones may form when certain salts and minerals build up in the urine and crystallize over time. A number of factors can contribute to this process, including:

 

• Dehydration: Not consuming enough water concentrates the urine, which makes it easier for minerals to bind together and form stones.
• High-sodium diet: Excess sodium raises the amount of calcium in the urine.
• High-oxalate foods: Many foods like spinach, nuts and chocolate contain oxalate, which can bind with calcium in the urine.
• High animal protein intake: Diets that contain large amounts of red meat, poultry, shellfish or other rich foods raise uric acid levels in the urine, which promote stone formation.
• Family history: A genetic predisposition to kidney stones may significantly increase the risk of developing them.
• Obesity: Excess body weight can, over time, alter the chemical balance in the urine, creating optimal conditions for stone formation.
• Medical conditions: Conditions like hyperparathyroidism, Crohn’s disease and UTIs all increase the risk of kidney stones.
• Medications: Certain diuretics, calcium-based antacids and other medications can raise the concentration of stone-forming minerals in the urine.
  
   

Types of Kidney Stone Conditions

Kidney stones can vary widely in size, location and behavior. Understanding the specific type of condition helps guide the most effective treatment approach.

Nephrolithiasis

Nephrolithiasis is the medical term for kidney stones that include all kinds of hard mineral deposits that form within the kidney itself. Stones may remain in the kidney without causing symptoms or may move into the urinary tract, triggering pain and other complications.

Ureteral Stones

Ureteral stones are kidney stones that have moved out of the kidney and into the ureter, the narrow tube connecting the kidney to the bladder. Stones lodged in the ureter can cause a blockage that impedes urine flow, causing severe pain and increasing the risk of infection or kidney damage if left untreated.

Large Kidney Stones

Stones larger than 10mm are unlikely to pass through the body naturally and typically require medical or surgical intervention. Large kidney stones can cause significant pain, obstruct urine flow and may need to be broken apart or surgically removed depending on the exact size and location.

Recurring Kidney Stones

Some patients experience kidney stones as a chronic condition, which may signal an underlying metabolic or dietary issue that needs to be addressed. Managing recurring stones often involves a combination of lifestyle changes, dietary adjustments and in some cases medication to reduce the risk of future stone formation.

Signs & Symptoms of Kidney Stones

The most common symptoms associated with kidney stones include:

Pain

Pain related to kidney stones may be centered in the lower back, on the side or in the lower abdomen, which may spread to the groin. This pain can be severe, especially during a passage event. Some patients experience pain that comes on in waves, fluctuating from dull and achy to sharp and intense.

Blood in Urine

Blood in the urine, called hematuria, is a common sign of kidney stones, as well as other urological conditions. The blood may be microscopic and therefore not visible to the naked eye, or it may cause the urine to appear pink or red.

Gastrointestinal Issues

Nausea and vomiting are common symptoms of kidney stones. This is typically caused by the intense pain some patients experience, which can make it hard to eat or drink as normal.

Frequent Urination

Many kidney stone patients report a need to urinate more often, or a burning sensation during urination. Some also have a feeling of urgency, even when they don’t produce any urine. Cloudy urine or urine with a distinct odor is also a sign of possible infection or kidney stones.

How Kidney Stones Are Diagnosed

If you have severe pain and other symptoms of kidney stones, your urologist will likely perform one or more of the following diagnostic tests to confirm the presence of stones:

 

• Imaging: Diagnostic imaging for kidney stones may include X-rays, CT scans or ultrasound.
• Blood tests: Labs can show the presence of calcium, uric acid or phosphorus, and can also test kidney function.
• Urinalysis: A urine test will confirm the presence of blood, crystals or signs of infection in the urine.
• Stone analysis: If you have passed a stone, it may be analyzed to determine size and type, to help guide your urologist in developing a treatment and prevention plan.

 

People who have had a kidney stone have a 25-50% chance of recurrence over time. This painful and prevalent disease can be managed and the risk of recurrence reduced if treated from both surgical and metabolic perspectives. Due to the high rate of recurrence, patients undergo a comprehensive analysis to assess their risk factors, including:

 

• History of large or multiple kidney stones
• Family history of stones
• Intestinal disease (particularly inflammatory bowel disease and chronic diarrhea)
• Gastric bypass
• Obesity
• Pathologic skeletal fractures
• Osteoporosis
• History of urinary tract infection with calculi
• Stones composed of cystine, uric acid or struvite
• Anatomic abnormalities
• Gout

Treatment Options for Kidney Stones

Treatment of each patient is individualized on the basis of the chemical composition of the stone and the patient’s overall medical condition.

Nonsurgical Treatment Options

Nonsurgical options for the prevention of recurrent kidney stones range from lifestyle modifications to nutritional adjustments to medication and may include:

 

• Wait-and-see: For patients with smaller stones, a urologist may recommend waiting to see if the stone passes naturally on its own with increased fluid intake.
• Shock wave lithotripsy: SWL uses sound waves to external send a pulse into the kidneys that can break apart larger stones into smaller pieces, allowing them to pass naturally.
• Pain management: While waiting for stones to pass naturally, a physician may recommend taking an anti-inflammatory or NSAID for over-the-counter pain management.
• Dietary changes: Patients may be asked to lower their sodium intake or reduce the amount of animal proteins they consume to prevent stones from recurring.
  
   

Surgical Treatment Options

When surgery is needed to treat large stones, we use advanced instruments that are half the size of traditional surgical tools and smaller incision to make the procedures as minimally invasive as possible. Surgical treatments include:

 

• Percutaneous nephrolithotomy: PCNL is a common procedure for large stones, in which a small incision in the back allows the surgeon to directly access the kidney and remove the stone.
• Ureteroscopy: In this procedure, a tube is passed through the urethra and bladder to access the ureter or kidney. This procedure may be paired with laser lithotripsy to break up the stones, or basket retrieval to remove them entirely.