Causes of Kidney Stones
The exact cause of kidney stones can vary depending upon the type of stone that is present. The most common form are calcium stones which are most often seen in males aged between 20 and 30. The stone is formed when the calcium combines with oxalate, carbonate or phosphate. Spinach for example, is one food where oxalate is found and should be consumed only in moderation by people who are prone to kidney stone development.

Hereditary disorders like cystinuria can result in cystine stones forming. Another type is the struvite stone which are stones that can grow large and result in blockage of the kidney, bladder or ureter. These are most common in women with urinary tract infections.

Men who have gout or who have had chemotherapy are more prone to getting uric acid stones, another form of kidney stone.

One of the major causes and risk factors of kidney stones is low fluid intake as well as a diet high in refined sugars, animal protein, fructose, apple and grapefruit juice and some soda drinks.

Symptoms of Kidney Stones
The signs of kidney stones are often not noticed until the stones have moved down the ureters, which results in the stones blocking the passage of urine from the kidneys to the bladder. This can result in extreme sudden pain in the side of the back or abdomen area, then sometimes becoming groin pain or testicle pain in men.

Kidney stones can cause a variety of other symptoms including vomiting, nausea, abnormal urine colour or blood in urine, and fevers.

Testing for Kidney Stones
Doctors are able to undertake a physical examination if you present with symptoms of kidney stones. Following a physical exam, certain tests may be performed including:

Kidney function tests

• Blood tests – to check the levels of minerals and electrolytes.
• Urinalysis
• CT scans, ultrasounds and x-rays may also be undertaken to confirm the presence of kidney stones.
• Once kidney stones are diagnosed, the doctor will examine the stone to determine which type it is.

Treatment Options for Kidney Stones
The severity of the symptoms and the type of kidney stones will determine which treatment options your physician will recommend.

Some very small kidney stones will pass through without any assistance. In some cases medication may be prescribed that will help to break the stone down and remove the offending material. The type of medication or product recommended will depend upon which type of stone you have. Antibiotics are often prescribed for struvite stones. For uric acid stones, doctors may recommend Allopurinol. Sodium bicarbonate and water pills are also occasionally used.

In some cases surgery may be required if the stone continues to grow, is too large to pass on its own or to be broken down with substances, or if the stone is resulting in infection of damage to the kidneys.

Footnotes:

1) Strategies for preventing calcium oxalate stones. CMAJ. 2006;174(10):1407-1409. Finkielstein VA (PubMed)

2) Preminger GM. Evaluation and medical management of urinary lithiasis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th edition. Philadelphia, Pa: Saunders Elsevier; 2007:chap 43. Pietrow PK.

3) Nephrolithiasis. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 128. Curhan GC.

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