About the Kidneys and Kidney Stones

The kidney is really a filter for your blood. This not only removes wastes products but regulates electrolytes and of course makes urine. In the kidney, ureter and bladder chemicals within the urine can crystallize forming a stone if the urine is too concentrated. These stones are very tiny when they form but grow over time to an inch or larger.

Urolithiasis means stones in the urinary tract, while nephrolithiasis (nephro = kidney) refers to kidney stones and ureterolithiasis refers to stones within the ureter. The size of the stone and where it is located and whether it obstructs urine is most important. A stone in the kidney will not typically cause pain in the ureter unless it is blocking and causes a pressure back up into the kidney. The kidney will then swell, causing pain and nausea.


Types of Kidney Stones

The stone-forming substances are:

  • Calcium
  • Oxalate
  • Urate
  • Cysteine
  • Xanthine
  • Phosphate
Signs & Symptoms

Signs and Symptoms of Kidney Stones

  • Pain in the lower back or flank of body
  • Nausea and/or vomiting
  • Blood in the urine
  • Pain when urinating
  • Unable to urinate
  • Feeling the need to urinate more often
Risk Factors

Risk Factors for Kidney Stones

Risks for developing kidney stones include:

  • Dehydration
  • Recurrent urinary tract infections
  • Blockage of urine in the urinary tract
  • Family history of kidney stones

Health conditions that affect the levels of the substances in the urine that can cause stones to form:

  • Hypercalciuria, which is high calcium levels in the urine
  • High blood pressure
  • Diabetes
  • Obesity
  • Osteoporosis
  • Gout
  • Kidney cysts
  • Cystic fibrosis
  • Parathyroid disease
  • Inflammatory bowel disease
  • Chronic diarrhea
  • Some surgical procedures, including weight loss surgery or other stomach/intestine surgeries


  • Crixivan ® (used to treat HIV infections)
  • Topamax ® and Dilantin ® (used to treat seizures)

Diagnosis of Kidney Stones

Diagnosis starts with a physical exam and review of your medical history.

Other tests include:

  • Blood test
  • Urine test
  • Imaging tests: kidney ultrasound, X-rays, and gold standing the CT scan

How to treat Kidney Stone?

Stones can be treated with shock wave lithotripsy, ureteroscopic lithotripsy, tube (PCNL) and occasionally open or laparoscopic surgery. Basic metabolic evaluation consists of urine analysis and electrolytes especially checking for hypercalcemia.

Full metabolic work-up is usually reserved for repeat stone formers using 24 hour urine testing.

Kidney stone treatment depends on the size and type of stone as well as whether infection is present. Stones 4 mm and smaller in about 90 percent of cases; those 5–7 mm do so in 50 percent of cases; and those larger than 7 mm rarely pass without a surgical procedure.

Medications called alpha blockers have been shown to increase the spontaneous passage of kidney stones, especially smaller stones in the lower ureter near the bladder.

These medications have the ability to relax the ureter. This relaxation serves to improve spontaneous stone passage rates by about 30 percent. Some of the alpha blocker medications include tamsulosin (Flomax), alfuzosin (Uroxatral), terazosin (Hytrin), and doxazosin (Cardura). If you are trying to pass a stone often the patient is instructed to strain their urine to collect the stone.

Extracorpeal Shock wave lithotripsy (ESWL) is used to treat stones in the kidney.

Xray or ultrasound is used to find the stone, then shock waves are used to breakdown the stone. The smaller pieces of the stones pass out in the urine over the course of a few weeks. ESWL does not work well on hard stones made of cystine, calcium oxalate and calcium phosphate or when stones are large. Patients can go home the same day and resume normal activities in two to three days. Risks and side effects are blood in the urine, passing stone parts, infection, or abscess, or hematoma around the kidney.

Ureteroscopy (URS) is used to treat stones in the kidney and ureter using a camera and a laser to blast the stones.

URS involves passing a very small telescope, called an ureteroscope, that goes into the bladder, then up into the ureter and into the kidney. Once the urologist sees the stone with the ureteroscope, a small, basket-like device grabs smaller stones and removes them. If a stone is too large to remove in one piece, it can be broken into smaller pieces with a laser or other stone-breaking tools.

Once the stone has been removed then a ureteral stent is placed. The stent does not stay forever, but can stay in for about 3-4 months. This can cause urgency and frequency of urination and some bladder discomfort. A stent is a tiny, rigid plastic tube that helps hold the ureter open so that urine can drain from the kidney into the bladder. The stent is removed in the office or clinic 7-10 days later in most situations. Just like shockwave treatment, patients go home the same day as the URS and can begin normal activities in two to three days. Sometimes a string is left on the end of the stent so you can remove it on your own.

When to See a Provider

Submit an online appointment request or call 310-582-7137 if you have any signs and symptoms that worry you.