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Kidney Stone Symptoms – Recognize the Signs

Kidney stones often cause severe flank pain, blood in the urine, and nausea. Learn which symptoms indicate kidney stones and when to seek medical attention.

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Kidney stones often cause severe flank pain, blood in the urine, and nausea. Learn which symptoms indicate kidney stones and when to seek medical attention.

What Are Kidney Stones and How Do They Form?

Kidney stones (medically known as nephrolithiasis) are hard deposits made of minerals and salts that form inside the kidneys. They develop when urine contains high concentrations of certain substances – such as calcium, oxalate, or uric acid – that crystallize over time. Kidney stones can range in size from tiny grains to stones several centimeters in diameter.

Common Symptoms of Kidney Stones

Small kidney stones often cause no symptoms and are discovered incidentally. However, when a stone moves into the ureter (the tube connecting the kidney to the bladder), it can trigger significant symptoms:

Pain

Renal colic: Severe, wave-like pain in the side and back, below the ribs, which may radiate to the lower abdomen, groin, and genitals.
Pain or burning sensation during urination
A dull ache or pressure in the kidney area

Urine Changes

Hematuria: Blood in the urine – the urine may appear pink, red, or brownish.
Cloudy or foul-smelling urine (a possible sign of an accompanying infection)
Frequent urge to urinate or difficulty urinating

General Symptoms

Nausea and vomiting
Sweating and restlessness
Fever and chills (in the presence of a urinary tract infection – requires immediate medical attention)

When to Seek Immediate Medical Help

The following symptoms require urgent medical evaluation:

Severe, persistent flank pain (renal colic)
Fever combined with back or flank pain – this may indicate a serious kidney infection (pyelonephritis)
Complete inability to urinate
Clearly visible blood in the urine

Possible Causes of Kidney Stones

Several factors can contribute to the formation of kidney stones:

Insufficient fluid intake
A diet high in oxalate (e.g., spinach, nuts) or animal protein
Family history of kidney stones
Metabolic conditions such as gout (elevated uric acid) or hypercalcemia
Chronic urinary tract infections
Certain medications

Diagnosis of Kidney Stones

Doctors use several methods to diagnose kidney stones:

Ultrasound: The first-line imaging method to locate stones
CT scan: Provides detailed information on the size and position of the stone
Urine analysis: Detects blood, signs of infection, and stone-forming substances
Blood tests: Assess kidney function and metabolic values

Treatment of Kidney Stones

Treatment depends on the size, location, and composition of the stone:

Conservative management: Increased fluid intake, pain relief, and alpha-blockers to relax the ureter – often sufficient for small stones
Extracorporeal shock wave lithotripsy (ESWL): Non-invasive fragmentation of the stone using sound waves
Ureteroscopy: A minimally invasive procedure to remove the stone through the urethra
Percutaneous nephrolithotomy (PCNL): Surgical removal for very large or complex stones

Prevention of Kidney Stones

The risk of recurrence can be significantly reduced by:

Drinking at least 2–3 liters of fluid per day
Following a balanced diet low in salt and animal protein
Limiting foods high in oxalate
Regular follow-up check-ups with a healthcare provider

References

Türk C. et al. – EAU Guidelines on Urolithiasis. European Association of Urology (2023). Available at: https://uroweb.org/guidelines/urolithiasis
Pearle MS, Goldfarb DS, Assimos DG et al. – Medical Management of Kidney Stones: AUA Guideline. Journal of Urology, 2014;192(2):316-324.
World Health Organization (WHO) – Chronic kidney disease and urolithiasis: global burden and prevention strategies. WHO Technical Report (2022).

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