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Calcium Stone – Causes, Symptoms and Treatment
Calcium stones are the most common type of kidney stone, usually composed of calcium oxalate or calcium phosphate. They form when urine contains too high a concentration of minerals.
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Calcium stones are the most common type of kidney stone, usually composed of calcium oxalate or calcium phosphate. They form when urine contains too high a concentration of minerals.
What Is a Calcium Stone?
A calcium stone is a type of kidney stone (medically known as urolithiasis) that forms in the kidneys or urinary tract. Calcium stones account for approximately 70–80% of all kidney stones, making them the most prevalent type. They are primarily composed of calcium oxalate or calcium phosphate, and sometimes a mixture of both. When mineral salts accumulate and crystallize in the urine, solid deposits called kidney stones can develop.
Causes
The development of calcium stones is multifactorial, meaning several factors can contribute:
- Hypercalciuria: Elevated calcium excretion in the urine is the most common cause. It can result from increased intestinal calcium absorption, reduced renal reabsorption, or increased bone resorption.
- Hyperoxaluria: Excess oxalate in the urine, for example due to a diet high in oxalate-rich foods (spinach, rhubarb, nuts) or a genetic disorder of oxalate metabolism.
- Low fluid intake: Insufficient hydration leads to concentrated urine, in which minerals are more likely to crystallize.
- Hyperparathyroidism: Overactivity of the parathyroid glands raises blood calcium levels and increases calcium excretion in the urine.
- Certain medical conditions: Crohn's disease, other inflammatory bowel diseases, and gout can increase the risk.
- Genetic factors: A family history of kidney stones is a recognized risk factor.
Symptoms
Small calcium stones often pass unnoticed. Larger stones, however, can cause significant discomfort:
- Renal colic: Sudden, severe, cramping pain in the flank or back, which may radiate to the groin, lower abdomen, or genitals.
- Blood in the urine (hematuria): Urine may appear pink, red, or brown.
- Nausea and vomiting
- Frequent urge to urinate and a burning sensation when urinating
- Fever and chills if a urinary tract infection is also present (medical emergency)
Diagnosis
Calcium stones are diagnosed using several methods:
- Ultrasound: A simple, radiation-free method for detecting kidney stones.
- CT scan (computed tomography): The most accurate imaging technique for determining the location, size, and number of stones.
- Blood and urine tests: To measure calcium, oxalate, phosphate, creatinine, and other relevant values.
- Stone analysis: If a stone is passed, it can be chemically analyzed to determine its exact composition.
Treatment
Conservative Management
Small stones (under approximately 5 mm) often pass on their own. The following measures support this process:
- Adequate fluid intake (at least 2–3 liters per day)
- Pain relief medications (e.g., diclofenac, metamizole)
- Alpha-blockers to relax the ureter muscles and facilitate stone passage
Medical Procedures
- Extracorporeal Shock Wave Lithotripsy (ESWL): Stones are broken up from outside the body using shock waves.
- Ureteroscopy (URS): A thin endoscope is inserted through the urethra to remove or fragment the stone.
- Percutaneous Nephrolithotomy (PCNL): A surgical procedure for very large stones, performed through a small incision in the flank.
Prevention
To prevent new stones from forming, doctors recommend:
- High fluid intake (target: more than 2 liters of urine output per day)
- Reducing consumption of oxalate-rich foods
- Maintaining normal dietary calcium intake (reducing calcium is counterproductive)
- A low-sodium diet
- Medications such as thiazide diuretics or allopurinol when indicated
References
- Turk C et al. - EAU Guidelines on Urolithiasis. European Association of Urology, 2023.
- Pearle MS, Goldfarb DS, Assimos DG et al. - Medical Management of Kidney Stones. American Urological Association Guidelines, 2019.
- Worcester EM, Coe FL. - Calcium Kidney Stones. New England Journal of Medicine, 2010; 363(10): 954–963.
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