Kidney stones Contents (Medically reviewed by Dr. Salma Anjum and Dr. Seher Anjum : Last updated on Friday July 5 at 5 AM UK Time)

* Overview * Symptoms * Causes * Diagnosis * Treatment * Prevention

Kidney stones can develop in 1 or both kidneys and most often affect people aged 30 to 60. They're quite common, with more than 1 in 10 people affected.

Kidney stones are usually found in the kidneys or in the ureter, the tube that connects the kidneys to your bladder. They can be extremely painful, and can lead to kidney infections or the kidney not working properly if left untreated.

Symptoms of kidney stones You may not notice if you have small kidney stones. You'll usually pee them out without any discomfort.

Larger kidney stones can cause several symptoms, including: * pain in the side of your tummy (abdomen) * severe pain that comes and goes * feeling sick or vomiting

Very small kidney stones are unlikely to cause many symptoms. They may even go undetected and pass out painlessly when you pee. Larger kidney stones can cause symptoms, including: * pain in the side of your tummy (abdomen) or groin – men may have pain in their testicles * a high temperature * feeling sweaty * severe pain that comes and goes * feeling sick or vomiting * blood in your urine * urine infection

Kidney stones are usually formed following a build-up of certain chemicals in the body. Certain medical conditions can lead to an unusually high level of these chemicals in your pee. You're also more likely to develop kidney stones if you do not drink enough water and other fluids.

Types of kidney stones Kidney stones come in a variety of sizes, shapes and colours. Some are like grains of sand, while in rare cases others can grow to the size of a golf ball.

The main types of kidney stones are: * calcium stones, the most common type of stone * struvite stones, usually caused by an infection, like a urine infection * uric acid stones, usually caused by a large amount of acid in your urine

Recurrent kidney stones  People who keep getting kidney stones include those who: * eat a high-protein, low-fibre diet * are inactive or bed-bound * have a family history of kidney stones * have had several kidney or urinary infections * have had a kidney stone before, particularly if it was before they were 25 years old

Medicines Certain medicines may increase your risk of developing recurrent kidney stones. These include: * aspirin  * antacids  * diuretics (used to reduce fluid build-up) * certain antibiotics * certain antiretroviral medicines (used to treat HIV) * certain anti-epileptic medicines

Blocked ureter and kidney infection A kidney stone that blocks the ureter, the tube that connects your kidney to your bladder, can cause a kidney infection. This is because waste products are unable to pass the blockage, which may cause a build-up of bacteria.

The symptoms of a kidney infection are similar to symptoms of kidney stones, but may also include: * a high temperature * chills and shivering * feeling very weak or tired * diarrhoea * cloudy and bad-smelling urine

When to get urgent medical help You should contact a GP immediately if: * you're in severe pain * you have a high temperature * you have an episode of shivering or shaking * you have blood in your urine

What causes kidney stones? Waste products in the blood can occasionally form crystals that collect inside the kidneys. Over time, the crystals may build up to form a hard stone-like lump.

This is more likely to happen if you: * do not drink enough fluids * are taking some types of medication * have a medical condition that raises the levels of certain substances in your urine

After a kidney stone has formed, your body will try to pass it out when you pee.

Treating and preventing kidney stones Most kidney stones are small enough to be passed in your pee, and it may be possible to treat the symptoms at home with medication. Larger stones may need to be broken up or removed with surgery.

It's estimated up to half of all people who have had kidney stones will experience them again within the following 5 years.

Most kidney stones are small enough to be passed out in your pee and can probably be treated at home.

Treatment from a GP But even small kidney stones can be painful, although the pain usually only lasts a couple of days and disappears when these stones have cleared.

To ease your symptoms, your GP might recommend: * drinking plenty of fluids throughout the day * painkillers, like ibuprofen * anti-sickness medicine * alpha-blockers (medicines to help stones pass) You might be advised to drink up to 3 litres of fluid throughout the day, every day, until the stones have cleared.

To help your stones pass: * drink water, but drinks like tea and coffee also count * add fresh lemon juice to your water * avoid fizzy drinks * do not eat too much salt Make sure you're drinking enough fluid. If your pee is dark, it means you're not drinking enough. Your pee should be pale in colour. You may be advised to continue drinking this much fluid to prevent new stones forming. If your kidney stones are causing severe pain, your GP may send you to hospital for tests and treatment.

Treating large kidney stones If your kidney stones are too big to be passed naturally, they're usually removed by surgery. The main types of surgery for removing kidney stones are: * shockwave lithotripsy (SWL) * ureteroscopy * percutaneous nephrolithotomy (PCNL) Your type of surgery will depend on the size and location of your stones.  

Shock wave lithotripsy (SWL) SWL involves using ultrasound (high-frequency sound waves) to pinpoint where a kidney stone is. Ultrasound shock waves are then sent to the stone from a machine to break it into smaller pieces so it can be passed in your urine. SWL can be an uncomfortable form of treatment, so it's usually carried out after giving painkilling medication. You may need more than 1 session of SWL to successfully treat your kidney stones. 

Ureteroscopy Ureteroscopy involves passing a long, thin telescope called a ureteroscope through the tube urine passes through on its way out of the body (the urethra) and into your bladder. It's then passed up into your ureter, which connects your bladder to your kidney. The surgeon may either try to gently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so it can be passed naturally in your urine. Ureteroscopy is carried out under general anaesthetic, where you're asleep.

Percutaneous nephrolithotomy (PCNL) PCNL involves using a thin telescopic instrument called a nephroscope. A small cut (incision) is made in your back and the nephroscope is passed through it and into your kidney. The stone is either pulled out or broken into smaller pieces using a laser or pneumatic energy. PCNL is always carried out under general anaesthetic.

The best way to prevent kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated. To prevent stones returning, you should aim to drink up to 3 litres of fluid throughout the day, every day.

Keeping your urine clear helps to stop waste products getting too concentrated and forming stones. You can tell how diluted your urine is by looking at its colour. The darker your urine is, the more concentrated it is. Your urine is usually a dark yellow colour in the morning because it contains a build-up of waste products that your body's produced overnight. Drinks like tea, coffee and fruit juice can count towards your fluid intake, but water is the healthiest option and is best for preventing kidney stones developing. You should also make sure you drink more when it's hot or when you're exercising to replace fluids lost through sweating.

Complications of treatment Complications can occur after the treatment of large kidney stones. Your surgeon should explain these to you before you have the procedure. Possible complications will depend on the type of treatment you have and the size and position of your stones. 

Complications could include: * sepsis, an infection that spreads through the blood, causing symptoms throughout the whole body * a blocked ureter caused by stone fragments (the ureter is the tube that attaches the kidney to the bladder) * an injury to the ureter * a urinary tract infection (UTI) * bleeding during surgery * pain

To avoid getting kidney stones, make sure you drink plenty of water every day so you do not become dehydrated.

It's very important to keep your urine pale in colour to prevent waste products forming into kidney stones.

Check if you're dehydrated Symptoms of dehydration in adults and children include:

* feeling thirsty * dark yellow and strong-smelling pee * feeling dizzy or lightheaded * feeling tired * a dry mouth, lips and eyes * peeing little, and fewer than 4 times a day Dehydration can happen more easily if you have: * diabetes * vomiting or diarrhoea * been in the sun too long (heatstroke) * drunk too much alcohol * sweated too much after exercising * a high temperature of 38C or more * been taking medicines that make you pee more (diuretics)

How you can reduce the risk of dehydration Drink fluids when you feel any dehydration symptoms. If you find it hard to drink because you feel sick or have been sick, start with small sips and then gradually drink more. You can use a spoon to make it easier for your child to swallow the fluids. You should drink enough during the day so your pee is a pale clear colour. Drink when there's a higher risk of dehydrating. For example, if you're vomiting, sweating or you have diarrhoea.

Where do kidney stones come from? Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The crystals grow larger into "stones." About 80% to 85% of kidney stones are made of calcium. The rest are uric acid stones, which form in people with low urine pH levels.

After stones form in the kidneys, they can dislodge and pass down the ureter, blocking the flow of urine. The result is periods of severe pain, including flank pain (pain in one side of the body between the stomach and the back), sometimes with blood in the urine, nausea, and vomiting. As the stones pass down the ureter toward the bladder, they may cause frequent urination, bladder pressure, or pain in the groin. "If you experience any of these symptoms, see your primary care physician," says Dr. Eisner. "He or she will likely perform a urinalysis and a renal ultrasound, abdominal x-ray, or CT scan to confirm kidney stones are the source of your pain and determine their size and number."

Let kidney stones pass Stones typically take several weeks to a few months to pass, depending on the number of stones and their size. Over-the-counter pain medications, like ibuprofen (Advil, Motrin IB), acetaminophen (Tylenol), or naproxen (Aleve), can help you endure the discomfort until the stones pass. Your doctor also may prescribe an alpha blocker, which relaxes the muscles in your ureter and helps pass stones quicker and with less pain.

If the pain becomes too severe, or if they are too large to pass, they can be surgically removed with a procedure called a ureteroscopy. Here, a small endoscope (a device with a miniature video camera and tools at the end of a long tube) is passed into the bladder and up the ureter while you are under general anesthesia. A laser breaks up the stones, and then the fragments are removed.

Take steps to bypass kidney stones Even though kidney stones can be common and recur once you’ve had them, there are simple ways to help prevent them. Here are some strategies that can help:

1.   Drink enough water. A meta-analysis from the National Kidney Foundation found that people who produced 2 to 2.5 liters of urine daily were 50% less likely to develop kidney stones than those who produced less. It takes about about 2 liters total of water daily to produce that amount.

2.   Skip high-oxalate foods. Such foods, which include spinach, beets, and almonds, obviously raise oxalate levels in the body. However, moderate amounts of low-oxalate foods, such as chocolate and berries, are okay.

3.   Enjoy some lemons. Citrate, a salt in citric acid, binds to calcium and helps block stone formation. "Studies have shown that drinking ½ cup of lemon juice concentrate diluted in water each day, or the juice of two lemons, can increase urine citrate and likely reduce kidney stone risk.

4.   Watch the sodium. A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine.

Guidelines suggest limiting total daily sodium intake to 2,300 milligrams (mg). If sodium has contributed to kidney stones in the past, try to reduce your daily sodium to 1,500 mg.

5.   Cut back on animal protein. Eating too much animal protein, such as meat, eggs, and seafood, boosts the level of uric acid. If you’re prone to stones, limit your daily meat intake to a quantity that is no bigger than a pack of playing cards.

Home Remedies for Kidney Stones:

* Water * Lemon juice * Basil juice * Apple cider vinegar * Celery juice * Pomegranate juice * Kidney bean broth * Other natural remedies * Dandelion root juice * Wheatgrass juice * Horsetail juice * See your doctor

Staying hydrated is key Drinking plenty of fluids is a vital part of passing kidney stones and preventing new stones from forming. Not only does the liquid flush out toxins, but it also helps move stones and grit through your urinary tract.

Although water alone may be enough to do the trick, adding certain ingredients can be beneficial. Be sure to drink one 8-ounce glass of water immediately after drinking any flavored remedy. This can help move the ingredients through your system.

Talk to your doctor before getting started with any of the home remedies listed below. They can assess whether home treatment is right for you or if it could lead to additional complications. If you’re pregnant or breastfeeding, avoid using any remedies. Your doctor can determine whether a juice may cause side effects for you or your baby.

1. Water When passing a stone, upping your water intake can help speed up the process. Strive for 12 glasses of water per day instead of the usual 8. Once the stone passes, you should continue to drink 8 to 12 glasses of water each day. Dehydration is one of the main risk factors for kidney stones, and the last thing you want is for more to form.

Pay attention to the color of your urine. It should be a very light, pale yellow. Dark yellow urine is a sign of dehydration.

2. Lemon juice You can add freshly squeezed lemons to your water as often as you like. Lemons contain citrate, which is a chemical that prevents calcium stones from forming. Citrate can also break up small stones, allowing them to pass more easily.

A great deal of lemons would be needed to make a huge effect, but some can help a little. Lemon juice has numerous other health benefits. For example, it helps inhibit bacteria growth and provides vitamin C.

3. Basil juice Basil contains acetic acid, which helps break down the kidney stones and reduce pain. It’s also full of nutrients. This remedy has been used traditionally for digestive and inflammatory disorders.

There are antioxidants and anti-inflammatory agents in basil juice, and it may help maintain kidney health. Use fresh or dried basil leaves to make a tea and drink several cups per day. You may also juice fresh basil in a juicer or add it to a smoothie.

You shouldn’t use medicinal basil juice for more than 6 weeks at a time. Extended use may lead to: * low blood sugar * low blood pressure * increased bleeding There’s very little research on how effective basil is for kidney stones, but it does have anti-oxidative and anti-inflammatory properties.

4. Apple cider vinegar Apple cider vinegar contains acetic acid. Acetic acid helps dissolve kidney stones. In addition to flushing out the kidneys, apple cider vinegar can help ease pain caused by the stones. There are numerous other health benefits of apple cider vinegar.

One lab study found that apple cider vinegar was effective in helping reduce the formation of kidney stones, though more studies are needed. But because of the numerous other health benefits, there’s probably little risk.

Shop for apple cider vinegar online. To reap these benefits, add 2 tablespoons of apple cider vinegar to 6 to 8 ounces of purified water. Drink this mixture throughout the day. You shouldn’t consume more than one 8-ounce glass of this mixture per day. You can also use it on salads straight or add it to your favorite salad dressing.

If ingested in larger amounts, apple cider vinegar can lead to low levels of potassium and osteoporosis. People with diabetes should exercise caution when drinking this mixture. Monitor your blood sugar levels carefully throughout the day. You shouldn’t drink this mixture if you’re taking: * insulin * digoxin (Digox) * diuretics, such as spironolactone (Aldactone)

5. Celery juice Celery juice is thought to clear away toxins that contribute to kidney stone formation and has long been used in traditional medications. It also helps flush out the body so you can pass the stone.

Blend one or more celery stalks with water, and drink the juice throughout the day.

You shouldn’t drink this mixture if you have: * any bleeding disorder * low blood pressure * a scheduled surgery You also shouldn’t drink this mixture if you’re taking: * levothyroxine (Synthroid) * lithium (Lithane) * medications that increase sun sensitivity, such as isotretinoin (Sotret) * sedative medications, such as alprazolam (Xanax)

6. Pomegranate juice Pomegranate juice has been used for centuries to improve overall kidney function. It will flush stones and other toxins from your system. It’s packed with antioxidants, which help keep the kidneys healthy and may have a role in preventing kidney stones from developing. It also lowers your urine’s acidity level. Lower acidity levels reduce your risk for future kidney stones.

Pomegranate juice’s effect on preventing kidney stones needs to be better studied, but there does appear to be some benefit in taking pomegranate extract, lowering the risk of stones.

There’s no limit to how much pomegranate juice you can drink throughout the day. You shouldn’t drink pomegranate juice if you’re taking: * medications changed by the liver * blood pressure medications, such as chlorothiazide (Diuril) * rosuvastatin (Crestor)

7. Kidney bean broth The broth from cooked kidney beans is a traditional dish, often used in India, that has been used to improve overall urinary and kidney health. It also helps dissolve and flush out the stones. Simply strain the liquid from cooked beans and drink a few glasses throughout the day.

Other natural remedies The following home remedies may contain ingredients that aren’t already in your kitchen. You should be able to buy them from your local health food store or online.

8. Dandelion root juice Dandelion root is a kidney tonic that stimulates the production of bile. This is thought to help eliminate waste, increase urine output, and improve digestion. Dandelions have vitamins (A, B, C, D) and minerals such as potassium, iron, and zinc.

Study showed that dandelion is effective in preventing the formation of kidney stones. You can make fresh dandelion juice or buy it as a tea. If you make it fresh, you may also add orange peel, ginger, and apple to taste. Drink 3 to 4 cups throughout the day.

Some people experience heartburn when they eat dandelion or its parts.

You shouldn’t drink this mixture if you’re taking: * blood thinners * antacids * antibiotics * lithium * diuretics, such as spironolactone (Aldactone) Talk to your doctor before taking dandelion root extract, as it can interact with many medications.

9. Wheatgrass juice Wheatgrass is packed with many nutrients and has long been used to enhance health. Wheatgrass increases urine flow to help pass the stones. It also contains vital nutrients that help cleanse the kidneys.

You can drink 2 to 8 ounces of wheatgrass juice per day. To prevent side effects, start with the smallest amount possible and gradually work your way up to 8 ounces. If fresh wheatgrass juice isn’t available, you can take powdered wheatgrass supplements as directed.

Taking wheatgrass on an empty stomach can reduce your risk for nausea. In some cases, it may cause appetite loss and constipation.

10. Horsetail juice Horsetail has been used to increase urine flow to help to flush out kidney stones and can soothe swelling and inflammation. It also has antibacterial and antioxidant properties that aid in overall urinary health.

However, you shouldn’t use horsetail for more than 6 weeks at a time. There are dangers of seizures, decreased levels of B vitamins, and loss of potassium.

You shouldn’t use horsetail if you take lithium, diuretics, or heart medications such as digoxin. Horsetail isn’t recommended for children and pregnant or breastfeeding women. Horsetail contains nicotine and shouldn’t be taken if you’re using a nicotine patch or trying to quit smoking.

You also shouldn’t drink horsetail juice if you have: * alcohol use disorder * diabetes * low potassium levels * low thiamine levels

When to see your doctor See your doctor if you’re unable to pass your stone within 6 weeks or you begin experiencing severe symptoms that include: * severe pain * blood in your urine * fever * chills * nausea * vomiting Your doctor will determine whether you need medication or any other therapy to help you pass the stone.

:: The kidneys :: The kidneys are 2 bean-shaped organs that are roughly 10cm (4 inches) in length. They're located towards the back of the abdomen on either side of the spine. The kidneys remove waste products from the blood. The clean blood is then transferred back into the body and the waste products are passed out of the body when you pee.