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Nephrolithiasis    See images

Overview | Symptoms | Treatment | Prevention

Alternative names:

Renal calculi; Kidney stones; Stones - kidney

Treatment

Treatment goals include relief of symptoms and prevention of further symptoms. Treatment varies depending on the type of stone and the extent of symptoms and/or complications. Hospitalization may be required if symptoms are severe.

Stones are usually passed spontaneously. The urine should be strained and the stone saved for analysis of the type of stone.

Fluids should be adequate to produce a high urinary output. Water is encouraged, at least 6 to 8 glasses per day. If oral intake is inadequate, intravenous fluids may be required.

Analgesics may be needed to control renal colic (pain associated with the passage of stones). Severe pain may require narcotic analgesics.

Depending on the type of stone, medications may be given to decrease stone formation and/or aid in the breakdown and excretion of the material causing the stone. These may include such medications as diuretics, phosphate solutions, allopurinol (for uric acid stones), antibiotics (for struvite stones), and medications that alkalinize the urine such as sodium bicarbonate or sodium citrate.

If the stone is not passed spontaneously, surgical removal of the stone may be required. Lithotripsy may be an alternative to surgery. Ultrasonic waves or shock waves are used to break up stones so that they may be expelled in the urine (extracorporeal shock-wave lithotripsy) or removed with an endoscope that is inserted into the kidney via a small flank incision (percutaneous nephrolithotomy).

Dietary modification may be needed to reduce the recurrence of some types of stones.

Prognosis

Kidney stones are painful but usually are excreted without causing permanent damage. They tend to recur, especially if the underlying cause is not found and treated.

Complications

• recurrence of stones
• urinary tract infection
• obstruction of the ureter, acute unilateral obstructive uropathy
• kidney damage, scarring
• decrease or loss of function of the affected kidney

Call Your Health Care Provider If:

Call your health care provider if symptoms indicate a kidney stone may be present.

Also call if symptoms of kidney stone recur, urination becomes painful, urine output decreases, or other new symptoms develop.

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