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Kidney Stones
Kidney stones result from the precipitation (crystallization of previously dissolved particles) of certain substances within the urine. These stones form in the kidney and subsequently travel through the ureter (the tube that conducts urine from the kidney to the bladder) and are eliminated through the urine if they are small. In some cases, the stone may not be able to travel through the ureter, causing pain and possibly causing an obstruction, blocking the flow of urine out of the kidney. Kidney stones can be caused by a large number of factors, such as infection, certain diets, medications, and conditions that result in an increased concentration of calcium or other substances, including oxalate and uric acid, in the urine. The composition of the stone depends on the cause, but the most common type of stone contains calcium. The March 2, 2005, issue of JAMA includes an article that reviews the causes and diagnosis of kidney stones and the available treatments.
SYMPTOMS
The symptoms associated with kidney stones vary depending on the size of the stone, its position within the urinary tract, and whether there is an associated kidney infection.
- Pain in the back or side
- Blood in the urine
- Vomiting
- Fever
- Urinary frequency or urgency (the sensation of the immediate need to urinate)
- Pain with urination
DIAGNOSIS
In addition to a complete medical history and physical examination, your doctor may order blood tests to assess your kidney function and the concentration of certain electrolytes and dissolved minerals (such as calcium) in your blood. A urinalysis (analysis of a small sample of urine for infection and blood) and a 24-hour urine collection (to look for substances associated with kidney stones) may also be performed. Your doctor may order a computed tomography (CT) scan, abdominal x-ray, or ultrasound test to locate the stone and to rule out other possible causes of the symptoms.
TREATMENT
- Initial treatment includes pain medication and oral or intravenous fluid to help the stone pass through the urine.
- Extracorporeal shock wave lithotripsy is a procedure that uses shock waves to break up the stone without the need for surgery.
- Surgery may be necessary if the stone is very large and if there is blockage of the affected kidney or infection.
- Depending on the cause of your kidney stone, your doctor may prescribe medication or suggest dietary changes to prevent a recurrence.
FOR MORE INFORMATION
INFORM YOURSELF
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: National Institute of Diabetes and Digestive and Kidney Diseases; National Kidney Foundation
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.
TOPIC: KIDNEY DISORDERS
Sarah Ringold, MD, Writer;
Tiffany J. Glass, MA, Illustrator;
Richard M. Glass, MD, Editor
JAMA. 2005;293:1158.
RELATED ARTICLE
A 44-Year-Old Woman With Kidney Stones
Gary C. Curhan
JAMA. 2005;293(9):1107-1114.
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