Kidney stones

Diagnosis

If your doctor suspects that you have a kidney stone, you may have diagnostic tests and procedures, such as:

• Blood testing. Blood tests may reveal too much calcium or uric acid in your blood. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
• Urine testing. The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances. For this test, your doctor may request that you perform two urine collections over two consecutive days.

• Imaging. Imaging tests may show kidney stones in your urinary tract. High-speed or dual energy computerized tomography (CT) may reveal even tiny stones. Simple abdominal X-rays are used less frequently because this kind of imaging test can miss small kidney stones.

  Ultrasound, a noninvasive test that is quick and easy to perform, is another imaging option to diagnose kidney stones.

• Analysis of passed stones. You may be asked to urinate through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.

Treatment

Treatment for kidney stones varies, depending on the type of stone and the cause.

Small stones with minimal symptoms

Most small kidney stones won't require invasive treatment. You may be able to pass a small stone by:

• Drinking water. Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day will keep your urine dilute and may prevent stones from forming. Unless your doctor tells you otherwise, drink enough fluid — ideally mostly water — to produce clear or nearly clear urine.
• Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
• Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain. Examples of alpha blockers include tamsulosin (Flomax) and the drug combination dutasteride and tamsulosin (Jalyn).

Large stones and those that cause symptoms

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Parathyroid glands

Parathyroid glands

The four tiny parathyroid glands, which lie near the thyroid, make the parathyroid hormone. The hormone plays a role in controlling levels of the minerals calcium and phosphorus in the body.

Kidney stones that are too large to pass on their own or cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment. Procedures may include:

• Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).

  ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.

  ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

• Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back.

  You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL is unsuccessful.

• Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.

  Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.

• Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result.

  Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that's causing your parathyroid gland to overproduce the hormone.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

Small kidney stones that don't block your kidney or cause other problems can be treated by your family doctor. But if you have a large kidney stone and experience severe pain or kidney problems, your doctor may refer you to a doctor who treats problems in the urinary tract (urologist or nephrologist).

What you can do

To prepare for your appointment:

• Ask if there's anything you need to do before your appointment, such as limit your diet.
• Write down your symptoms, including any that seem unrelated to kidney stones.
• Keep track of how much you drink and urinate during a 24-hour period.
• Make a list of all medications, vitamins or other supplements that you take.
• Take a family member or friend along, if possible, to help you remember what you discuss with your doctor.
• Write down questions to ask your doctor.

For kidney stones, some basic questions include:

• Do I have a kidney stone?
• What size is the kidney stone?
• Where is the kidney stone located?
• What type of kidney stone do I have?
• Will I need medication to treat my condition?
• Will I need surgery or another procedure?
• What's the chance that I'll develop another kidney stone?
• How can I prevent kidney stones in the future?
• I have other health conditions. How can I best manage them together?
• Do I need to follow any restrictions?
• Should I see a specialist? If so, does insurance typically cover the services of a specialist?
• Is there a generic alternative to the medicine you're prescribing?
• Do you have any educational material that I can take with me? What websites do you recommend?
• Do I need a follow-up visit?

Besides the questions you prepare in advance, don't hesitate to ask any other questions during your appointment as they occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Has anyone else in your family had kidney stones?