Kidney stones: what they are and how to treat them

By Cristiano Antonino On Feb 10, 2023

Kidney stones, what trouble! A sharp twinge, a dull, intense pain in the back or side, immediately makes us think of a colic

So you sit down at your PC and start looking up all the symptoms, and what comes out is not pretty.

Kidney stones, in fact, are one of the main causes of this symptomatology.

But of course, as much as doing a web search can help you understand your disorder, it is not the solution to the problem, for which, instead, a medical consultation is needed.

In general, however, we can help you understand what kidney stones are, what causes them and how to treat them.

Kidney stones, what they are

Kidney stones are a very common disorder in today’s western population.

Unfortunately, cases are on the rise, especially among males between the ages of 20 and 40.

The phenomenon now affects 5 to 10 per cent of the population and the growing trend, according to studies, is said to be due to the increased consumption of animal protein, or the poorer quality of the latter.

Don’t think, however, that this is a recent pathology, just think that calculi were found in an Egyptian mummy a good 7,000 years ago!

But let’s understand what stones or nephrolithiasis are.

They are essentially hard deposits, aggregations of mineral salts that form in the urinary tract and can be composed of different combinations of substances such as calcium, phosphate, oxalate, which is why there are also different types of stones.

The problems caused by these aggregations undoubtedly have a very painful symptomatology in some cases, but above all the fact that they can, in the long run, damage the kidneys to the point of causing severe renal failure.

Kidney stones, what are the main symptoms

Sometimes it is a sharp, almost unbearable pain.

When one is faced with this symptom, it means that the kidney stone is obstructing the passage of urine.

It is therefore renal colic, but the obstruction can also occur inside the kidney or in the passage between it and the ureter.

Sometimes, however, if the stone does not move, you do not experience pain, you do not have colic, but you may still experience symptoms such as burning and frequent urination.

The intensity of the pain does not depend so much on the size of the stone as on the anatomical conformation of the kidney and the sensitivity threshold of each individual.

The main symptoms include:

acute pain in the back or flank
fever and chills (if there is an infection);
vomiting;
blood in the urine;
Bad-smelling or cloudy urine;

How kidney stones are diagnosed

Generally, if any of the above symptoms are detected, the best thing to do is to seek medical advice and then a diagnosis.

This is carried out by means of a series of instrumental tests, including an ultrasound scan of the kidneys, urinalysis, and an accurate medical history.

It must also be ascertained that there are no malformations or additional diseases, such as polycystic kidney syndrome, and other kidney diseases.

An ultrasound scan of the kidneys is a completely painless test, just like an X-ray, it is non-invasive and has no side effects, and can therefore be performed by everyone, obviously after consulting a doctor.

It is particularly recommended for those with a family history of diseases such as stones and polycystic kidney disease.

However, ultrasound alone does not always give an exhaustive picture of the situation, so it may be necessary to perform an urography, with or without contrast fluid, or a spiral CT scan.

How renal colic is treated

Painful twinges can be kept under control by administering antispasmodic and analgesic drugs, such as NSAIDs, always to be taken under prescription.

Fortunately, surgery is not always necessary; a large part of the stones can be expelled by drinking plenty of water, more than two litres a day, with the therapy known as ‘water blowing’.

In more important cases, however, surgical or ultrasonic removal may be necessary.

However, surgery is always recommended when the stone is not expelled by drinking plenty of water for a reasonable period of time, or if it is large or in a position that makes it difficult to expel.

Even if it causes an infection, it is good to remove the stone surgically, as well as when it damages kidney tissue causing bleeding.

Among the most commonly used procedures today are extracorporeal lithotripsy, shock waves outside the body that fragment the stone making it easier to pass through the urinary tract so it can be expelled.

Percutaneous nephrolithotomy, on the other hand, is recommended in the case of very large stones: a small incision is made in the back in order to create an opening up to the kidney to remove the stone with the nephroscope.