Renal calculi; Nephrolithiasis; Stones - kidney

The goal of treatment is to relieve symptoms and prevent further symptoms. (Kidney stones that are small enough usually pass on their own.) Treatment varies depending on the type of stone and how severe the symptoms are. People with severe symptoms might need to be hospitalized.

When the stone passes, the urine should be strained and the stone saved and tested to determine the type.

Drink at least 6 - 8 glasses of water per day to produce a large amount of urine. Some people might need to get fluids through a vein (intravenous).

Pain relievers can help control the pain of passing the stones (renal colic). For severe pain, you may need to take narcotic pain killers or nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen.

Depending on the type of stone, your doctor may prescribe medicine to decrease stone formation or help break down and remove the material that is causing the stone. Medications can include:

• Allopurinol (for uric acid stones)
• Antibiotics (for struvite stones)
• Diuretics
• Phosphate solutions
• Sodium bicarbonate or sodium citrate (which make the urine more alkaline)

Surgery is usually needed if:

• The stone is too large to pass on its own
• The stone is growing
• The stone is blocking urine flow and causing an infection or kidney damage

Today, most treatments are much less invasive than in the past.

• Extracorporeal shock-wave lithotripsy is used to remove stones slightly smaller than a half an inch that are located near the kidney. This method uses ultrasonic waves or shock waves to break up stones. Then, the stones leave the body in the urine.
• Percutaneous nephrolithotomy is used for large stones in or near the kidney, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with an endoscope that is inserted into the kidney through a small opening.
• Ureteroscopy may be used for stones in the lower urinary tract.
• Standard open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible.

Images

Kidney anatomy

Intravenous pyelogram (IVP)

Lithotripsy procedure

Kidney - blood and urine flow

Nephrolithiasis

Kidney stones

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Review Date: 01/14/2009
Reviewed By: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)