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Kidney stones

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of kidney stones.

Alternative Names

Calcium stones; Nephrolithiasis

Symptoms

In many cases, kidney stones do not produce symptoms. However, if a stone becomes stuck in the ureter (the thin tube between the bladder and the kidney), symptoms can be very severe. Often, they vary depending on the stone's location and then progress.

Kidney stone attacks tend to be most common late at night or in the early morning, possibly because of minimal urine output or constriction of the ureters during the early morning hours. Kidney stone attacks are least common during the late afternoon

• Pain usually begins abruptly on one side and then usually continues as intense, constant pain. (In some cases it persists for a few minutes, resolves, and then returns after about 10 minutes.)
• The patient cannot become comfortable and usually stands, sits, paces, or reclines in a vain search for a position that will bring relief.
• If the stone is in the kidney or upper urinary tract, the pain usually starts in one flank area (to the side of the back near the waist). It typically moves to the groin as the stone passes down.
• If the stone is too large to pass easily, the pain follows the muscle contractions in the wall of the ureter as they try to squeeze the stone along into the bladder.
• Nausea and vomiting may occur.
• Blood in the urine may be present.
• As the stone passes down the ureter closer to the bladder, a person may feel the need to urinate more often or a burning sensation during urination.
• If fever and chills accompany any of these symptoms, an infection may be present.

The size of the stone does not necessarily predict the severity of the pain; a very tiny crystal with sharp edges can cause intense pain while a larger round stone may not be as distressing. Struvite stones can often occur without symptoms.

• Review Date: 5/22/2006
• Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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