Kidney Stone Symptoms

Clinical Symptoms that Suggest Kidney Stones

Kidneys deal with maintaining the healthy levels of electrolytes in blood, as also the excretion of substances that are no more required in the body. This process also makes them vulnerable to formation of stones, a common medical problem. While prevention of stone formation itself is the best scenario, when such stones do get formed, they need medical interventions. When diagnosed early, kidney stones can be treated without significant residual damage. That is why it is important to know about their symptoms, and immediate medical advice must be sought at once in all cases where it is suspected.

How Common are Kidney Stones?

Kidney Stones are of the most common ailment that affects mankind, affecting as much as up to 10% of the people at some point in their life time. It is at least twice more common in males and usually happen between the age of 20 years and 50 years. Most kidney stones can exist silently without any symptom for pretty long periods, but when they do lead to symptoms, it can be one of the worst experiences of one's life.

What are Kidney Stones? 

Most kidney stones are made of calcium oxalate, but it could be made of other salts too. Roughly, about three fourth of the stones calcium with oxalate, phosphate or carbonate. Over 10% of the stones are struvite made up of calcium, magnesium and ammonium phosphate. In Gout, the stones are made of uric acid, while in Cystinuria, stones consist of cystine. Calcium oxalate stones are more common with a calcium deficient diet, because in the absence of calcium in the intestines, more oxalate gets absorbed and its excretion leads to calcium oxalate stones in kidneys. 

How are Kidney Stones formed? 

Kidney stones are formed inside the body of kidney by gradual precipitation and deposition of certain salts that are present in blood in very small fractions but which are actively separated from blood by the kidney and excreted in urine. These precipitates start getting deposited at some point within kidney, and gradually grow in size - a process that may take from a few months to a few decades. They may remain silent for years, but when they grow big enough to start putting pressure on the kidney tissue then they produce an aching sensation in the loin area, more pronounced on the back. This aching sensation is mild to moderate in severity and can be either intermittent or continuous. 

What are the Symptoms of Kidney Stones? 

For a long time, kidney stones are silent. In other words, it is possible that a person who has never experienced any symptoms related to kidney stones may actually have stones in kidneys that get diagnosed only during the investigations undertaken as a part of routine medical check-up. When the symptoms do arise, they can take two different forms, typical of a passing stone or a long standing stone that leads to infection. 

What are the Symptoms of a Passing Kidney Stone? 

The characteristic symptoms of kidney stones are actually produced when the stone, or a part of it, gets detached from the point of its attachment in the kidney and moves with urine to the ureters or further down the urinary tract. At this point it usually leads to very severe excruciating pain, often described by the sufferer as 'the worst pain of his life'. Typically the site of the pain moves from 'loin to groin' reflecting the movement of the stone downwards. Usually this pain is associated with difficulties in urination, increased frequency and sometimes blood in urine that results from the irritation and damage caused by the passing stone.

The worst pain is felt when the stone gets lodged in the junction of ureter and urinary bladder and blocks it. Ureter carries urine in to the urinary bladder, and its blockage can lead to accumulation of urine in ureters and their dilation. If the blockage persists, a backward pressure on kidney is also exerted, which not only worsens the pain but can damage some of the kidney functions. This pain is extremely difficult to tolerate, and the person suffering may find it difficult to remain either silent or in one position.

What are the Symptoms of an Attached Kidney Stone with Infections 

A somewhat different clinical presentation of kidney stones can be seen in cases of long standing stones in the kidney, which are initially silent, but can give rise to milder but continuous, dull aching pain in some cases, particularly if they become large enough. Most commonly, the clinical picture in such cases can become complicated by the existence of infection, which may cause fever, burning sensation in urinary tract and sometimes even pus in urine. As the stones or precipitated salt finally passes through, the patient may also complain of 'sand in urine'. If any part of the stone gets detached, it can cause the pain typical of a passing stone described earlier.

In some cases, the severe kidney pain is also associated with vomiting and heartburn, which can make the diagnosis difficult. This arises because of the common origin of kidney and intestines and their common nerve supply. The signals arising from kidney get referred to the intestines and lead to vomiting and abdominal pain. 

What are the Diagnostic Tests in suspected Kidney Stones? 

The symptoms of kidney stone are usually severe and typical but sometimes they too can be confused with other diseases. Every case of suspected kidney stone needs to be confirmed by further Lab tests like X-rays, Ultrasonography and CT Scan or MRI of abdomen. Urine and blood testing is mandatory to get the complete picture and clues about infection.

Most kidney stones create the greatest problem while they are passing out. While a part of stone may have passed out, the original stone may continue to exist and grow within the kidney, and lead to a recurrence of pain when another part of it gets separated and again passes out of the body. Hence in every case of kidney stone, it is preferable to investigate thoroughly and treat the underlying stone even if the pain has disappeared and the patient appears fine. Removal of remaining stones by lithotripsy is generally the treatment of choice, and prevents future recurrence of symptoms. Even after lithotripsy, it is advisable to get lab tests like ultrasonography done at regular intervals to ensure that no fresh stone is getting formed in the kidney.