Management of Kidney Stones

A kidney stone (also known as renal lithiasis) is a hard mass of crystals made of minerals and salts (such as calcium, sodium, potassium, oxalate, uric acid and phosphate) that form inside your kidney.  Stones form when the urine becomes too concentrated, allowing minerals to crystallise and clump together.  The stones can affect any part of your urinary tract (from your kidneys and ureter to your bladder and urethra).  The stones will cause symptoms when they become too large and injure the kidney or when the stone dislodges from the kidney and get stuck in the ureter or urethra.

Click to view  to watch TED Ed video on Kidney Stones

Risk factors for getting kidney stones

You are more likely to get kidney stones when you have a family history, do not drink enough water or have dehydration especially in hot climate conditions, taking a high salt or high protein diet, being overweight, have certain conditions like kidney disease, hyperparathyroid disease or recurrent urinary tract infections.


  • Pain in the side which can radiate to the groin or back
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Need to urinate more often or in small amounts
  • Urine which can be cloudy or foul smelling (due to infection)
  • Urine which can be pink or red colour (due to bleeding)
  • Fever or riggers (when there is infection)
  • Nausea and vomiting

Diagnostic Tests

You will need to undergo some diagnostic tests to locate and determine the cause of your stone before the doctor can recommend any form of treatment.

  • Blood tests ((to detect your blood, liver and kidney profile and levels of calcium and uric acid)
  • Urine tests (to detect infection as well as looking for minerals or proteins in your urine)
  • X-ray, CT or MRI scan to locate your stone and to view your kidney anatomy
Image MIMS

Treatment Options

1. Conservative Treatment

A small kidney stone (usually less than 5mm in size) may pass out by itself without the need for surgery.  You will be encouraged to drink lots of plain water (around 2 litres a day) to help flush the stone out.  Your doctor may prescribe your medication for your pain and an alpha-blocker medicine to help relax the ureter to make it easier for the stone to pass out.  Larger stones which cannot pass out by itself will need treatment.  Your doctor will recommend the treatment most suitable for your condition.

2. Extracorporeal Shock Wave Lithotripsy (ESWL)

ESWL uses sound waves to create shock waves that break large stones into smaller pieces which can pass out with your urine. The procedure can last about 30-60 minutes.  You may be given light sedation or anaesthesia because the procedure may cause some discomfort or moderate pain.  Some kidney stones may require a few ESWL sessions to remove completely

Click to view European Association of Urology video on ESWL

3. Surgery

Larger or impacted stones may required surgery to remove them.

Taking Care After Treatment

  • You may experience nausea and vomiting, bruising and pain on your affected side, some discomfort on passing urine as well as blood in your urine.  As such, do take some medication for pain relief.
  • You can usually get back to your normal activities within 2-3 days.
  • You should drink lots of later to help flush out residual stone fragments
  • Do consult a dietician to help you modify your diet to prevent further stone formation

See your Urologist to discuss your treatment options

Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

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