5 things you need to know about kidney stones

In our latest Ask the Expert article, featured in West Essex Life Magazine, Mr Stuart Graham, a Consultant Urological Surgeon at The Holly Private Hospital talks about this common and extremely painful condition.

What you need to know about kidney stones

Recently, Nicky Campbell, the BBC Radio 5 Live breakfast presenter, missed his show because of an attack of kidney stones. What do you need to know to avoid this extremely painful condition? Mr Stuart Graham consultant urological surgeon and head of the stone unit at Barts health explains more.

What exactly are kidney stones?

They are just that – stones. They are mineral deposits that form in the kidneys and do not dissolve. Most of them are hard, and not very pretty! Most of them are salts of calcium, but for most people it is the other part of the stone, usually a compound called oxalate, which is the dangerous part.

What are the symptoms?

Many people joke about Nicky’s situation, but a proportion of people do indeed present having fallen to the floor, writhing in agony from colic. It can be extremely painful and indeed, many women say it is more painful than childbirth. Often, it is not very serious, just painful, but occasionally it can be life threatening if infection is associated with the blockage from the stone. Having this type of pain checked out especially if you have a temperature, is very important, therefore.

Stones can also present with pain in the loin which is at the back on one side, underneath the lower ribs. They can also produce infections and blood in the urine. A large proportion are now picked up incidentally on scans for other conditions.

What causes kidney stones?

Kidney stones form because the minerals involved will not dissolve. Those of us who are susceptible to them do not have enough of other minerals that try and stop the stones from forming. If we get dehydrated or eat food that can promote stones, then they are more likely to form. Having a relative with stones also increases your risk. I do a lot of prevention work with people to try and stop them making more stones, and a lot of this involves changes to their diet.

When should I see a doctor?

Many people with the severe pain of colic will simply call an ambulance. This is especially true if they have a temperature as well. The many others, they continue to get a loin ache that radiates down to the groin on one side. The Holly offer a seven-day scanning service, and those patients who contact me via the Holly can be scanned on the day and have a diagnosis. It is well worth you seeing your doctor if you find blood in your urine or you keep getting a loin ache. If you have had severe pain which has gone away, and you have passed something again, have your doctor check you out, because you may have more than one stone. I have seen many patients who have passed something and when I have scanned them, there is another stone or two often in the other kidney. Some of these have no symptoms at all at the time, but I know that they are going to cause trouble at some point.

What treatments are available?

Some people watch their stones. This is especially true if they are small. While some people again will watch larger stones, there is some risk to this. Stones in the correct place in the kidney, which are soft enough, can be treated with a soundwave treatment called lithotripsy. Stones in other positions in the kidney although is too hard or too large, are treated with surgery. This includes telescopic keyhole surgery through the natural pipes to get to the kidney, and keyhole surgery through the side to take out large stones. I perform all of these different treatments at the Holly for my Private patients.

Is there anything I can do to prevent getting kidney stones?

Yes. Stones are very common. Approximately 10% of the population will get an attack at some point. The number of people with stones is going up rapidly, and this is especially true in women. The most important thing is fluid replacement. If you are worried about stones or have had one, you should be drinking enough so that you produced 2 to 2 ½ L of urine a day. This is especially true if you go to the gym or you sunbathe and get dehydrated. We know that large amounts of animal protein (meat fish and chicken) increase your stone risk, as does salt. What is important is that calcium generally decreases your risk of stones and so having normal or even high levels of calcium in your diet are a good thing. Hard water is therefore not a problem!

Recurrent kidney stones

If you have had a kidney stone, you have a 50% chance of another one. This can go up if the stones are on both sides, or made of rarer materials, or you are a child, or you have had stones before. I will test people’s urine and blood to look for causes if they have an increased risk, and see how I might help further to reduce their risk of more stones.

Mr Stuart Graham has clinics at The Holly Private Hospital on Monday morning’s and Wednesday evenings.

To make an appointment please call 020 8936 1201.