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Dealing with Kidney stones can be challenging, especially when pain is associated with this condition. Over the past decade, the occurrence of kidney stones has been on the rise, which we mostly attribute to the fast-paced lifestyle we lead, where lifestyle, dietary habits, and dehydration very commonly affect our daily lives.
This blog highlights the latest innovations and best practices in kidney stone treatment, combining traditional methods and emerging technologies to help patients make informed decisions.
Synopsis
What Are Kidney Stones? Causes and Symptoms
Also known as renal stones, kidney stones are solid deposits that can develop anywhere in the urinary tract. They are formed due to the crystallisation of salts and minerals.
The most common types include:
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Calcium Oxalate Stones: Typically formed when there is too much calcium or oxalate in the urine.
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Uric Acid Kidney Stones: Occur when urine is persistently acidic, more common in people with high-protein diets or gout.
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Struvite Stones: Often linked with urinary tract infections.
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Cystine Stones: Rare and usually associated with a hereditary condition called cystinuria.
Causes and Risk Factors
There can be varied causes behind kidney stone formation; however, the major key contributor is lifestyle changes, and ‘we’ are responsible for that. Below are common kidney stone causes:
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Inadequate water intake leading to concentrated urine
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Diets rich in oxalate-rich foods, such as spinach, nuts, and chocolate
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High sodium or animal protein intake
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Metabolic issues like hyperparathyroidism
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Genetic predisposition
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Certain medications or supplements (e.g., high doses of vitamin C)
Kidney Stone Symptoms
Kidney stone symptoms can develop suddenly and intensely. Watch out for the below signs:
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Sharp pain in the side or lower back
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Blood in urine
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Painful urination or urinary urgency
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Nausea and vomiting
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Fever
Prompt identification of these symptoms plays a crucial role in preventing complications like urinary obstruction, infection, or even kidney damage.
Diagnosis and Initial Evaluation
Accurate kidney stone diagnosis is very important for doctors to develop an appropriate treatment plan and prevent the recurrence of these stones. This evaluation can involve:
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Medical History and Physical Examination: Helps identify risk factors and eliminate differential diagnoses
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Imaging Tests:
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Non-Contrast CT Scan: highly sensitive and the gold standard for identifying even small stones
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Ultrasound: safer for pregnant women and children, though it may miss smaller stones
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Urinalysis: detects blood, infection, or crystals
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Metabolic Workup: especially important for patients with recurrent kidney stones; includes 24-hour urine collection to assess volume, pH, calcium, oxalate, uric acid, and citrate levels
Meet our top urologist at Manipal Hospital Malleshwaram for a thorough evaluation.
Best Treatment for Kidney Stones
Treatment depends on the size, location, and composition of the stone, as well as the presence of symptoms or complications.
A. Conservative Management
When stones are small (less than 5 mm) and symptoms are mild, conservative kidney stone treatment may be sufficient. This approach includes:
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Increased fluid intake (aim for 2.5–3 litres/day)
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Pain control using NSAIDs or, in severe cases, opioids for kidney stone pain relief
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Medical expulsive therapy (MET) with alpha-blockers to relax the ureter and facilitate passage
B. Pharmacologic Interventions
Once the stone type is identified, targeted kidney stone medications can be prescribed. Some common medications used include Citrate supplements, Allopurinol, and Thiazide diuretics. These treatments aim to resolve current stones and prevent recurrence, particularly in high-risk individuals.
C. Minimally Invasive Kidney Stone Surgery
When stones are larger (greater than 6 mm), persist despite MET, or cause complications, more active intervention is needed:
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Extracorporeal Shock Wave Lithotripsy (ESWL)
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A non-invasive kidney stone treatment that uses high-frequency sound waves to break stones into passable fragments
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Works best for stones greater than 2 cm located in the kidney or upper ureter
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May require multiple sessions
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Ureteroscopy for kidney stones (URS)
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Involves passing a small scope through the urethra and bladder into the ureter
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Stone is fragmented using kidney stone laser treatment (usually with Holmium: YAG laser)
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A stent may be placed temporarily for drainage and recovery
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Percutaneous Nephrolithotomy (PCNL)
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Ideal for large, complex, or staghorn stones
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A small incision in the back allows direct access to the kidney
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Requires hospital stay but offers high success rates
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Mini-PCNL, Ultra-mini, and Micro-PCNL
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Advanced forms of PCNL that use even smaller instruments
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Part of the rising trend in minimally invasive urology, these techniques offer reduced bleeding, faster recovery, and shorter hospital stays
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D. Retrograde Intrarenal Surgery (RIRS) – The Gold Standard for Complex Renal Stones
Among all available techniques, Retrograde Intrarenal Surgery (RIRS) stands out as a transformative advancement in kidney stone treatment. It combines precision, safety, and minimal invasiveness, making it particularly effective for stones located deep within the kidney or in patients who are poor candidates for more invasive surgery.
How it Works: A thin, flexible scope is gently passed through the body’s natural urinary pathway, from the urethra to the bladder, up the ureter, and into the kidney. This is done without the need for any cuts or incisions. Once the stone is located, it’s broken down into fine dust using advanced Holmium or Thulium fibre lasers. These tiny fragments are either flushed out naturally with urine or removed using delicate retrieval tools, allowing for a safe and effective stone clearance with minimal discomfort.
Ideal For: Stones ≤2 cm in the kidney, lower pole stones, or those resistant to other treatments.
Benefits: The patient benefits from no external incisions, minimal bleeding, high precision, and faster post-op recovery. Often done as a day-care procedure. RIRS has become the preferred option in centres of excellence for its ability to treat even anatomically challenging stones with finesse and minimal trauma.
Read our blog: Hyperuricemia and Chronic Kidney Disease (CKD): Is There A Link?
Kidney Stone Prevention Tips: Lifestyle Modifications
Long-term renal stone management involves more than just treatment—it means preventing recurrence. Below are a few kidney stone prevention tips you may follow:
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Hydration for Kidney Stone Prevention: Drink enough water to produce at least 2 to 2.5 litres of urine daily
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Adopt a Kidney Stone Diet:
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Reduce sodium intake – stop having salt separately, other than what goes into cooking foods (less than 2,300 mg/day)
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Limit oxalate-rich foods like beets, nuts, and tea
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Increase natural citrate sources, such as lemons and oranges
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Avoid high-protein diets that promote uric acid formation
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Calcium Should Not be Avoided Entirely: adequate dietary calcium helps bind oxalate in the gut
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Routine follow-ups, including imaging and lab tests for those with a history of recurrent kidney stones
Emerging Trends and Future Directions
Recent years have seen a revolution in kidney stone treatment, marked by:
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Digital ureteroscopes that provide better visualisation and flexible navigation
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Next-gen laser advancements that fragment stones more efficiently with minimal tissue damage
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AI and machine learning for predicting recurrence, tailoring treatment, and improving diagnostics
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Personalised medicine by evaluating stone composition, genetic markers, and metabolic profiles to develop individualised care plans
These innovations reflect a shift toward more precise, predictive, and patient-centric renal stone management.
Conclusion
Kidney stones are more than just a painful inconvenience—they're a medical condition that requires timely, individualised care. From medical expulsive therapy and citrate therapy to advanced surgical options like PCNL, patients today benefit from a broad spectrum of effective treatments. However, prevention remains just as crucial. Appropriate hydration, dietary changes, and follow-up care can significantly reduce the risk of recurrent kidney stones.
By staying informed and following certain lifestyle changes for kidney stone prevention, we can ensure we avoid complications related to the disease and lead a healthier life.
If you’re experiencing symptoms or need expert guidance on prevention and treatment, consult the specialists at our Urology Department at Manipal Hospital Malleshwaram. Stay informed, act early, and take the right steps toward a healthier life.
FAQ's
Treatment of kidney stones is largely based on the size and location of the stones. Options include ESWL, URS, PCNL, and kidney stone medications.
Smaller kidney stones, especially if they are less than 5 mm, can pass with urine. Drink enough water to dilute your urine and keep the stone moving through your urinary tract. Medical expulsive therapy may also help you pass a kidney stone, where alpha-blockers (like tamsulosin) relax the muscles in your ureter, and the stone passes more quickly and with less pain.
Common kidney stone symptoms include:
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Severe pain in the side or lower back
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Painful urination or urinary urgency
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Blood in the urine
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Nausea
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Fever
To prevent kidney stones, follow a kidney stone diet, maintain adequate hydration, and undergo regular metabolic screenings.
Increased hydration and citrus fruits may help, but always consult a urologist before using kidney stone home remedies, as most of these remedies don’t have enough evidence to support the claims.
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