Kidney stone disease is one of the most common renal (kidney) problems around. Some estimates suggest that around one in ten people are affected. Medstars’ specialist Mr Shabi Ahmad is a consultant urologist based at City and Sandwell Hospitals in Birmingham. He also works privately at Spire Little Aston Hospital, BMI Priory Birmingham and Derby Nuffield Hospital. He says that there are certain populations and groups who are more likely to develop kidney stones.
“The condition is more common in the Afro-Caribbean and Asian populations, and in people aged 30 to 60, but it can affect anyone.”
What are kidney stones?
Kidney stones are hard stone-like lumps that form inside your kidneys. They may then travel from your kidneys down the ureter, the tube that connects your kidneys to your bladder. If the stones remain small, you will often pass them in your urine without even noticing. However, if they get too big, they can cause pain, and a feeling of sickness. You may also have a high temperature or see blood in your urine—and if so, you should always see a doctor.
What causes kidney stones?
Kidney stones occur when waste products in the blood form crystals in the kidneys. These can build up over time to make hard, stone-like lumps. However, why does this happen in some people and not others? The various causes of kidney stones include:
Low urine volume – mainly caused by dehydration as a result of not drinking enough water or over exercising.
Diet – a high salt intake increases a person’s chance of developing kidney stones.
Bowel conditions – a person may be more prone to developing kidney stones due to certain bowel conditions, such as Crohn’s Disease or ulcerative colitis.
Obesity – this may change the acid levels in a person’s urine, leading to stones developing.
Family history – you may be more likely to develop kidney stones if a member of your family has had them in the past.
Medications – can sometimes increase your risk of developing kidney stones. Additionally, both calcium and vitamin C supplements can heighten the chances, too.
Shabi Ahmad notes,
“We know that some medical conditions mean that you have more of the stone-forming chemicals in your blood. Taking certain medicines—including aspirin and certain antibiotics—can also mean that you are more likely to get kidney stones. People who have had a kidney stone before are also more likely to get another.”
Types of kidney stones
Kidney stones come in many different forms, so how you treat them depends on the location and the severity of the stone. The types of kidney stones are:
Calcium stones – these account for 80% of kidney stones and they are caused by the overproduction of calcium in the urine.
Uric acid stones – these stones are far less common and are a result of chemical changes in the body. These changes may stem from being overweight, having high blood sugar, having too much protein in the diet or other issues.
Struvite stones – such stones are related to urinary tract infections, and these stones are often large and grow quickly.
Cystine stones – perhaps the rarest type of kidney stone, these are caused by an inherited metabolic disorder causing the kidneys not to reabsorb cystine.
Kidney stones symptoms
There are various symptoms you may encounter when you have kidney stones – most commonly, you will feel a sharp pain in the location of your kidneys. However, other signs include:
An intense feeling of needing to urinate
Burning sensations during urination
Dark or blood-coloured urine
Nausea and vomiting
As a male, you may feel a burning sensation in the tip of your penis
How to prevent kidney stones?
One of the best ways to prevent kidney stones is to drink plenty of water. The ‘normal’ recommendation is to drink two litres of water a day. However, urologists may suggest that people who have had kidney stones should drink even more, around three litres per day. Shabi Ahmad says,
“We always tell people to ‘pee pale’. If your urine is dark yellow, you’re probably not drinking enough. It should be a pale straw colour.”
How are kidney stones treated?
What are your treatment options if you develop kidney stones? You may be able to pass small stones through your urine. However, the process could be painful. Your GP might advise you to take non-steroidal, anti-inflammatory drugs such as ibuprofen to help with the pain.
If you have a large stone, surgery may be needed. However, this does not need to be traumatic. Shabi Ahmad has done a lot of work on a new technique called percutaneous stone removal.
“In percutaneous stone removal, I use a keyhole technique to remove large stones. I’ve managed to remove large stones through extremely small incisions. It makes stone surgery much easier—for me, but especially for my patients. A lot of stone surgery now is also done using endoscopy and advanced laser technology, with access through the ureter. This means there is no need for incisions, which makes it much less traumatic.”
Most endoscopic stone surgery is now done as a day case. Even when large stones are removed, patients usually only have to stay one night in hospital. Shabi Ahmad is rightly proud of his record in reducing the length of stay.
“Before we started doing endoscopic stone removal, and surgeries with very small incisions, patients used to have to stay three to seven days in hospital. Now, even after removing large kidney stones, they go home the next day. It’s not too much of a stretch to say it has revolutionised kidney stone surgery in Birmingham, and I’m proud to be able to say that I’ve been involved in that work.”
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