Causes of Kidney Stones

Written by Hu Lin
Nephrology
Updated on January 01, 2025
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The causes of kidney stone formation include the following: One reason is the increased amount of stone-forming components in the urine. Various factors that cause an increase in the concentration of salts, uric acid, oxalates, and cystine in the urine can exceed their solubility. This results in the precipitation and crystallization from the urine, which further grows into stones. For example, hyperuricemia can lead to an increased excretion of urinary uric acid, making it easy to form urate stones. Secondly, the reduction in urine substances that inhibit stone formation, including decreases in citrate and magnesium, can promote stone formation. Third, urinary tract obstruction and infection can lead to stone formation. In cases of urinary tract obstruction and poor urine flow, small crystals formed in the urine can easily adhere to the epithelial cells of the urinary tract, becoming the nucleus of the stone. Urinary tract obstruction may also lead to urinary tract infections where bacteria, pus, and damaged, necrotic epithelial cells can also form the core of stones and gradually develop into larger stones. Fourth, diet and hydration play significant roles. Long-term, high intake of high-protein, high-sodium, high-sugar foods can cause increased excretion of urinary calcium and uric acid, while reducing citrate levels, thus promoting stone formation. A decrease in water intake can also cause urine concentration, further promoting stone formation. Fifth, environmental factors and genetic factors are considered to be related to the formation of kidney stones. It is believed that the hardness of water and genetic factors also have certain relationships with kidney stone formation.

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Written by Zeng Zhong
Urology
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Do you need to be hospitalized for kidney stones?

Patients with kidney stones need to decide on a treatment plan based on the size of the stones, which determines whether hospitalization is necessary. For kidney stones smaller than 1.5 cm, extracorporeal shock wave lithotripsy can be utilized, allowing the patient to avoid hospitalization. After treatment, the patient can go home, where it is advised to engage in physical activity, drink plenty of water, and urinate frequently to facilitate the expulsion of the stones. A follow-up ultrasound of the urinary system should be conducted one week later at the hospital to monitor the status of the stone expulsion. If the stones are larger than 1.5 cm, surgical treatment is required, which necessitates hospitalization.

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Written by Wang Jian
Urology
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Is kidney stone surgery painful?

For the treatment of kidney stones, larger kidney stones or multiple stones, stag-horn stones might consider surgical treatment. There are two types of surgery, the first is percutaneous nephrolithotomy, which involves inserting a nephroscope through a puncture in the kidney to break up and expel the stones from the body; the second type of surgery is ureteroscopy, which does not require an incision, by entering the kidney through the urethra and ureter, and then breaking up the stones and expelling them from the body. Both surgical methods are performed under anesthesia, so the patient will not feel pain. However, pain after ureteroscopy is typically less than that after percutaneous nephrolithotomy, which requires absolute bed rest post-operation, while ureteroscopy does not.

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Written by Chen Feng
Urology
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What are the symptoms of kidney stones?

The symptoms of kidney stones vary depending on the size of the stones and whether they cause obstruction. If the stones are relatively small, they can usually pass smoothly through the ureters and urethra and be expelled from the body without causing any symptoms. When the stones are expelled, small stones can be seen in the urine. If the kidney stones are relatively large but do not cause obstruction in the kidneys or bladder, they generally do not cause any symptoms. Symptoms occur only when larger stones move downward and become lodged in the ureters, causing back pain, nausea, and vomiting. The stones can scratch the walls of the ureters, leading to blood in the urine. When stones get stuck in the urethra, it can cause painful urination discomfort and perineal pain. Since the stones can scratch the inner walls of the urethra, they may also cause blood in the urine.

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Written by Chen Feng
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How can kidney stones be expelled from the body?

The method of expelling kidney stones from the body is related to the size of the stones. If the diameter of the kidney stone is less than 0.6 centimeters, it can generally pass smoothly through the ureter and urethra to the outside of the body. This can be facilitated by drinking plenty of water and performing physical activity to naturally expel the stones. If a stone gets stuck in a physiologically narrow part of the ureter during expulsion, conservative treatment methods can be used to dilate the ureter, allowing the stone to pass on its own. If the kidney stones are relatively large but do not cause obstruction within the kidney, they can be observed temporarily without treatment. If larger stones get stuck in the ureter or urethra and cannot be expelled on their own, surgery is generally required to remove the stones. After surgery, it is also important to drink plenty of water and urinate frequently.

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What department should I go to for kidney stones?

Kidney stones are a urological condition requiring treatment at a hospital's urology department. Diagnosis involves imaging, such as ultrasound or CT scans, to determine the stone's exact size and location for appropriate treatment. If the stone is relatively small, with a diameter of six millimeters or less, referred to as a small stone, it generally does not require special treatment. Increased fluid intake, frequent urination, and exercise can help facilitate the expulsion of the stone. If the stone's diameter is between 0.7 and 1.5 centimeters, extracorporeal shock wave lithotripsy or ureteroscopy may be considered. For larger stones exceeding 1.5 centimeters, possibly accompanied by hydronephrosis, the recommended treatments are percutaneous nephrolithotomy or open surgery for stone removal.