Kidney stone treatment

The type of treatment^[22] used for kidney stones depends on a stone’s size, what it’s made of, whether it is painful, and whether it’s blocking your urinary tract.

How to prevent kidney stones

One of the best treatments for kidney stones is preventing them from forming in the first place. Generally, the people who should be concerned with preventing kidney stones are those who have already had them and (or from recurring, if you have already had them). Understanding what your kidney stones are made of can also help you make necessary changes to your diet and lifestyle to prevent the recurrence of stones. There are several ways you can help prevent^[23] kidney stones:

• Drink plenty of liquids: Drinking lots of fluids is one of the best ways of preventing kidney stones. In 2015^[24], the National Kidney Foundation found that people who produce 2–2.5 liters of urine daily were 50% less likely to develop kidney stones than those who produced less.

Unless you have kidney failure, it’s generally recommended that you drink at least 6 eight-ounce glasses^[25] of fluids per day. While drinking water is the healthiest way to stay hydrated, drinking more fluids, in general, can help you produce larger quantities of diluted urine.

• Avoid high-oxalate foods: Some foods, including spinach, beets, and almonds, can raise the level of oxalate in the body, contributing to the development of oxalate kidney stones.
• Decrease your sodium intake: High-sodium diets increase the amount of calcium in your urine, potentially leading to calcium kidney stones. Eating lemons can also help prevent calcium stones from forming: they contain citrate, which binds to calcium and helps block the formation of stones.
• Cut back on animal protein: Consuming large quantities of animal protein (including meat, eggs, and seafood) increases uric acid levels in the body.
• Medication: If you’ve had one or more kidney stones already, your healthcare provider may prescribe medication to help prevent more from forming in the future.

Kidney stone medication

What medication is prescribed will depend largely on the type of kidney stone you had. Struvite stones may be treated with oral antibiotics, while allopurinol can help treat uric acid stones.

Kidney stone surgery

Most small kidney stones don’t require surgery or invasive treatment. However, stones that are too difficult to pass on their own (those that are large and have jagged edges or cause bleeding, kidney damage, or ongoing UTIs) may require surgical removal^[26]. A urologist—a specialist in urinary and sexual problems—can remove a kidney stone or break it into small pieces using the following treatments^[27]:

• Shock wave lithotripsy: As its name implies, this outpatient procedure uses shock waves to break up stones in the kidney, bladder, or ureter into small pieces. These pieces can then pass through the body in your urine much more easily.
• Cystoscopy and ureteroscopy: In a cystoscopy, a tool called a cystoscope (a long instrument with an eyepiece and a tiny lens and light at either end) is used to look for stones inside the urethra and bladder. In a ureteroscopy, a ureteroscope (which is longer and thinner than a cystoscope) is used to see detailed images of the linings of the ureters and kidneys. Both of these instruments are inserted through the urethra (the external opening of the urinary tract).

Once one or more stones have been located, they can either be removed or broken into smaller pieces to be passed through the urine.

• Percutaneous nephrolithotomy: This procedure also involves using a thin viewing tool—called a nephroscope—to locate and surgically remove kidney stones. The nephroscope is inserted directly into the kidney through a small incision in the back. In the case of larger kidney stones, a urologist may also use a laser to break them apart into smaller pieces.

You may be required to leave a thin, flexible tube called a ureteral stent in your urinary tract for a few days after undergoing percutaneous nephrolithotomy in order to help improve urine flow or pass a stone. After the stone passes or is removed, it is sent to a lab for analysis.

• Parathyroid gland surgery: Calcium phosphate stones can be caused by overactive parathyroid glands. These glands are located on the four corners of the small, butterfly-shaped gland called the thyroid, which is located at the base of the neck. Overactive parathyroid glands produce too much parathyroid hormone, which can cause your calcium levels to rise and lead to the formation of calcium stones.