Everything you need to know about kidney stones

Key points:

• Kidney stones, also known as ‘hell,’ ‘pain pebbles’ and ‘literal nightmares,’ develop when too little fluid has to flush too much waste from the urinary system

• Although some kidney stones or fragments of a kidney stone may be expelled during urination without much pain or concern, significant build-ups may pose health risks

• Passing a kidney stone is excruciatingly painful

This edition of Aged Care Guide covers the causes, symptoms and potential treatment options available for someone experiencing pain related to kidney stones. As people age, the likelihood of developing kidney stones increases over time and a family history of the urinary tract disorder, along with obesity or chronic dehydration, may contribute to the probability of build-up over time.

In this article, you will learn how to best support an older person deal with the associated symptoms of the common disorder, which one-in-10 men and one-in-35 women will deal with at least once in their lifetime. By the end of this Guide, you’ll understand why Indiana Jones ran as fast as he did, in fear of the huge boulder tumbling through the tight tunnel.

Causes of kidney stones

If you don’t want to groan and grovel as you process gravel, experts suggest that you continue to drink plenty of water to ensure your body stays hydrated.

In general, there are four kinds of kidney stones, each with respective causes for build-up:

Calcium oxalate/phosphate — likely caused by a diet which contains an excess of calcium, salt or sugar; obesity; kidney or digestive disease; hyperparathyroidism.

Struvite — likely caused by a urinary tract infection (UTI) which renders the urine waste more alkaline and prevents waste from being secreted.

Uric acid — likely caused by a diet high in meat.

Cystine stones — caused by cystinuria, which is a rare and lifelong disease which can be controlled, but not cured.

Aside from cystine stones, which will regularly develop in someone with cystinuria, experts suggest that the three most common causes of kidney stones can be prevented or staved off through hydration, a balanced diet and seeking treatment for symptoms of a UTI.

Symptoms of a UTI may include:

• Frequent urination
• Pain or discomfort urinating
• Cramping or associated lower abdominal pain
• Red, murky or irregular colour of urine
• Distinct smell emanating from urine

Another thing to consider when preventing kidney stones or seeking to treat existing causes of kidney stones may be asking your general practitioner [GP] about current medicines and potential side effects for comorbid conditions. Changing the acidity of your urine can occur incidentally through treatment for kidney disease, human immunodeficiency virus [HIV] or cancer.

Symptoms of kidney stones

Symptoms of kidney stone development may include:

• Pain located in the side of the body or in the back
• Traces of blood in urine
• Sharp pain in bladder or while urinating
• Nausea and/or vomiting
• Shivering
• Constant need or compulsion to urinate, even with an empty bladder

Treatment of kidney stones

An older person with kidney stones may seek treatment for kidney stones, although smaller stones may pass without incident between three to six weeks after symptoms arise. However, for stones which do not pass, there are four primary methods for removal of the mass — a mass exodus, if you will. Treatment may include:

Extracorporeal shock-wave lithotripsy (ESWL) — which uses soundwaves to break down stones less than two centimetres in diameter, in order for tolerable passing.

Percutaneous nephrolithotomy — which involves a small incision in the back of a person with a kidney stone — larger than two centimetres in diameter — with removal performed using a unique tool.

Endoscope removal — which involves the use of a slim camera device inserted into the urethra, allowing doctors to break down or remove the stone.

Surgery — assuming other, less-intrusive, methods of breaking down the stone are ineffective, surgery may be performed through an incision on the back for direct removal by a professional through traditional practice.

In some instances where naturally passing the stone will lead to absolutely abhorrent pain, some clinicians may provide medication to mitigate pain.

Related content:

Incontinence issues in the elderly

The importance of elderly nutrition

Hydration for elderly people and the dangers of dehydration