Kidney stones result from the precipitation (crystallization of previously dissolved particles) of certain substances within the urine. These stones form in the kidney and subsequently travel through the ureter (the tube that conducts urine from the kidney to the bladder) and are eliminated through the urine if they are small. In some cases, the stone may not be able to travel through the ureter, causing pain and possibly causing an obstruction, blocking the flow of urine out of the kidney. Kidney stones can be caused by a large number of factors, such as infection, certain diets, medications, and conditions that result in an increased concentration of calcium or other substances, including oxalate and uric acid, in the urine. The composition of the stone depends on the cause, but the most common type of stone contains calcium. The March 2, 2005, issue of JAMA includes an article that reviews the causes and diagnosis of kidney stones and the available treatments.
The symptoms associated with kidney stones vary depending on the size of the stone, its position within the urinary tract, and whether there is an associated kidney infection.
Pain in the back or side
Blood in the urine
Vomiting
Fever
Urinary frequency or urgency (the sensation of the immediate need to urinate)
Pain with urination
In addition to a complete medical history and physical examination, your doctor may order blood tests to assess your kidney function and the concentration of certain electrolytes and dissolved minerals (such as calcium) in your blood. A urinalysis (analysis of a small sample of urine for infection and blood) and a 24-hour urine collection (to look for substances associated with kidney stones) may also be performed. Your doctor may order a computed tomography (CT) scan, abdominal x-ray, or ultrasound test to locate the stone and to rule out other possible causes of the symptoms.
Initial treatment includes pain medication and oral or intravenous fluid to help the stone pass through the urine.
Extracorporeal shock wave lithotripsy is a procedure that uses shock waves to break up the stone without the need for surgery.
Surgery may be necessary if the stone is very large and if there is blockage of the affected kidney or infection.
Depending on the cause of your kidney stone, your doctor may prescribe medication or suggest dietary changes to prevent a recurrence.
National Institute of Diabetes and Digestive and Kidney Diseases 800/891-5390 http://www.niddk.nih.gov
National Kidney Foundation 800/622-9010 http://www.kidney.org
American Kidney Fund 800/638-8299 http://www.akfinc.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: National Institute of Diabetes and Digestive and Kidney Diseases; National Kidney Foundation
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.
TOPIC: KIDNEY DISORDERS
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.