Kidney stone is a very common problem in the Indian context. 12% of Indians suffer from kidney stone problems & 50% of these suffer kidney damage. For example, if you take 100 random people, 12 will be having kidney stones, 6 out of these 12 have kidney damage, and a few of them can have permanent kidney failure.

It is always better to consult with your doctor to understand how much your kidney stone can be harmful to you and your kidney. This is called individualized risk stratification which is crucial for further decision-making if any treatment is required or not, at all. Each patient needs a different approach for the diagnosis of kidney stones and also for treatment. There is no magic pill or magic solution for all kidney stone problems. By the end of this article, you may be well aware of the medical science of kidney stones.

How Kidney Stone Are Formed

The first ever description of urinary stones in human history details the presence of bladder stones in a Mummy. The history of kidney stones goes in parallel with the history of humankind civilization. A simple vegetarian diet of clarified butter and alkaline liquids was advised for the treatment even in ancient times.

Worldwide around 12% of the population suffers from urinary stone problems and their consequences like kidney damage and kidney failure. Though it can happen at any age, but 20-49 years is the age group that is most commonly affected.

The formation of stone is a biological process and is a result of supersaturation (crystals start getting deposited in the solution rather than being resolved). In a simple example, if we take a small amount of water (say 10-15 ml) and try to mix salt in it with increasing quantity, at a point salt will not mix further and it will remain at the bottom of the water in the same salt form. Stones are also similar type crystals, with different compositions, that get deposited in urine at a point where either amount of urine is not enough to dissolve those crystals or the quantity of crystals is out of proportion for the amount of urine.

Stones are formed in a stage-wise manner within the kidney(Can use pic)

Formation of invisible crystals: Crystals started to grow by further deposition of crystals around them. Similarly, growing crystals start aggregating and form big crystals. Big crystals come out and take a shape of stone

What do kidney stones look like and types of stones?

Urinary stones can be categorized or classified based on chemical composition or as of their size or their shape.

Based on chemical composition stone can be classified into:

  • Calcium stone: most common type of stone and 80% of kidney stones are calcium stones. They can be Calcium oxalate monohydrate, Calcium oxalate dihydrate, and Calcium phosphate stone.
  • Magnesium ammonium phosphate or Struvite Stones: these are most commonly affecting patients with chronic urinary tract infections.
  • Uric acid stone: Formation of due to intake of foods with a high concentration of natural compounds such as Purines. Purines lead to the production of monosodium urates that form stones in the right conditions. Usually, these stones run in the family.
  • Cystine stones: These are rare types of kidney stones that mostly run in the family.
  • Drug-induced stone

Based on the size they can be classified into

  • Less than 5 mm
  • 5-10 mm
  • 11-20 mm
  • More than 20 mm

Based on the stone location

  • Kidney
  • Upper calyx
  • Middle calyx
  • Lower calyx
  • Renal pelvis
  • Upper ureter
  • Mid ureter
  • Lower ureter
  • Urinary bladder
  • Urethra

What are the chances that I can get kidney stones?

1 in 10 Indians has a chance to get some form of kidney stones in their lifetime. Your lifestyle habits & environmental factors are majorly responsible for kidney stone formation.

Apart from this, the more yes you have from the following checklist, the more chances for you to get kidney stones & also for stone recurrence.

  • Excess animal protein (red meat) intake  Y/N
  • Excess salt intake (more than 5 gm per day)
  • Excess fast food/ snacks/pickles/ namkeen
  • Inadequate water intake (less than 2 lt per day)
  • Inadequate fruit & vegetable intake
  • Too much hot environment
  • Family history of stones
  • Repeat urinary infection (UTI)
  • Hypertension
  • Obesity

Common location of stone 

Kidney: Kidney stones present in the kidney are usually measured in mm size. It can range from a few mm (2 mm, 3mm, 3.4 mm, 6mm, 7.5 mm or like this) to centimeter size (35mm, 45mm or like this). These are the measurements that patients usually get when they get their ultrasound done. One should always consult with their doctor to understand how important it is for them to take further action. An unbiased opinion is very crucial before proceeding with any surgery.

Ureter: ureter is a 25 cm long tube that connects our kidney to the bladder and helps to transport urine. Is divided into three parts (upper ureter, mid ureter & lower ureter) for easy understanding of stone location both for patient and doctor. Stone of any size (a few mm to a few cm) can be present in any part of the ureter. Every ureteric stone needs treatment either with medicine or surgery. Ureteric stones can not be left untreated. Stone size and location decide:

  • How it should be treated
  • When it should be treated
  • What technique should be used for treatment

Bladder stone: The majority of the time if a stone passes from the ureter, it may pass through the bladder and urethra unnoticed. Sometimes these stones may get stuck in the urethra and can cause sudden urine block (Urinary retention). Sometimes these stones remain in the urinary bladder and become larger over years. Bladder stones can remain for years without any symptoms.

What are the common symptoms of kidney stones?

Symptoms are different from location to location and can vary from mild pain to severe pain that may require emergency hospital admission to blood in the urine.

  • Pain: pain is the most common symptom that brings someone’s attention toward the possibility of having a stone. Patients usually come with “kamar me bahut tej dard hai”. This flank pain can be on either side left or right deepening upon the side of the stone. Simple back pain or heaviness in the back can also be a presenting complaint. If the stone is in the ureter pain can start from the flank and radiate toward the inguinal region.
  • Burning in urine: if the stone has come into the ureter and is stuck at the end of the ureter, patients complain of burning in passing urine. This situation can also happen with stones in the urinary bladder and urethral stone.
  • Frequency of urine: patients may feel a very strong desire to pass urine at very short intervals. When they go to the washroom, it takes too much effort to pass or even sometimes not at all able to pass urine. The number of times they need to go to the washroom suddenly increases significantly.
  • Blood in urine: when a stone passes through the ureter, it may cause some injury to the mucosal lining of the ureter. This causes bleeding from those sites and when the patient passes urine it becomes red color.
  • Decreased urine volume: it can be a danger sign that needs to be attended to urgently. Sometimes both ureters become blocked by stones which can result in significant damage to the kidney. If this is left untreated, kidney damage can be permanent also.
  • Unable to pass urine: this happened when a stone got stuck in the urethra. The situation is more common in males because they have a 15 cm long urethra in comparison to a 4 cm long urethra in females. Patients feel a very strong desire to pass urine with severe abdominal pain. Sometimes that can be appreciated in the lower abdomen because of the dissented urinary bladder.
  • Nausea & Vomiting: these symptoms can mimic acidity if happening alone. This situation happens with ureteric stones and some very large kidney stones.
  • Fever: if a blockage occurs, urine gets infected and can cause fever. If this is not treated in time, the infection can spread to the blood and serious consequences can happen.

Kidney stone symptoms in females and males are usually similar. They can occur alone or in any combination. Ultrasonography is the first and basic investigation for our KUB (Kidney, Ureter & bladder) screening. It is always better to consult a doctor to understand your condition.

Diagnosis of Kidney Stones

The Diagnosis of kidney stones will begin with understanding your symptoms via physical examination, tests, and understanding your medical history. Your doctors will want to learn about the size and type of kidney stone to understand better and decide on the treatment they are going to give you. So, for that, they will take a CT scan or X-ray from the kidney to the bladder which is otherwise called a” KUB x-ray”. The results of the x-ray will help doctors to determine what type of stone it is and what kind of medication or treatment will be suitable for your kidney stones.

What is the treatment for kidney stones?

The Treatment of urinary stones is based on two different factors such as:

  • Location of stone
  • Size of stone

Few stones can be managed conservatively, which means waiting for some time (say 1-3 weeks), with help of some medicine, precaution, and lifestyle modification stone usually come out. Stones other than this need operation. Again which operation is best depends upon the location and size of the stone primarily. Stone shape & its composition sometime may also change the choice of the operative procedure

In most cases where surgery is advised for the removal of stone, it is an elective procedure. That means you are not supposed to get the operation done immediately. As it is not a life-threatening situation and the patient may not survive if surgery is not done. Whenever you have advised for surgery, always take a second opinion to be clear of what should be done, How it should be done, What is the success rate of the operative procedure, What are chances of stone recurrence, What are the complications of each modality of treatment

Which one will be best for that individual?

The success of the operation cannot be generalized, as if someone got the laser treatment for their stone, so it would be best for me to get the same. The same also applies to the bad consequence of the operation, if somebody’s case becomes complicated after the laser treatment for their stone, it might also get complicated in my case also.

An unbiased second opinion helps to understand your case better & to make the decision better. An unbiased opinion can be asked from where they are not asking to come to them and get yourself treated. They are not talking about their advanced technology and expertise. They just give you a fair and transparent opinion.

Broadly operation that can be offered to the patient

  • Endourological procedure
  • Laparoscopic procedure
  • Open surgery
  • Lithotripsy

Which is the best laser treatment for stones?

This is very common confusion & patients usually ask their Doctor. Lasers are not a type of operation. Laser is a source of energy that is used to break the stone, so that small stone fragments can be easily taken out from your kidney or ureter, or bladder.

What are the common causes of Kidney stones? 

The kidney is used to filter out waste such as Phosphate and Calcium. Sometimes, when the kidney is not able to filter the waste, that waste forms crystals. This happens when Individuals start to eat products or food items that are difficult to digest or filtered by kidneys. There are some common risk factors that lead to kidney stones, and some of these risk factors can be controlled by lifestyle or eating habits. While some factors are not controllable such as:

Controllable causes: Drinking less water can be one of the major causes of kidneys’ failure to filter waste. In our modern lifestyle, our food habits have been affected badly. We eat foods that are good for our taste buds, but bad for our health. Most of the time, these food items are difficult to digest and difficult for the kidney to filter waste. The Diet of any person plays a crucial role in developing health. Eating too much animal protein, sodium, high-oxalate foods, and too sugary products, can boost the risk of kidney stones. Apart from these certain medications have side effects on the kidney, sweetened beverages.

Is beer good for kidney stones and come under controllable causes?

Many times people used to take advantage to get more opportunities to have alcoholic beverages. Beer is one of them and it is not a magical solution that pushes stone and gives it a command that gets out from this patient. Also, it is not miraculous, that as soon as it comes in contact with the stone, it will dissolve stone like in a fictional movie. All alcoholic beverages cause diuresis, meaning they increase urine production, which sometimes helps to push stones from the ureter. Drinking a good quantity of water or other non-alcoholic beverages will also do the same task and help stones in pushing out of the urinary system. So, you need to increase your liquid intake, not particularly Beer.

Controlling these things can help you reduce the risk of kidney stones.

Uncontrollable causes:

Sometimes there are certain uncontrollable conditions when individuals cannot control the kidney stones. These stones are not formed due to lifestyle or food habits, but other reasons. For instance, family history, rare kidney stones that run in the family, and the formation of stones due to medications. Moreover, some medical conditions such as high blood pressure, and infections can increase the chances of kidney stones. These are some of the situations when individuals have chances of kidney stones due to uncontrollable situations.


Kidney Stones are one of the most common medical conditions that are faced by the majority of people across the globe. Depending on lifestyle and eating habits, kidney stones and their types may vary. Most of the time, kidney stones are formed due to bad eating habits and lifestyle. The risk of stones increases in such situations. If you have bad eating habits, it’s time to control and put a full stop. Apart from these, if you are experiencing these symptoms, it’s best to consult a doctor immediately. The more you delay, the more it will have a negative impact. The above-mentioned guide will help you understand everything you need to know about kidney stones and their treatment.