How to Treat Kidney Stones: What Works?

Drinking fluids helps, so does knowing when to seek medical attention

A mature man holds his back in pain while sitting on a couch, representing kidney stone symptoms.

Drinking fluids helps, so does knowing when to seek medical attention

Every year more than half a million people go to the emergency department for kidney stones, according to the National Kidney Foundation, and an estimated one in 10 people will have a kidney stone in their lifetime. 

These hard particles accumulate from minerals in urine, and they have multiple causes, sizes, pain levels, treatments and outcomes. 

Here, two Scripps Health physicians offer tips on how to keep your kidneys in the clear.

What causes kidney stones?

“The most common cause of kidney stones is dehydration,” says Carol Kashefi, MD, a urologist at Scripps Clinic

“Genetics also plays a role — having a family history of stones — as well as metabolic disorders that affect how your kidneys filter blood. More and more over the past 30 years, people are forming stones due to poor diet or obesity. 

“Some types of gastric bypass surgeries can also increase the risk of kidney stones. Less common causes are medication or supplement-induced stones.”

How to prevent kidney stones

Because dehydration is the most common cause of kidney stones, the simplest prevention method is to rehydrate

“It’s a good idea to drink 6 to 8 cups of fluid a day, but if you have a history of stones, you should drink at least 8 cups per day, keeping in mind that 1 cup equals 8 ounces,” Dr. Kashefi suggests.

“The second piece of advice I usually give is to minimize sodium intake to 2,400 milligrams per day — that’s the equivalent of 2 teaspoons of salt per day for all your meals combined. Sodium is sneaky, and it’s not just in saltshakers. It’s in things that aren’t even salty, like bread, and high in most restaurant or packaged foods. 

“Your best bet is to cook for yourself so you can control your sodium intake. Finally, if you can have calcium in your diet, stick to roughly 1,000 milligrams per day, through diet and/or supplements,” Dr. Kashefi says.

Kidney stones symptoms

Symptoms of kidney stones include severe pain in your lower back, cloudiness or blood in the urine, nausea or vomiting, fever and chills. You could also have intense flank pain (on the upper side of your back) that comes on suddenly. Evaluation of your symptoms can include an X-ray and ultrasound, blood work, urinalysis or CT scan.

When to see a doctor

“If you suspect that you have a kidney stone, contact your primary care provider. You could also be evaluated at an Urgent Care, or Emergency Department if it is after hours,” says Tara Robbins, MD, a family medicine physician at Scripps Clinic Del Mar. “If you have uncontrollable pain, are unable to eat or drink anything, or have a fever, then go to the Emergency Department.”

While treatment options for kidney stones vary depending on their size and location, the first step, Dr. Robbins adds, is to increase fluid intake. “Certain medications can also be given to help the body pass the stone,” she says. “If the stone does not pass or is too large to pass, then other treatments are warranted.” 

Treatment options at Scripps

Scripps offers a full range of treatment options. 

“At Scripps, we have the capability to treat all sorts of kidney stones — those that are within the kidney or the ureter,” explains Dr. Kashefi. 

“We take a conservative approach and try not to operate on stones that aren’t causing any obstruction, but we also take a proactive approach on stones that are likely to cause problems in the future. 

“We work closely with our nephrologists (kidney specialists) by doing metabolic workups to help find the causes specific to each patient’s kidney stones, especially if they have recurring stones. In this way, we try to not only treat the stones, but to prevent them as much as possible.”

The cover of San Diego Health magazine.

This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.

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