Kidney Stones

Kidney stones are hard deposits that form in the kidneys from concentrated urine. They are very common in India — particularly in the hot, dry "stone belt" across Rajasthan, Gujarat, Maharashtra, north Karnataka, and parts of north India. Most small stones pass on their own; larger ones need a urological procedure.

Typical presentation

• Severe, colicky pain starting in the flank and moving to the groin or scrotum.
• Nausea and vomiting during attacks.
• Blood in urine — visible or microscopic.
• Burning urine, frequency — if the stone is at the bladder outlet.
• Fever + flank pain + stone = urological emergency (infected, obstructed kidney).

Types of stones

• Calcium oxalate (most common) — driven by low water intake, high oxalate intake, high animal protein, high salt.
• Uric acid stones — linked with high-purine diet, gout, obesity.
• Struvite stones — from chronic urinary infection.
• Cystine stones — rare, genetic.
• Stone analysis after passing one helps tailor prevention.

Diagnosis

• Ultrasound KUB — first-line.
• Non-contrast CT KUB — most sensitive; picks up small stones.
• X-ray KUB — for follow-up of radio-opaque stones.
• Blood tests (calcium, uric acid, creatinine); 24-hour urine studies for recurrent stones.

Treatment

• Small stones (< 5 mm): plenty of water, pain relief, alpha-blocker class medicine can help passage; 70–80% pass within a few weeks.
• Larger stones: urological procedures — shock wave lithotripsy (ESWL), ureteroscopy with laser (RIRS), or percutaneous nephrolithotomy (PCNL) — widely available at urology centres across India.
• Obstructing stone + infection — emergency drainage (DJ stent or nephrostomy) before definitive stone treatment.
• Pain management during colic — NSAID class + anti-emetic is usually first-line (unless NSAID contraindicated).

Preventing recurrence — high value, under-done

• 2.5–3 litres of water a day — target 2 litres of urine output (clear or pale yellow). The single most effective prevention.
• Reduce salt — under 5 g/day (the sodium page, applied).
• Moderate animal protein — don't over-consume red meat, seafood.
• Eat enough calcium from food (don't restrict — paradoxically, low dietary calcium raises stone risk).
• Limit oxalate-heavy foods if calcium oxalate stones — spinach, beetroot, nuts, chocolate in excess; tea in moderation.
• Treat gout, obesity, diabetes if present.
• Potassium citrate supplements for recurrent stone formers, under a doctor.
• Summer and dehydration particularly drive Indian stone recurrence — drink more in heat and after physical work.