BackTable / Urology / Topic / Condition
Kidney stone disease, or nephrolithiasis, is becoming increasingly prevalent worldwide. Crystal concretions formed within the kidneys are called kidney stones. Stone may also form in the ureter or urinary bladder, and the location of stone formation influences the symptoms that follow. These stones may be made up of calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid, or cystine. Calcium oxalate stones formed at Randall’s plaque are the most common. Kidney stones increase risk of end-stage renal failure and developing chronic kidney diseases, cardiovascular diseases, and diabetes. Some symptoms of kidney stones include renal colic, flank pain, urinary tract infections, blood urine, and dilation of the kidney.
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Kidney Stones Diagnosis
Kidney stones are confirmed with laboratory testing and imaging studies. Stone analysis is especially important in diagnosing patients with cystine, uric acid, infection-induced, drug-induced, and ammonium urate kidney stones. Laboratory tests include blood profiles and a urine metabolic evaluation while imaging studies are usually performed with CT. Systemic and environmental influences should be identified during kidney stone diagnosis so they can be addressed during treatment, if possible. Systemic influences include intestinal disease, primary hyperparathyroidism, recurrent urinary tract infection, and medullary sponge kidney.
Kidney Stones Podcasts
Listen to leading physicians discuss kidney stones on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.
Dr. Jose Silva y Dr. Fernando Cabrera, urologista de Cleveland Clinic en Florida, hablan sobre el diagnóstico y tratamiento de cálculos renales y ureterales. Los doctores discuten cuáles pacientes necesitan la intervención, los métodos quirúrgicos para romper los cálculos, y consejos sobre cada tipo de terapia.
UT Southwestern endourologist Dr. Jodi Antonelli shares her tips and tricks for difficult ureteroscopy cases. Listen to learn about pre-op and post-op medication, dealing with large prostates and narrow ureters, variations in baskets, access sheaths, and ureteroscopes, dusting vs. basket retrieval, and performing ureteroscopies on pregnant women.
Dr. Margaret Pearle, the Vice Chair of Urology at UT Southwestern Medical Center, joins us to discuss percutaneous nephrolithotomy (PCNL). Dr. Pearle shares advice on pre-operative urine culture analysis, CT scans, percutaneous access, and placing a ureteral stent vs. a nephrostomy tube
Kidney Stones Treatment
The most common kidney stone treatments are shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Treatment selection is based on the location and complexity of the kidney stones. Options to prevent a recurrence of nephrolithiasis are available and should address the cause of stone formation in order to be effective. Adjusting diet and increasing fluid intake are essential. While there is no drug that cures and prevents recurrent kidney stones, thiazide diuretic, alkali, or allopurinol treatments can be used to reduce recurrence.
Kidney Stones Articles
Read our exclusive BackTable Urology Articles for quick insights on kidney stones, provided by physicians for physicians.
PCNL (percutaneous nephrolithotomy) procedure is a minimally invasive surgery alternative to open kidney stone surgery. A PCNL procedure is a surgical technique that is used to remove large or complex kidney stones. Learn more!
 Alelign, T., & Petros, B. (2018, February 4). Kidney Stone Disease: An update on current concepts. Advances in Urology. Retrieved December 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5817324/
 Miller, N. L., & Lingeman, J. E. (2007, March 3). Management of Kidney Stones. BMJ (Clinical research ed.). Retrieved December 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1808123/
 Sakhaee, K., Maalouf, N. M., & Sinnott, B. (2012, March 30). Clinical review. Kidney stones 2012: pathogenesis, diagnosis, and management. The Journal of clinical endocrinology and metabolism. Retrieved December 7, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387413/
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