Nephrolithiasis

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Nephrolithiasis Treatment

Treatment goals include relief of symptoms and prevention of further symptoms. (Kidney stones usually pass on their own.) Treatment varies depending on the type of stone and the extent of symptoms and/or complications. Hospitalization may be required if symptoms are severe.

When the stone passes, the urine should be strained and the stone saved for analysis to determine the type.

Drink enough fluids to produce a high urinary output. Water is encouraged, at least 6 to 8 glasses per day. Intravenous fluids may be required.

Analgesics (pain relievers) may be needed to control renal colic (pain associated with the passage of stones). Severe pain may require narcotic analgesics.

Depending on the type of stone, medications may be given to decrease stone formation and/or aid in the breakdown and excretion of the material causing the stone. These may include such medications as diuretics, phosphate solutions, allopurinol (for uric acid stones), antibiotics (for struvite stones), and medications that alkalinize the urine such as sodium bicarbonate or sodium citrate.

If the stone is not passed on its own, surgical removal may be required. Lithotripsy may be an alternative to surgery. Ultrasonic waves or shock waves are used to break up stones so that they may be expelled in the urine (extracorporeal shock-wave lithotripsy) or removed with an endoscope that is inserted into the kidney via a small flank incision (percutaneous nephrolithotomy).

Dietary modification may be needed to reduce the recurrence of some types of stones.