What are kidney stones?

Kidney stones are mineral lumps that form in the pipework of the kidneys when certain substances in the urine — mainly minerals and salts like calcium, oxalate, or uric acid — become too concentrated and stick together. They can range in size from a grain of sand to the size of a golf ball. Some of them stay in the kidney, but some move down the ureter (kidney tube) and can get stuck.

What causes kidney stones?

Dehydration is one of the biggest risk factors for kidney stones. When you don’t drink enough fluid, urine becomes more concentrated, increasing the chance of minerals in your urine forming crystals and then stones. We also know that diets high in salt, sugar, or animal protein make stones more likely. Other risk factors include being overweight, digestive diseases like Crohn’s disease, certain medications, and a family history of stones.  

What symptoms would I get with kidney stones?

Symptoms can vary widely. Stones that are not causing any blockage in the kidney may cause little or no symptoms. Stones that get stuck in the ureter block the flow of urine and can cause sudden, excruciating pain in the back or side. Some people also experience blood in the urine, nausea, vomiting, fever, or a persistent urge to urinate.

What treatments are available forkidney stones?

Treatment depends on the stone’s size, location, and whether it is causing symptoms or complications. Small stones may pass by themselves. For larger stones or those that don’t pass, various procedures are available. Shock Wave Lithotripsy (SWL) remains widely used — it breaks stones into smaller fragments using high-energy sound waves, allowing them to pass naturally. 

Ureteroscopy is another common procedure where a thin telescope instrument is inserted into the urinary tract under an anaesthetic to break up and remove stones with a laser. For very large or complex stones, a keyhole operation called Percutaneous Nephrolithotomy (PCNL) may be performed, where instruments are inserted through a small incision in the back to remove the stone.

What are the latest developments and the future for treating kidney stones?

Advances in laser technology have made ureteroscopy safer and more effective for breaking stones into dust-like fragments. New, more flexible scopes allow urologists to reach stones in difficult locations in the kidney.

There is also an increasing focus on prevention. Genetic testing is helping identify people who have inherited conditions that increase their risk. New medications are being studied to lower levels of substances like oxalate or uric acid in the urine. Some researchers are working on probiotics that may help the gut break down oxalate, reducing stone formation naturally.

How can I prevent kidney stones?

Preventing stones is still mainly about lifestyle: staying well-hydrated is the single most effective step. Dietary adjustments such as cutting back on salt, eating less meat, and ensuring adequate calcium intake (too little paradoxically increases stone risk). 

Regular follow-up with a specialist, urine tests, and stone analysis help tailor prevention plans. Together, these advances mean fewer people need to suffer the pain and disruption of kidney stones in the future.

By J Graham Young Consultant Urological Surgeon

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