Kidney Stones - Risk Factors

Diagnosis

The doctor will perform a physical exam. This includes tapping on the back over the kidneys and pressing on the abdomen to detect tender locations.

Medical History

The patient's age is a significant factor. Kidney stones that occur in children and young patients are more likely to result from inherited problems that cause excess cystine, xanthine, or, in some cases, calcium oxalate. In adult patients, calcium stones are most common.

A medical history may help predict which crystal has formed the stone. The doctor will need to know the following:

• Any previous kidney stone attacks
• History of cancer, sarcoidosis, or small bowel disease
• Any medications being taken, including non-prescription substances, particularly high doses of vitamins D or C and calcium-containing antacids

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Ruling out Other Disorders

Many conditions can cause symptoms similar to those of kidney stones. Usually the diagnosis is easily made because of the specific nature of the symptoms, but it is not always clear. Urinary tract infections can cause similar, but usually less intense, pain. In fact, people with an infection may also have a kidney stone.

Other causes of pain that may mimic kidney stones include:

• Gallstones
• Diverticulitis (infection or irritation of abnormal pouches in the intestines)
• Intestinal blockage
• Blood clots
• Irritable bowel syndrome
• Appendicitis
• Peptic ulcers
• Pancreatitis (inflammation of the pancreas)
• Hepatitis
• Pelvic inflammatory disease
• Inflammatory bowel disease (Crohn's and colitis)
• Heart attack

Imaging Techniques

Various imaging techniques are helpful in determining the presence of kidney stones. The best approach uses spiral (or helical) computed tomography (CT) scans. If these scans are not available, the patient will need ultrasound or standard x-rays. If no stones show up, but the patient has severe pain that suggests the presence of kidney stones, the next step is an intravenous pyelogram (IVP).

X-Rays. A standard x-ray of the kidneys, ureters, and bladder may be a good first step for identifying stones, because many stones are visible on x-rays. Calcium stones can be identified on x-rays by their white color. Cystine crystals can also show up on x-rays.