Kidney Stones - Risk Factors

Diagnosis

The doctor will perform a physical exam. This includes pressing against abdominal areas for tender locations that might indicate the presence of the stone.

Medical History

The patient's age is a significant factor. Kidney stones that occur in children and young patients are more apt to result from inherited problems that cause cystine, xanthine, or, in some cases, calcium oxalate stones. 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
• Histories 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

Ruling Out Other Disorders

Many conditions can cause symptoms similar to 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, infection may be present with a kidney stone. Other causes of pain that may mimic kidney stones include:

• Gallstones
• Diverticulitis
• Intestinal blockage
• Blood clots
• Irritable bowel syndrome
• Appendicitis
• Stomach ulcers
• Hiatal hernia
• Pancreatitis
• 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 scans. It is not always available, however, in which case ultrasound or standard x-rays are usually performed. If no stones show up but the patient has severe pain indicative of kidney stones, the next step is an intravenous pyelogram.

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