Kidney Stones (Nephrolithiasis)

Kidney stones form when minerals such as calcium, uric acid, or cystine crystallize in the urinary tract. Stones may cause severe pain, obstruction, or infection. Without proper prevention, many patients experience recurrent episodes.

At The Medical Group of New Jersey, nephrologists provide comprehensive care for both acute episodes and long-term prevention, working closely with urologists when surgical treatment is required.

Symptom Onset & Initial Evaluation

Kidney stones typically present with:

Sudden, severe flank pain that may radiate to the groin
Nausea or vomiting
Blood in the urine
Frequent urination or discomfort
Fever or chills (urgent sign of infection)

Your evaluation will include:

Reviewing dietary habits, fluid intake, and prior stone history
Assessing pain severity and vital signs
Evaluating for infection or obstruction
Ordering imaging to confirm stone size and location

Diagnosis & Stone Characterization

To properly diagnose and treat kidney stones, your nephrologist may order:

Non-contrast CT scan (gold standard for diagnosis)
Renal ultrasound for radiation-free evaluation
Urinalysis to check for blood, crystals, or infection
Serum creatinine and electrolytes
Stone analysis if a stone is passed
24-hour urine metabolic evaluation in recurrent stone formers

Treatment & Acute Management

Treatment depends on stone size, location, and symptoms.

Conservative Management

Adequate hydration
Pain control
Medications like tamsulosin to help stones pass

Urologic Procedures

Shock-wave lithotripsy
Ureteroscopy with laser removal
Percutaneous nephrolithotomy for large stones

Emergency Intervention

Urgent drainage may be required if obstruction is accompanied by infection or declining kidney function.

Prevention & Long-Term Management

Preventing recurrence is a major goal of care. Strategies include:

Increasing fluid intake
Reducing dietary sodium and oxalate
Adjusting calcium intake appropriately
Weight management
Medications such as thiazides, potassium citrate, or allopurinol

Your nephrologist will personalize prevention based on stone type and metabolic results.