Kidney stones often remain asymptomatic until they move within the urinary tract. Key symptoms include:

• Severe Pain: Sudden, intense flank or lower abdominal pain radiating to the groin (renal colic), often triggered by stone movement (Mayo Clinic).
• Hematuria: Visible or microscopic blood in urine.
• Urinary Symptoms: Dysuria (painful urination), urgency, or frequency.
• Nausea and Vomiting: Common due to pain or obstruction.
• Complications: Fever or chills may indicate infection (e.g., pyelonephritis), while obstruction can lead to hydronephrosis (kidney swelling) (Lippincott Review of Pathology).

Some stones are "silent" and detected incidentally during imaging.

Kidney stones form due to urinary supersaturation of minerals. Types and risk factors include:

1. Calcium Stones (Oxalate/Phosphate): Most common. Linked to high dietary sodium, oxalate (spinach, nuts), or hyperparathyroidism.
2. Uric Acid Stones: Associated with low urine pH, gout, or high-purine diets (red meat, shellfish).
3. Struvite Stones: Caused by urinary tract infections (UTIs) with urease-producing bacteria.
4. Cystine Stones: Rare, genetic disorder causing cystine leakage into urine.

Risk Factors: Dehydration, obesity, family history, medications (diuretics, calcium supplements), and metabolic disorders (BNF, WHO).

Preventive measures depend on stone type:

• Hydration: Aim for 2–3 liters of water daily to dilute urine (Mayo Clinic).
• Dietary Adjustments:
  • Reduce sodium and oxalate for calcium stones.
  • Limit purines for uric acid stones; increase citrate intake (lemonade).
• Medications:
  • Thiazide diuretics (reduce calcium excretion).
  • Allopurinol (for uric acid stones).
  • Potassium citrate (alkalinizes urine) (Lange Textbook of Clinical Pharmacology).
• Lifestyle Changes: Maintain healthy weight and moderate protein intake.

Acute Management:

• Pain Relief: NSAIDs (e.g., ibuprofen) or opioids for severe pain.
• Medical Expulsive Therapy: Alpha-blockers (tamsulosin) relax ureteral muscles to aid stone passage (Lippincott Textbook of Pharmacology).

Procedures for Large Stones:

• Extracorporeal Shock Wave Lithotripsy (ESWL): Non-invasive sound waves break stones.
• Ureteroscopy: Laser fragmentation and removal via scope.
• Percutaneous Nephrolithotomy: Surgical removal for large or complex stones.

Infection Management: Antibiotics for UTIs; urgent decompression if obstruction occurs.

Alternative Therapies: Herbal remedies (e.g., Phyllanthus niruri) show limited evidence (Lange Textbook).

Urolithiasis can cause debilitating symptoms but is manageable with timely intervention. Prevention through hydration, diet, and medication reduces recurrence. Treatment ranges from pain management to advanced procedures. Consult a healthcare provider for personalized care, especially with recurrent stones or comorbidities. Early action mitigates complications and improves quality of life.

• Comprehensive Pharmacy Review
• Lippincott Review of Pathology
• British National Formulary (BNF)
• Mayo Clinic
• World Health Organization (WHO)
• Lippincott Textbook of Pharmacology
• Lange Textbook of Clinical Pharmacology