From the Guidelines
Red flags for kidney stones include severe, sudden pain in the back or side that may radiate to the lower abdomen and groin, often described as one of the most intense pains possible, as well as blood in the urine, nausea and vomiting, signs of infection, and inability to urinate, which require immediate medical attention, especially if accompanied by fever over 101.5°F (38.6°C) 1.
Key Red Flags
- Severe, sudden pain in the back or side that may radiate to the lower abdomen and groin
- Blood in the urine (hematuria)
- Nausea and vomiting that prevents keeping down fluids or medications
- Signs of infection such as fever and chills
- Inability to urinate
- Persistent symptoms despite home treatment
High-Risk Populations
Certain populations should be particularly vigilant, including:
- Those with only one functioning kidney
- Transplant recipients
- Individuals with compromised immune systems
Importance of Prompt Medical Evaluation
Kidney stones form when minerals and salts in urine crystallize and build up, with dehydration being a major risk factor 1. While smaller stones (under 5mm) may pass naturally with pain management and increased fluid intake, larger stones or those causing severe symptoms need prompt medical evaluation to prevent complications like kidney damage or urinary tract infections 1.
Prevention and Management
Preventive measures include increasing fluid intake to achieve at least 2 L of urine per day, and pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol in patients with active disease in which increased fluid intake fails to reduce the formation of stones 1.
Diagnostic Approaches
Imaging, such as non-contrast CT scans, and preoperative testing, including urinalysis and urine culture, are crucial for the diagnosis and management of kidney stones 1.
From the Research
Red Flags for Nephrolithiasis (Kidney Stones)
The following are red flags for nephrolithiasis:
- Severe flank pain, hematuria, and nausea/vomiting 2
- Urinary tract infection or hematuria 3
- Stone size larger than 10 mm 4
- Urinary obstruction 4
- Recurrent infections 4
- Lack of access to health care 4
- Growth or symptoms of asymptomatic kidney stones 4
- High risk of stone recurrence 4
Risk Factors
Risk factors for nephrolithiasis include:
- Supersaturation of urine 2
- Male sex, with the first episode occurring before 30 years of age 5
- Family history of kidney stones
- Certain medical conditions, such as idiopathic hypercalciuria, hypocitraturia, absorptive hyperoxaluria, and primary hyperoxaluria type I 6
- Dietary factors, such as low fluid intake, high animal protein and salt content 5, 6
Diagnostic Red Flags
Diagnostic red flags for nephrolithiasis include: