Kidney Stones
Kidney stones are one of the most common reasons for emergency hospital visits in Ireland. They can cause severe pain, infection, and lasting kidney damage if not managed properly. For most patients, the first concern is dealing with the acute episode. The bigger long-term concern is preventing the next stone. Up to half of patients who pass one stone will have another within five years if no preventive plan is in place.
Dr Rory McQuillan provides specialist metabolic assessment and individualised prevention plans for patients with recurrent or complex kidney stone disease.
What are kidney stones?
Kidney stones are hard deposits of minerals and salts that form inside the kidneys. They can be tiny enough to pass unnoticed or large enough to cause obstruction and severe pain. There are several different chemical types, and identifying the type is central to preventing recurrence.
Types of kidney stones
The main types are:
- Calcium oxalate stones (around 70% of stones)
- Calcium phosphate stones
- Uric acid stones
- Struvite stones (associated with urinary infections)
- Cystine stones (rare, inherited)
Symptoms of kidney stones
Symptoms can include severe one-sided pain in the back or side that may move toward the groin, blood in the urine, nausea and vomiting, frequent urination, painful urination, and fever if there is an associated infection. Some stones cause no symptoms and are discovered on scans done for other reasons.
Acute treatment
Acute treatment is generally provided through the emergency department or urology service. It may include pain relief, fluids, medications to help the stone pass, and procedures such as ureteroscopy, lithotripsy, or percutaneous nephrolithotomy for larger stones. Most patients with their first uncomplicated stone are managed conservatively.
Specialist metabolic assessment
After the acute episode, the goal becomes preventing recurrence. Specialist metabolic assessment is recommended for patients with recurrent stones, family history, single-functioning kidney, or unusual stone types. The assessment includes:
- Detailed history including diet, fluid intake, medical conditions, and family history
- 24-hour urine collection to measure calcium, oxalate, uric acid, citrate, sodium, and other markers
- Blood tests including calcium, phosphate, uric acid, and parathyroid hormone
- Analysis of any stones that have been passed or surgically removed
- Imaging review
Prevention strategies
Prevention is individualised based on the metabolic assessment. Our guide to preventing recurrent stones explains the approach in more detail. Common strategies include:
- Increased fluid intake, aiming for around 2.5 to 3 litres per day
- Dietary modification, often reducing salt, animal protein, and oxalate-rich foods
- Maintaining a normal calcium intake (restricting calcium often worsens stone risk)
- Medication such as thiazide diuretics, potassium citrate, or allopurinol where indicated
- Treatment of underlying conditions such as hyperparathyroidism or gout
When to see a specialist
GP referral to a nephrologist is recommended for patients with two or more stones, stones in a single-functioning kidney, family history of recurrent stones, unusual stone composition, or stones associated with reduced kidney function. The goal is to break the cycle of recurrence with a clear, evidence-based plan.
Appointments
Appointments are arranged through GP referral.
Frequently Asked Questions
Without preventive measures, around half of patients will have a second stone within five years. With a personalised prevention plan, this risk falls substantially.
For most stone-formers, the target is around 2.5 to 3 litres per day, enough to produce around 2 litres of dilute urine. Spread fluid intake through the day.
No. Adequate calcium intake (from food, not supplements) actually reduces stone risk by binding oxalate in the gut. Restricting calcium often makes things worse.
Family history increases risk. A small number of patients have inherited conditions that cause stones, and these benefit from specialist assessment.
Most stones cause no lasting damage if passed or treated promptly. Recurrent stones, large stones, or obstruction can cause kidney damage, which is why prevention matters.
Have a Question?
If you’d like more information about Dr. McQuillan’s services or need assistance from the practice team, please get in touch below.
Please note: Appointments are arranged via GP referral.