- What is a UTI?
- What are kidney stones?
- Symptoms – UTI vs kidney stones
- Causes – UTI vs kidney stones
- Can kidney stones cause UTI symptoms?
- When to see a doctor
- Diagnosis – UTI vs kidney stones
- Can UTI tests detect kidney stones?
- Treatment – UTI vs kidney stones
- Can you have a UTI and kidney stones at the same time?
- How to reduce your risk (of UTIs and kidney stones)
- Conclusion
It can be confusing for doctors and health workers to distinguish between urinary tract infections (UTI) and kidney stones.
These conditions share similar clinical pictures and symptoms.
So, let’s see how you can differentiate these two conditions easily by the end of this article.
What is a UTI?
A UTI is an infection in any part of the urinary tract. The urinary system includes:
- Kidneys: two bean-shaped organs that make urine.
- Ureters: the tubes that drain urine from each kidney to your bladder.
- The bladder: a hollow organ that stores urine until you pee or urinate.
- The urethra: is a tube attached to the bladder that allows urine to flow out of your body.
Urinary tract infections can occur in children as well as in adults. However, because women have a shorter urethra and anal and genital regions closer to them, they are at higher risk of contracting UTIs than men.
Urinary tract infections can be classified by where the infection occurs in the urinary system. They are usually classified as upper or lower, although sometimes difficult or impossible to distinguish.
Lower urinary tract infections are infections of the bladder known as cystitis. Interestingly, a few clinicians consider infections of the urethra and prostate to be lower UTIs.
Upper urinary tract infections are infections of the kidneys, also called pyelonephritis. Since the kidney is a paired organ, the infection can occur in one or both organs.
What are kidney stones?
Kidney stones are hard deposits of minerals and acid salts like hard little pebbles that stick together in concentrated urine and may be deposited along the urinary tract. Some stones are too small to see, while others are larger than an inch.
A stone in one of the ureters is called a ureteral stone, while one in the bladder is known as a bladder stone.
Although several substances can form stones, these are the most common:
- Calcium
- Cystine
- Uric acid
- Struvite
Kidney stones that form in your kidneys can remain in the kidney or travel down your urinary tract. Suppose a stone leaves your kidney, it will either get stuck somewhere in your urinary tract, or you will pee it out. However, when passing through the urinary tract, these stones usually don’t cause permanent damage but can cause pain and bleeding.
The most common symptom is severe pain, usually in the side of the abdomen, often associated with nausea. Also, if the kidney stone gets stuck, it can cause an infection or block the urine flow. If the urine flow is blocked for a long time, the kidney can swell enough to be damaged. [1]
Symptoms – UTI vs kidney stones
Some symptoms of urinary tract infections include:
- Burning sensation during urination
- Frequent urination
- Frequent urge to urinate, but incomplete voiding
- Pain or pressure in the back or lower abdomen
- Pelvic pain
- Blood in urine
- Cloudy, dark, or strange or strong-smelling urine, mixed with blood in some cases
- Tiredness
- Fever and chills
- Nausea and vomiting
- Vaginismus
Some signs of kidney stones include:
- Pain in the back or side part of the body
- Severe, sharp, or sudden pain in the abdomen
- Pain can occur during urination
- Having nausea or vomiting
- Blood in the urine or frequent urination
- Sweating
- Passage of gravel or a stone
- Patients are usually unable to sit still and move around frequently
Causes – UTI vs kidney stones
UTIs
Urinary tract infections (UTIs) are almost always caused by bacteria, although some viruses, fungi, and parasites can also infect the urinary tract. Bacteria from the intestine or vagina cause more than 85% of UTIs.
However, having bacteria in the bladder does not always mean an infection. Like the bowel, the bladder has commensal bacteria and other microorganisms that keep it healthy and functioning correctly.
Escherichia coli is the most common bacteria to cause a UTI. Other infectious causes of UTIs are bacteria like Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis.
In addition, viruses like Adenovirus and cytomegalovirus can cause UTIs in immunocompromised patients and children. Fungi like the Candida species can also cause urinary tract infections.
Predisposing factors for urinary tract infections include:
- Presence of an abnormal connection (fistula) between the vagina and bladder or the intestine and bladder
- Abnormal bladder function that prevents proper emptying, such as occurs in neurologic diseases
- Medical conditions such as diabetes, multiple sclerosis, stroke, spinal cord injury
- Leaking of the valve-like mechanism between the ureter and the bladder
- Insertion of a urinary catheter or any instrument by a doctor
- Specific birth control methods, for example, diaphragms
- Prostate enlargement or infection of the prostate
- Sexual intercourse and multiple sexual partners
- A blockage anywhere in the urinary tract
- Abnormalities in the urinary tract
- Weakened immune system
- Pregnancy
- Menopause
- Kidney stones
- Urinary surgery
These organisms that cause infection enter the urinary tract by one of two routes. The most common route is through the lower end of the urinary tract or the bloodstream, usually to the kidneys.
UTIs are not contagious and do not spread from person to person unless a sexually transmitted disease causes it. Typically, bacteria that enter the urinary tract are washed out by the flushing action of the bladder as it empties.
Kidney stones
Kidney stones have several different causes. Risk factors for stone formation include obesity, diabetes, hypertension, and metabolic syndrome.
These alone could lead to hypertension, chronic kidney disease, and end-stage renal disease. Also, diet, some medical problems, and certain supplements and medications play a role in forming kidney stones.
However, you’re more likely to have kidney stones risk if you:
- Have too much calcium (a mineral) or other substances in your urine
- Have certain medical conditions, including certain cancers
- Are middle-aged or older
- Have a family history of kidney stones
- Are male
Can kidney stones cause UTI symptoms?
Yes, in a few cases, a person with a kidney stone may experience symptoms similar to those of a urinary tract infection. However, struvite stones usually develop as a result of urinary tract infections.
As mentioned above, if a kidney stone gets stuck, it can cause an infection due to urinary obstruction. In addition, such a dysfunction increases the risk of a UTI or kidney infection, as bacteria grow in the stagnant urine.
This is one of the complications that can develop with kidney stones. The symptoms include frequent urination or urge to urinate and pain or discomfort during urination. [2]
When to see a doctor
When to see a doctor about a UTI? Generally, you have to see the doctor when you experience severe symptoms or the symptoms worsen. UTIs can be dangerous if the infection spreads to the kidneys.
Suppose you suspect that you or someone you care for may have a urinary tract infection. You need to see the doctor when one of the following signs and symptoms start:
- Pain in the lower tummy or the back, just under the ribs
- A very high temperature, or feeling hot and shivery
- A shallow temperature below 36C
- Confusion, drowsiness, or difficulty speaking
- Not being able to urinate all-day
- Visible blood in the urine
Complications resulting from untreated urinary tract infections include:
- Recurrent infections
- Permanent kidney damage
- Narrowing of the urethra, or urethral stricture, particularly in men
- Sepsis, a life-threatening response to infection
Are kidney stones dangerous? Yes, they can be. Kidney stones can cause damage if left untreated until it causes repeated infections or severe kidney blockage that can cause the kidney to stop working.
So, if you suspect that you or someone you care for may have kidney stones, you need to see the doctor when one of the following signs and symptoms start:
- A high temperature or kidney stone fever
- Episodes of shivering or shaking
- Blood in the urine
- Severe pain
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Diagnosis – UTI vs kidney stones
The standard tests for urinary tract infections include the following:
- Urine analysis: To detect the presence of organisms causing disease.
- Urine culture: To see the type of organism causing infection.
- Cystoscopy: Using a long tube-like instrument to view the inside of the urethra and urinary bladder.
- CT scan: CT scan of the abdomen is performed to check for abnormalities in the urinary tract and performed in select patients to rule out complicating factors.
- Magnetic resonance imaging (MRI): MRI of the abdomen provides a detailed image of the urinary tract and is performed in select patients to rule out complicating factors.
- Pregnancy tests and testing for sexually transmitted infections.
Silent kidney stones or those that cause no symptoms are often incidental findings when an X-ray is taken during a routine health exam. Other patients have their stones diagnosed when sudden pain occurs while the stone is passing and medical attention is needed. However, the standard tests for kidney stones include the following:
- Urine analysis: To detect the presence of blood, minerals, and acid salts.
- CT scan: CT scan of the abdomen is performed to check for abnormalities in the urinary tract.
- Ultrasound of abdomen and pelvis: to check for abnormalities in the urinary tract, especially for patients for whom radiation exposure should be minimized, such as pregnant and pediatric patients.
- Magnetic resonance imaging (MRI): MRI of the abdomen provides a detailed image of the urinary tract.
Can UTI tests detect kidney stones?
Yes, both involve analyzing a sample of urine. The urine analysis test that can detect the presence of organisms causing a urinary tract infection can also be used to detect the presence of blood or minerals and acid salts.
Also, imaging tests tell the health care provider if there are abnormalities in the urinary tract, such as a kidney stone, how big the stone is, and where it is located.
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Treatment – UTI vs kidney stones
Antibiotics are the first line of treatment. The type of antibiotic, its dosage, and duration depend on the type of organism and severity of infection. Also, optimal therapy depends on disease severity, local resistance patterns, and patient characteristics.
In most cases, patients need to take oral antibiotics to fight the bacteria. They also must complete the prescribed course of antibiotics and drink plenty of water to flush out the germs. They can also use heating pads to get relief from back pain.
How are kidney stones treated? The approach to management depends if the kidney stones are causing symptoms or whether there are large kidney stones. If tiny stones are not the reason for blockage or infection, then no treatment is required as these stones pass on their own.
Although, pain medication might be needed. However, larger stones don’t pass on their own, requiring either conservative or Interventional treatment.
Conservative treatment involves the use of an alpha-blocker like tamsulosin. This medication relieves ureter muscle spasms, promotes the passing of ureteral stones smaller than 10 mm, and reduces painkillers for kidney stone pain.
Interventional treatment includes:
- Shock wave lithotripsy: Using powerful sound waves to break up the stone into tiny pieces. These waves are focused on the stone using X-rays or ultrasound to pinpoint the stone, and replicated firing of shock waves causes the stone to break into small pieces.
- Ureterorenoscopy: the use of a scope to remove the stone.
The scope may be passed through the urethra or kidney. Once in, the stone can be pulled out by the scope. It can also be broken with a laser or alternatives such as shock wave lithotripsy. Once the stones are in smaller pieces, they can pass easily and be collected for lab tests.
Can you have a UTI and kidney stones at the same time?
Yes, you can have both an infection and a kidney stone in a few cases. However, there is the ‘chicken or the egg dilemma in medical research.’
It is a known fact that kidney stones that cause blockage can lead to urinary tract infections. Also, recent studies show that bacteria play a role in forming kidney stones such as struvite stones. [3]
How to reduce your risk (of UTIs and kidney stones)
You can help prevent UTIs or kidney stones by following some simple steps:
- Empty the bladder when you feel the urge and ensure that you frequently urinate, thus, flushing bacteria out.
- Improving hygiene: Women should wipe from front to back after using the bathroom, avoid feminine hygiene sprays, and clean the genitals before and after intercourse.
- Drink plenty of water to help dilute urine.
- Urinate after intercourse to flush out any germs that would have entered the urinary tract.
- Lifestyle modifications such as improving diet and losing weight can help keep a healthy urinary tract. In addition, foods such as apples, basil, celery, grapes, and pomegranates reduce the risk and impact of kidney stones.
- Being obese can put stress on the kidneys. Therefore, managing weight and diet are critical to a healthy urinary tract.
Conclusion
Kidney stones and urinary infections have similar symptoms; however, their cause is a crucial difference. Kidney stones are crystallized deposits of minerals that your kidneys cannot dissolve. At the same time, urinary tract infections are infections in any part of the urinary system, including the kidneys, bladder, or urethra.
If you or someone you know is exhibiting symptoms of urinary tract infection or symptomatic kidney stones, seek medical attention immediately. Your healthcare provider will work with you to develop a care plan that may include one or more treatment options. In certain exceptional cases, a urologist is needed to prevent complications.
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