Kidney stones are hard deposits of minerals and salts that form inside the kidneys, often causing intense pain as they move through the urinary tract. Urgent care facilities can handle the initial diagnosis and immediate symptom management for uncomplicated cases. However, the severity of the symptoms and the size of the stone determine if a patient requires the advanced resources of an emergency room.
Initial Assessment and Symptom Management at Urgent Care
A visit to urgent care for suspected kidney stones starts with assessing symptoms and medical history. Providers focus on the location and intensity of the pain, which often starts in the back or flank and radiates toward the abdomen or groin as the stone moves down the ureter. This evaluation helps distinguish kidney stone pain from other causes of abdominal pain.
To confirm the presence of a stone, the urgent care staff performs laboratory testing. A urinalysis is a standard diagnostic tool that detects red blood cells, crystals, or signs of infection like white blood cells or bacteria in the urine. Blood tests may also be conducted to check kidney function and assess for systemic infection.
For patients with mild to moderate pain, the primary goal is immediate symptom relief. Providers can prescribe oral pain medication, such as NSAIDs or, in some cases, stronger narcotic pain relievers. Anti-nausea medication may also be prescribed to control vomiting. Patients are instructed to increase fluid intake to help flush out the stone and are given a strainer to catch the stone for later analysis.
Determining Case Severity: Urgent Care’s Limitations
While urgent care is well-equipped for initial stabilization and symptom management, facilities have limitations compared to an emergency department. The major limitation is the lack of specialized imaging equipment needed for definitive diagnosis and treatment planning. Many clinics do not have access to computed tomography (CT) scanners, which are the most precise way to locate and measure the stone.
Most urgent care centers cannot offer continuous patient monitoring or administer intravenous (IV) fluids and strong IV pain medication, which may be needed for severe dehydration or uncontrolled pain. Furthermore, they are not equipped to perform interventional procedures, such as placing a stent to bypass a blocked ureter or performing lithotripsy. If a stone is suspected to be large (6 millimeters or greater) or if the patient’s condition is unstable, transfer to an emergency room is necessary.
Warning Signs Requiring an Emergency Room Visit
Specific symptoms indicate that a kidney stone episode requires immediate medical attention. The presence of a fever above 101.5 degrees Fahrenheit or chills accompanying the pain is an immediate warning sign. This combination suggests a trapped stone has caused an infection in the kidney (pyelonephritis), which can rapidly progress to sepsis and requires immediate IV antibiotics and possible drainage.
Another urgent symptom is the complete inability to urinate (anuria) or significant difficulty passing urine. This means the stone is completely blocking the flow of urine, potentially causing acute kidney injury or severe hydronephrosis (swelling of the kidney). Severe, unrelenting pain not controlled by oral medication also necessitates an emergency room visit for stronger, intravenous pain relief and immediate imaging. Persistent vomiting that prevents the patient from keeping down fluids, leading to rapid dehydration, requires immediate emergency care for IV hydration and stabilization.
Follow-Up Care and Next Steps
Once the acute episode is managed, proper follow-up care is essential. Patients should obtain a referral to a urologist, a specialist in the urinary tract. The specialist determines if the stone is small enough to pass naturally or if an intervention, such as shock wave lithotripsy or ureteroscopy, is required for removal.
If the stone was passed at home, it should be collected and sent for analysis to determine its chemical composition. Knowing the stone type is crucial for implementing specific preventive strategies to reduce recurrence risk. The urologist may order a 24-hour urine collection test, which measures stone-forming and stone-inhibiting substances to identify the metabolic cause of formation.
Preventive measures focus on lifestyle and dietary adjustments guided by the stone analysis results. For almost all stone types, increasing fluid intake to produce a high volume of pale, dilute urine is recommended. Specific dietary changes may include reducing sodium, limiting animal protein, or modifying the intake of oxalate-rich foods, depending on the stone’s composition.