Staghorn Kidney Stones: Causes, Symptoms, Treatment, Prevention

Staghorn kidney stones are fast-growing stones that have branches. They block the urinary tract and cause inflammation and pain and can lead to complications. They account for 10-15% of the cases of kidney stones.⁽¹⁾

Staghorn stones are composed of magnesium ammonium phosphate or struvite.

These stones can diminish kidney function and lead to serious symptoms including urosepsis, which is a life-threatening condition of the urinary tract. Staghorn stones can also lead to pain and discomfort.

There are several causes of staghorn kidney stones. Females are twice as likely to get staghorn kidney stones than males.⁽¹⁾ It is also common in people with the following conditions:

• Distal renal tubular acidosis
• Congenital urinary tract malformation
• Diabetes
• Renal tract disorders
• Medullary sponge kidney
• Neurogenic bladder in which the nerves or brain cannot communicate with the bladder muscles
• Indwelling foley catheter
• Ileal ureteral division

According to the American Urological Association, the risk factors for kidney stones are:⁽²⁾

• Obesity
• Dehydration
• Bowel conditions including Crohn’s disease or ulcers
• Surgery
• Certain medications
• Family history of kidney stones
• Excessive intake of calcium and vitamin C

Evidence shows that staghorn stones occur more commonly in people living in developing countries.⁽¹⁾

Additionally, like other types of kidney stones, where diet plays a role in the formation of kidney stones, in staghorn kidney stones diet does not play a direct role.

Evidence suggests that eating a diet that has less phosphate and calcium and consuming estrogen supplements and iron gel can be helpful in reducing the recurrence of staghorn stones.⁽³⁾

Being large and disruptive, staghorn kidney stones can lead to the following symptoms in people suffering from them:

• Fever
• Flank pain
• Kidney infection
• UTIs
• Hematuria

To diagnose a staghorn kidney stone the doctor reviews the symptoms and performs a physical examination. CT scans and renal nuclear scans are performed to confirm a diagnosis.

Percutaneous nephrolithotomy is the standard treatment for staghorn kidney disease. It is also done for those with other stones larger than 2 centimeters. The surgery involves creating an opening from the skin to the back of the kidney and inserting instruments through a tube to remove the stone.

People might need more than one procedure to remove the stones.

Previously open surgery was preferred by doctors. It involves a much larger opening and has a longer recovery time. Moreover, studies show that it has a high success rate as compared to percutaneous nephrolithotomy and other less invasive procedures.⁽¹⁾

Shockwave lithotripsy is another removal technique that involves using a laser to break the stones.

Recovery varies according to the treatment. In the case of percutaneous nephrolithotomy, the recovery is faster.

The following steps can be taken to reduce the likelihood of staghorn kidney stones:

• Staying hydrated
• Taking antibiotics
• Dietary changes
• Using oral urease inhibitors

Staghorn kidney stones have a high mortality rate but surgical removal is often successful. If removal of all kidney stones is not possible, a person can pass the small fragments in the urine.

A doctor should be consulted if a person has lower flank pain and blood in the urine. If ignored, it can lead to complications such as urosepsis. Early intervention is therefore important.