Kidney stones are a common health problem, affecting about 1 in 11 people.
How are kidney stones formed?
When the concentration of certain substances such as calcium, oxalate, uric acid and cystine in the urine increases, they begin to form crystals that adhere to the kidney and gradually enlarge to form stones.
How many types of stones are there?
80% of kidney stones are made of calcium, and some are calcium oxalate and some are calcium phosphate.
The rest of the stones are uric acid stones, infection stones and cystine stones.
risk of kidney stones factor:
- Some diseases, medicines, wrong diets increase the chance of stone formation like-
- Excessive amounts of calcium or oxalate in the urine.
- Factors such as low calcium in the diet, a diet high in oxalates, high amounts of animal protein, or a high sodium intake in the diet.
- Dehydration due to drinking less water and lack of fluids.
- Taking excessive doses of calcium, vitamin D and vitamin C.
- People with diabetes, high blood pressure, obesity, gout, hyperparathyroidism, or those who have undergone gastric bypass or bariatric surgery are more prone to stone formation.
- Hereditary factors: Some stones such as cystine are found in relatives that indicate genetic disorders.
- Recurrence of stones – If someone has a history of kidney stones in the past, the risk of developing another stone in the future is high, especially in men. 10 – 30% of men may fall victim to stone again in the next 5 years.
It depends on the size of the stones and their location.
The most common symptom that occurs as a result of stones is pain in the lower abdomen or its lower part, which can extend to the waist. Pain is most common when the stone is removed. It also causes waves of severe, excruciating pain called ‘renal colic’ that last for 20-60 minutes.
Difficulty urinating, blood in the urine, or vomiting may occur.
Hard particles such as sand can come out of the urine.
The stone can become lodged in the urinary tract, causing blockage and pain when urinating.
If the stones in the kidney are very small, they will not cause a blockage, so no symptoms of the stone will be visible.
Kidney stones are diagnosed by ultrasound or CT scan. X-rays and intravenous pyelography are also helpful for diagnosis.
CT scan is more accurate, but the patient is exposed to radiation.
To know the type of stone, a 24-hour urine determination of calcium/oxalate/uric acid and citrate is necessary.
Urine tests are useful to see if there is an infection or if the urine is acidic or alkaline.
Stone treatment depends on the size and location of the stone in the urinary tract.
Stones smaller than 5 mm usually fall out without specific treatment. Fluid intake and taking painkillers are required.
Severe kidney disease may require hospitalization for treatment, including intravenous fluids and other medications.
Larger stones, ie larger than 9 mm, may require surgical removal by percutaneous nephrolithotomy or shock wave lithotripsy.
Surgery is required in about 10-20% of kidney stone cases.
- Kidney stones can be prevented by making some changes in diet and habits
- One should drink the right amount of water to maintain good urine flow. Must drink at least 7-8 glasses of water per day.
- There must be enough calcium in the diet. Milk, cottage cheese, legumes, oranges and other dairy products are rich in calcium
- Eat the right amount of protein- Daily protein needs are usually met with 2-3 servings per day.
- Reduce the amount of sodium in your diet by 2-3 grams. Minimize processed foods such as hot dogs, chutneys, dry soups, pickles, etc., as they are high in salt.
- Avoid excessive doses of vitamin C because vitamin C produces oxalate, which can result in high amounts of oxalate in the urine.
- Also avoid consuming foods full of oxalates such as spinach, almonds, peanuts, walnuts, butter, blueberries.
- Do not take vitamin D supplements without a doctor’s advice
- Control blood sugar, blood pressure and body weight with regular exercise as they reduce the risk of stones.
Dr. Deepak Shankar Ray, Consultant – Nephrologist and Chief Kidney Transplant, Rabindranath Tagore International Institute of Cardiac Sciences, Mukundpur, Kolkata