Kidney Stones and the risk that comes along with it.

Mr. Raman came to me complaining of recurring kidney stones. He left no stone unturned and visited many physicians, but in vain. There was no definite diagnosis for his recurring stone formations. He gave up all his favourite cuisines and started eating bland diets. He was emotionally down and came to me very depressed.

Well, this is not the first case I have seen, every day in my clinic I come across at least one case of kidney stone. It’s a very common phenomenon now with 1 out of 6 Indian recorded to suffer from a kidney stone. Today I am going to discuss in detail every nook and corner behind the formation of kidney stones, its prevention, and management.

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First of all, you must keep in mind stone formation is a sequel of metabolic disorders that is persistent for a long time. To make it clear the concept of supersaturation important.

Understanding of supersaturation and ‘upper limit of meta stability’.

Have you ever tried to dissolve max sugar in a cup of water? What have you noticed? After a certain amount sugar does not dissolve but when you heat the water more sugar gets dissolved. This is supersaturation. Now when you cool the water sugar crystallizes back as sediments. Compare the same phenomenon with kidney stone formation. Where urine is the solvent and sugar is the minerals like Ca, uric acid, and oxalate. The ratio of solute (minerals) and solvent (urine) must be balanced, if this ratio is altered urine becomes supersaturated and beyond a certain threshold, these minerals start forming crystals. The threshold value is called the ‘upper limit of meta stability’

An individual’s urine contains different dissolved minerals like calcium, oxalate, phosphate, and uric acid. Those who have increased levels of these minerals in the urine have a higher probability of stone formation. Although kidney stone formation begins in negligible size it might grow larger obstructing the inner space of the kidney. At times, the kidney stone can reach down the ureter and the bladder. While the stone is in the bladder it might pass out of the body through urine. On the other hand, if it is stuck in the ureter, it might obstruct the urine flow resulting in pain.

What are the type of Kidney Stones?

Kidney stones vary in type and colour. Treatment of kidney stones and preventing their re-formation depends upon the type of stone an individual is having. Some common types of stones are-

Calcium oxalate and calcium phosphate stones (80 percent of stones)

Uric acid stones (5-10 percent of stones)

Struvite/infection stones (10 percent of stones)

Cystine stones (less than 1 percent of stones)

Xanthin stones (less than 1 percent of stones)

Symptoms of Kidney stone

Cramping pain in the back and side (flank pain)62ad4bCramping pain in the back and side (flank pain)

The pain starts randomly and comes in waves

Severe need to urinate

Haematuria (presence of blood in the urine )

Dark coloured urine

Nausea and vomiting

Burning feeling during urination

Causes of Kidney Stone

Dehydration

Obesity

Diet with high levels of protein, salt, or sugar

Other than that there are certain metabolic diseases that are also responsible for Kidney Stone.

Diseases such as:

Hyperparathyroidism

Hypercalcinuria

Hyperoxaluria

Gout

Inflammatory bowel diseases that increase calcium absorption

Medications such as diuretics (torsemide Furosemide), antiseizure drugs, and calcium-based antacids , calcium supplements ,  Vitamin D supplements, corticosteroid, allopurinol.

The best way to prevent kidney stones

It is advisable to:

Drink plenty of water ( 8-10 glass daily),

Do not opt for fizzy drinks

Avoid high protein diet,

Have lemon juice with water (this might again vary regarding the type of stone one might have)

But it is better not to make any changes to your diet without consulting with a dietician first.

Dietary Management for Kidney Stone:

Choosing which food to limit depends on the type of stone developing in a person’s body.

In general, one must avoid the consumption of high-sodium foods, including processed, packaged foods, fast food, certain animal proteins, etc.

As stones vary in composition it is not wise to exclude or include any kind of food in your diet without consulting a dietician. Thus it is very important to know the type of stone an individual is having and decide the diet likewise.

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What happens if a kidney stone is left untreated?

One of the major factors that increase the risks of kidney stones is the production of less than 2-2.5 liter of urine per day. If left untreated it might lead to:

Severe back side pain

Increases the risk of UTIs

Infections in the kidney

Kidney failure

Another risk related to kidney stones is that they have a tendency to reappear. If an individual has kidney stones, the chances of their recurrence in the next 5-7 years increase, especially in the cases of metabolic diseases like Hypercalcinuria, Hyperoxaluria, and Gout. This also increases the risk of recurrence of urinary tract infections and other related health issues.

When is surgery needed for kidney stones?

Usually, kidney stones can be dissolved by the use of medication and proper diet or can be passed with sufficient water intake. If the stone’s size is larger than 5 mm or if it becomes lodged in a position that obstructs the passage of urine, surgery becomes the only viable solution. Once identified that the kidney stone is causing intense pain or is significantly impeding urine flow, it is unwise to neglect undergoing surgery.

If one maintains precautions, one can easily treat and prevent a kidney stone. One should not treat this matter lightly since a kidney stone itself isn’t the sole problem. The complications arising from its occurrence, such as urinary tract infections or kidney infections, can also take more perilous courses. Therefore, staying vigilant, conducting necessary tests on time, and promptly consulting a doctor if any symptoms are observed are advisable actions.

When it comes to Kidney stone let me know what works best according to you?

(a) diet

(b) medication