Dr. Ashish Kumar Saini, MS, MCh (Urology, Gold Medalist, AIIMS), DNB
Director and Head, Urology
For the past several decades common thinking was that kidney stones usually develops in males who are middle-aged, obese. It was attributed to men who follow an unhealthy diet and take less water. The books taught us the same but with the recent studies, we may need to rewrite and rethink regarding stones. A recent study done in US suggest that the overall incidence of kidney stones is going up and also mentioned that children and women who were not considered high risk before are now forming more stones.
Why do we form kidney stones?
Kidney stones develop due to crystallization (akin to Mishri/Rock Sugar) of certain chemicals in the urine(most commonly calcium oxalate, phosphate or uric acid. Small crystals can pass from your body through the urine without you ever knowing about them. When the crystals grow larger and become stones, they can get stuck in the ureter and block the flow of urine. This causes infection and pain.
What Are the Risk factors for stone formation?
Risk factors are
• Diet : typical western diet including high intake of animal protein, sodium, and sugar.
• Chronic dehydration, low intake of fluids
• Health Issues like gout, diabetes, obesity, Inflammatory bowel disease (Crohn’s disease and ulcerative colitis) or intestinal bypass(Bariatric Surgery or ostomy surgery)
• Family history: kidney stones can run in families (incidence increases with number of effected close relatives. Some rare disorders can cause kidney stones. Some of those disorders are:
• Renal tubular acidosis, sometimes a hereditary disease
• Cystinuria (crystals of cystine form)
• Hyperoxaluria (crystals of oxalate form)
• Absorptive hypercalciuria (the body takes in too much calcium from food)
• Medications: calcium supplements, Protein supplements, diuretics or calcium-based antacids
While a specific cause may be impossible to identify, kidney stones are common, affecting about 19% of men and 9% of women by age 70.
Doc why should I bother regarding stones?
I will suggest just ask someone who had a recent episode of ureteric colic. Believe me it’s akin to labor pain !!!
Seldom will you find that kidney stones are discovered incidentally and pass on their own, never causing symptoms or needing treatment. By and large they become stuck (usually at vesicoureteric junction) leading to pain, blood in urine or infection.
They can become stuck anywhere in the urinary system, including the kidney, the ureters (the narrow tubes connecting each kidney to the bladder), the bladder, or the urethra.
In addition to pain and urinary problems, kidney stones can also cause bleeding and resultant kidney damage. They can increase the risk of a urinary tract infection and have even been linked to cardiovascular disease. So yes its high time you start bothering.
Recent Research and Evidence
A latest study published in the Clinical Journal of the American Society of Nephrology describes an analysis of over 150,000 people in US with kidney stones.
The study findings were:
• The frequency of kidney stones increased by 16% over a period of 15 years.
• The principal increases were among children, women, and African Americans.
• While more men than women had kidney stones (as has been noted in the past)
• In the age group (< 25 years ) women outnumbered men .
Why are we forming more stones?
This study like the ones in the past is not been able to elucidate the reason kidney stones seem to be on the rise. The postulated theories may be increase rate of obesity especially among children and global warming (leading to dehydration). We need more research to understand why stones are becoming more common. Bottom line: it’s an enigma. If we can figure it out why there’s a good chance we can find superior ways to stop them.
What’s one should do?
If you have symptoms of kidney stones, see a Urologist. The most common symptoms are waves of pain in the back or lower abdomen, pain with urination, or blood in the urine.
If you’ve already been diagnosed with a kidney stone, it’s important to figure out why it happened (if possible) and take steps to avoid recurrence. See your urologist to discuss dietary measures and medications to take (or avoid). The details vary depending on the type of stone you had and the results of your blood and urine tests.
PREVENTION IS THE KEY
AS mentioned above its better to prevent stones by following healthy life style and taking plenty of water. Ask anyone who has had pain due to stones it is definitely not your cup of tea.