health

Kidney Stones: Causes, Risks and Preventions

Dr.Poonam Sharma

March 15, 2022

Kidney stones are also known as renal calculi. It refers to the situation wherein minerals and salt are deposited and accumulated in the kidneys. The deposits and other wastes and chemicals grow and develop crystals known as stones. Kidney stones may result from various factors, including diet, excess body weight, medical conditions, and some supplements and drugs. Kidney stones are harmful to the whole urinary tract.

How do I know if I have a kidney stone?

Several symptoms may help you realise that you have a kidney stone. However, the most common symptom of kidney stones is extreme pain. Let us look at the other symptoms.

Pain in the Back, Belly, or Side

Kidney stone pain amounts to a severe form of discomfort. A lot of people compare this pain to being stabbed by a knife. The pain is so intense that over half a million people seek admission to hospital emergency rooms per year.

The pain usually begins after the stone enters into the narrow ureter. It results in a blockage, leading to increased pressure on the kidney. The pressure triggers and stimulates the nerve fibres to send pain signals to the brain. Kidney stone pain occurs randomly in waves. The pain worsens as the ureter contracts and attempts to force the stone out. The waves of severe pain can last a few minutes. However, it can be so intense that even a few minutes seem too long.

You may usually feel discomfort across your side, back, and below the ribs. In addition, when the stone goes down the urinary tract, it results in pain in the abdomen and groyne area. Although the magnitude of the discomfort is not always proportional to the stone’s size, the bigger the stone, the more pain it causes.

Cloudy or Smelly Urine

Healthy urine is transparent and does not carry a pungent smell. Urine that is cloudy or smells terrible indicates an infection in the urinary tract. Accumulation of specific chemicals and waste material in the body may lead to cloudy urine. It is common for smaller stones to pass unnoticed. However, more giant stones obstruct the urinary tract, resulting in infection. It causes pus in the urine and makes it appear cloudy.

Blood in Urine

People suffering from kidney stones witness one of its common symptoms of blood in the urine. Hematuria is another name for this condition. Urine blood can be red, pink, or brown. However, the blood cells are very minute, and your doctor can examine them only using a telescope. Therefore, you should go to a doctor for a urine check. They look at the urine sample and detect infections etc. if any.

Pain or Burning During Urination

On reaching the junction of the ureter and the bladder, you experience the pain of varying severity while urinating. The medical term for this condition is dysuria.

You can feel extreme and searing discomfort. People easily confuse a kidney stone for a urinary tract infection. However, it is possible to develop kidney stones and disease in the urinary tract. Therefore, timely and proper diagnosis is essential.

Fever and Chills

Fever and chills are symptoms of a kidney infection or other urinary tract related issues. These may be a sign of the severe impact of kidney stones. Therefore, you should not take it lightly. Aside from kidney stones, it may also be a symptom of more severe disorders. Consequently, it would help if you treated any fever accompanied by pain as soon as possible.

Fevers associated with infection are typically high, reaching 100.4˚F (38˚C) or higher. Fever is frequently accompanied by chills and shivering.

Causes of Kidney Stones

Low Urine Volume

Consistently decreased urine flow is a leading cause of kidney stones. In addition, dehydration through intense exercise, commuting or residing in a hot environment, or not consuming sufficient fluids can affect urine volume.

When the quantity of urine goes very low, urine turns concentrated and darker in colour. Due to highly concentrated urine, the body lacks sufficient fluid to dissolve salts and minerals. There is less fluid in concentrated urine to keep salts dissolved. The salts present in urine dilute on drinking more water.

Diet

Diet also influences the likelihood of developing a stone. Urine with a high calcium concentration is one of the leading causes of calcium kidney stones. It doesn’t necessarily depend on the amount of calcium intake. You can rarely prevent stones by reducing the quantity of calcium in your food.

Dietary calcium restrictions are detrimental to bones and can increase the risk of kidney stones. However, calcium consumption should be balanced and not excessive. Instead of consuming less calcium-rich food, the doctors advise reducing sodium intake to lower calcium in the urine. Overconsumption of salt may also lead to calcium stones. An excess of salt in the urine prevents calcium absorption into the bloodstream.

Since oxalate is the principal constituent of kidney stones, limiting oxalate-rich food helps prevent them. In addition, a high-protein diet, such as beef, fish, poultry, and pork, raises the body’s acid levels and urine. Calcium oxalate and uric acid stones quickly form when there is a lot of acid in the body. 

Bowel Movement

Few bowel disorders like Crohn’s disease may force you to go for gastric bypass surgery. However, it increases the risk of calcium oxalate kidney stones. In addition, diarrhoea can cause huge fluid loss from the body, reducing urine volume. It also leads to increased oxalate absorption from the intestine by the body. As a result, it results in high oxalate levels in the urine. Low urine levels and high oxalate concentration may form calcium oxalate kidney stones.

Medical Conditions

Kidney stones are more likely in people with certain medical disorders. Parathyroid glands are responsible for regulating calcium metabolism. The abnormal growth of this gland causes high calcium concentration in the blood and urine of the body. It further results in kidney stones. In addition, distal renal tubular acidosis, a disorder wherein the body accumulates acid, increases calcium phosphate kidney stones.

Specific rare genetic problems also increase the likelihood of particular types of stones. A few examples are cystinuria, in which the amino acid cystine is present in excess in the urine. Furthermore, primary hyperoxaluria causes the liver to produce too much oxalate.

Obesity

Obesity significantly increases your chances of developing a kidney stone. If your BMI is 30 or over, you are considered obese. Obesity may lead to metabolic disorders such as insulin resistance and compensatory hyperinsulinemia. These disorders may contribute to calcium kidney stones.

Hyperinsulinemia increases calcium excretion through urine. It results in the formation of calcium stones. People with obesity excrete more uric acid and oxalate in the urine, both of which are potential causes for calcium oxalate kidney stones.

Obesity can impact the effectiveness of medicines taken to remove stones. Obese people with kidney stones are more resistant to medication doses to prevent stones than non-obese patients. Therefore, obese people may require additional treatments and the standard prescribed medicines.

Can Foods Cause Kidney Stones?

Foods play a crucial role in our body’s functioning. Most health disorders are somehow related to our dietary habits. Hence, some foods may lead to or worsen kidney stones.

High Oxalate Foods

Foods high in oxalates are rich in many nutrients beneficial to your health. But, oxalates bind to calcium as they leave the body. Therefore, they can increase the risk of kidney stones. Consequently, you should limit their consumption in your regular diet. In addition, if you are suffering from kidney stones, you should avoid these foods. A study describes the impact of dietary oxalate and its contribution to stone growth. High oxalate foods include:

  • Spinach
  • Almonds and cashews
  • Miso soup
  • Beets
  • Cocoa powder
  • Okra
  • French fries
  • Raspberries

Sodium Rich Foods

As per one study, dietary sodium intake is associated with an 11% to 61% increase in the risk of kidney stones. A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine. So, you should consume a low-sodium diet if you are stone prone. You should limit your total daily sodium intake to 2,300mg. Some sodium-rich foods that you should avoid are:

  • Processed food
  • Canned soups
  • Canned vegetables
  • Foods containing monosodium glutamate
  • Edibles with sodium nitrate
  • Foods that have sodium bicarbonate

Foods that cause the urine to turn more alkaline

Acidic urine may increase your risk of developing uric acid kidney stones. Therefore, you should reduce the intake of foods that make the urine more alkaline. These foods include:

  • Fresh fruit juices
  • Vegetable juices
  • Molasses

Kidney Stones: Prevention

Stay Hydrated

Adults with kidney stones should drink enough water to produce at least 2.5 litres of urine daily. It will require roughly 3 litres of fluid consumption each day. While water is the essential liquid that everyone consumes, what matters most is to drink enough. Try drinking orange juice and lemonade. They both contain citrate, which prevents the formation of stones in the urinary tract. 

Consume Calcium-Rich Food

The most common kidney stones are calcium oxalate stones. It is a widespread misunderstanding among people that consuming a diet low in calcium will prevent kidney stones. The inverse is true. Low-calcium food can raise the risk of kidney stones and osteoporosis. However, consuming calcium supplements can increase the chances of developing stones. Therefore, you may take these supplements with your meal. Calcium supplements are available for purchase in the market. Calcium-rich foods include dairy products, spinach, cereals etc.

Limit Sodium Intake

A diet rich in salt raises your chances of developing calcium kidney stones. Excess salt in the urine prevents calcium absorption into the bloodstream for further circulation. It increases the amount of calcium in urine resulting in kidney stones.

You can lower the calcium level in urine by consuming less salt. In addition, low calcium concentration in your urine makes it less likely for the body to develop kidney stones.

Medical Treatment of  Kidney Stones

The type of treatment of kidney stones varies as per their size, composition, level of discomfort arising from it, and its blockage of the urinary tract. The doctor prescribes a urine test, blood test, x-ray, and CT scan to find suitable treatment.

In the case of small kidney stones, painkillers and a lot of water are essential recommendations by the doctor. Drinking plenty of water helps the stone quickly pass the urinary tract and eventually out of the body. Surgeries and other medical treatments are needed in case of blockage of the urinary tract by larger kidney stones. 

Shock Wave Lithotripsy

One of the treatments involves Shock Wave Lithotripsy. The use of shock waves breaks down kidney stones into tiny fragments. In the process, these little particles of kidney stone pass through the urinary tract and urine flow out of the body. The completion of the whole process takes around 45 to 50 minutes. People can take anaesthesia in case of any pain during the treatment. 

Ureteroscopy

Another treatment of kidney stones involves ureteroscopy. This procedure is performed under general anaesthesia as well. A long tube-shaped tool locates and extracts the stone or break down the stone. It is relatively easier to break smaller kidney stones into fragments. In the case of larger stones, a laser targets the stones and breaks them into tiny particles that can smoothly flow out of the body with urine. 

Percutaneous Nephrolithotomy Surgery

Doctors use percutaneous nephrolithotomy surgery in rare cases. Unlike the treatments mentioned above, it is not that common. In this process, a tube is placed right into the kidney throughout the surgery to remove the stone. The patients must stay in the hospital for around two days. It is essential to recover safely from the surgery. 

Passing Kidney Stones

It is relatively more accessible for small kidney stones to pass entirely on their own without any medical treatment. Your doctor may advise you to drink more water to remove the stone from the system. In certain instances, your doctor prescribes the medicine Tamsulosin. Tamsulosin relaxes the ureter, allowing stones to move out more quickly. Few people feel the need to have painkillers to ease their pain. It can be over-the-counter or by prescription.

The treatment of kidney stones should be within six weeks of their formation. However, in case of severe pain that keeps increasing, the patient should get medical help as soon as possible. 

A doctor considers putting a ureteral stent in the appropriate place in certain circumstances. It allows urine to bypass the stone, whether you remove it or not. Surgeons typically save surgery for removing stones that result in infections. The additional use of surgeries eliminates stones that do not easily pass and prevents normal urine flow out of the kidney.

Conclusion

The constituents of kidney stones are complex salt and mineral deposits. They develop in the kidneys and can spread to different regions of the urinary tract. Pain, difficulty in urinating, cloudy or stinking urine, nausea, and vomiting are all symptoms of stones.

In some instances, stones naturally pass through the kidneys. Others require sound wave treatment or surgery to break the stones. If you come across any symptoms of kidney stones, contact the physician. The sooner you get medical treatment for kidney stones, the lesser the chances of developing severe health problems.

About the Author

I, Dr. Poonam have 3+ years of experience in the field of Medicine. Currently serving as a Resident Physician at HealthifyMe, I have worked with premier hospitals such as Manipal Hospital, Bangalore as a Resident in Plastic and Reconstructive surgery and Rajiv Gandhi Government Hospital, Chennai as a Medical Officer. I aspire to put my knowledge in medicine to use in providing healthcare and fitness services to people and help enhance my abilities in meeting the ever-growing healthcare needs.


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