Kidney Stones - Do We Really Produce Stones?

What are kidney stones?
A kidney (renal) stone is a rigid, pebble-like material that can form in one or both of the kidneys when high levels of certain minerals are present in the urine These stones rarely cause permanent damage if treated by a health care professional. Kidney stones are not stones, but crystal concretions formed within the kidney. These pebbles can vary in size, for e.g., some can be grain sized, and some can be as big as a golf ball. This is the most common disease of the urinary pH tract and has affected mankind since 4000 B.C. It has affected over 15% of the world population. While in India, approximately 2.3% population has been affected by this disease. It is shown that 1 out of 20 people develop this disease in some point of their life span. 80% of those with renal stones are men, and remaining 20% are women.

Mostly, men encounter their first experience with kidney stones between 20-30 years of age, while women experience at their later age. In regions like Gujarat, Punjab, Maharashtra and Rajasthan, kidney stone is so prevalent that most of the members of a family sometimes suffer from this disease. Its prevalence is as high as 7.6% in Satpura region of Maharashtra, Gujarat, Madhya Pradesh and parts of Andhra Pradesh.' The progressively increasing incidence of kidney stones in Udaipur and some other parts of Rajasthan has also been reported.'

What are the 4 types of kidney stones?
Knowing the type would help to determine the cause, and might give hints on how to lessen the risk of developing a kidney stone.

calcium Stones (Calcium oxalateand calcium phosphate): They are predominant renal stones comprising 80% of all stone types." Eating fewer oxalate rich food like peanuts, chocolates, beets, spinach, fruits, can reduce the risk of developing this type.

Struvite Stones (Magnesium Ammonium Phosphate): This accounts approximately for 1015% of all stone types. These stones form in response to an infection and is mostly found in women with Urinary Tract Infection (UTI). There is a possibility of these stones growing quickly and becoming too large, sometimes with little warning or few symptoms. Treating an underlying infection can prevent the development of such stones.

uric acid stones or urate: This type of renal stone is more common in men than women. kidneys can form in people who do not drink enough fluids, those who eat high animal protein diet, and those who have gout. Animal protein diet like beef, chicken, egg, fish, milk, cheese etc., should be replaced by plant based food such as legumes, soy foods, nuts and nut products, sunflower seeds, etc.

Cystine Stone: These stones comprise less than 2% of all stone types. Basically, this type occurs due to a genetic disorder that causes the kidneys to excrete too much of cysteine in the urinary pH leading to cystinuria, an autosomal recessive disease that is characterized by high concentrations of the amino acid cysteine in the urine, which eventually leads to the formation of cystine stones in the kidneys, ureter, and bladder.

How are kidney stones formed?
Supersaturation of the urine with calcium and oxalate salts, leading to crystalline particle formation is the major reason behind kidney stone formation.

Due to supersaturation, initialization of small crystals takes place which is called as nucleation. These nucleates grow and form clusters, termed as aggregation. This aggregation finally leads to stone formation.

calcium oxalate forms the major proportion of the kidney stones (80%), while calcium phosphate forms a small percentage (15%) of these stones.

What tests are done to diagnose kidney stones?

blood testing: This test can help in revealing too much uric acid or calcium in patient's blood.

Urine testing (Urinalysis): The 24hour urinalysis may show that the patient is excreting too few stonepreventing substances and too many stone-forming minerals.

Imaging: Options range from simple abdominal X-rays, which can miss small kidney stones, to high-speed or dual energy Computerized Tomography (CT) that may reveal even tiny stones. Other imaging options include an Ultrasound, CT scan, MRI etc.

Analysis of passed stones: To catch the stones, the patient will be asked to urinate through a strainer. Reports will reveal the makeup of kidney stones, which can help to determine the cause of kidney stone and to avoid future kidney stones.

What are treatment options for kidney stones?
Depending upon the type of stone and the cause, treatment for kidney stones varies accordingly.

For Small stones with minimal symptoms below is effective treatment:

Water: If the calcium or kidneys salts in the urine cannot dissolve, then it leads to formation of kidney stones. The salts then form crystals, which develop into stones. Hence, to lower the risk, the urine should be diluted as much as possible. Drinking minimum 2 litres of water can help flush out your urinary tract.

Pain reliever: When a patient tries to pass a stone, there can be discomfort and hence to relieve this mild pain, doctors may suggest the patient to consume pain reliever medications.

For Large stones with severe symptoms below is effective treatment:
Shock wave lithotripsy: This technique is used to break the stone into smaller ones, so that these smaller stones will be able to pass through the urinary tract.

Cystoscopy and ureteroscopy: In cystoscopy, a cystoscope is used to look into the urethra and bladder whereas in ureteroscopy,

Utereoscope is used to see the detailed images of the lining of the ureters and kidneys. Once the stone is detected, it is broken into small pieces.

Percutaneous nephrolithotomy: To locate and remove kidney stones, nephroscope, a thin viewing tool, is used. For larger kidney stones, a laser can be used to break the kidney stones into smaller pieces.

What is the best way to prevent kidney stones?
- Drink water throughout the day (2-3 litres a day)
- Avoid carbonated drinks
- Eat fewer oxalate rich foods
- Consume diet which is low in salt and animal protein

What are the risk factors for developing kidney stones?
- Family or personal history
- Dehydration
- Certain diets
- Being obese
- Digestive diseases and surgery

Kidney stone V/S You It is safe to say that kidney stone is treatable, but on contrary, people who have had kidney stones are likely to get another one. Hence, it is important to drink plenty water and change your diet. Changing your lifestyle can lower the chances of kidney stones. And why change lifestyle only to treat your disease? Exercise daily, eat healthy, and live a healthy lifestyle to avoid any disease!