Hey there! Welcome to my new article.
I have seen a lot of kidney stone cases myself. It's quite common, actually. But most of the cases I have seen were of small stones. The size of stones can range from less than 5 millimeters to a few centimeters. There have been a few cases in the past that have recorded some exceptionally enormous kidney stones. In 2003, 11.6 cm wide and weighing approx 350g stone was recorded. That's huge, but nothing compared to a case from England in 2012. This is the biggest stone ever recorded and surgically removed. It was about 20 cm wide and weighed approx 2 kg or 4.4 pounds.
Image by Jacupika, Wikimedia, CC BY-SA 4.0
In medical terms, Kidney stones have got many names. Most commonly "Nephrolithiasis" meaning stones forming in the nephrons (functional unit of the kidney). Another name is "Urolithiasis" meaning stones forming in the urinary tract. It can be also called "Calculi" which just means stones. As you can see, Stones are not just formed in the kidney, it can form anywhere in the urinary tract, hence the different names.
The lifetime prevalence of Kidney stones is about 20%, i.e. a person has a 20% chance of forming a kidney stone. Also, the recurrence rate is also high, which is about 70%. Meaning, if a person has already been treated for this once, then he has a 70% probability of developing it again within 20 years.
In this article, I will talk about how kidney stones are formed, what are the different variations, the role of the diet and ways to prevent it.
Formation of kidney stones
As we all know, kidneys are the organ that filters the blood and produces urine with the purpose to remove all the waste products. More specifically, nephrons are the one to filter blood, excrete waste and reabsorb things back to the blood stream. Therefore, this plays a major role in regulating electrolytes and fluid balance. To understand kidney stones, we need to be aware of the composition of urine. We can consider urine as a solution with the mixture of solute and solvents. Solvent being the water, which constitutes more than 95% and solutes being
- Urea
- Uric Acid
- Calcium
- Potassium
- Sodium
- Magnesium
- Phosphate
- Sulphate
- Ammonia
- Creatinine and others
All of these constitutes less than 5% of the urine. When these solutes precipitate out from the urine, it forms something called "nidus". Nidus is just an accumulation of the precipitates. This is very small, less than 1 millimeter. This nidus acts a seed for the stone. As more and more solutes deposits on the nidus and helps it get bigger. Now, why do solutes precipitate out in the first place? Well, there can be many causes for that. We can understand this as inactivity of the urine. When the urine is very concentrated as in dehydration, it becomes supersaturated with solutes which forces the solutes to precipitate out leading to formation of nidus. So, the main root is the imbalance between the solutes and the solvent. Dehydration is not only the cause for this, diet plays a major role.
Variations of Kidney Stones
Mostly we observe these five types of stones. These stones have their own chemical composition and are linked to different form of diets.
Calcium Oxalate Stone
This is the most common one. Formed by binding of calcium and oxalate. This can happen due to consuming more oxalate rich foods. Oxalate are found in many green vegetables or "healthy" foods. Some examples are barn cereal, grits, spinach, etc.
This stone has an irregular surface and is very spiky. Therefore, if this stone grows enough, it can lead to severe complications. As, irregular surface can lead to internal wounds.
Uric Acid Stone or Calcium Phosphate stones
These stones are formed due to high level of uric acid in the blood. But, there are some other factors that leads to precipitation of the uric acid. That is high acidity of the urine. High acidity of the urine is due to high levels of purines. What is purine? It's a substance found highly in animal proteins like fish, red meat, shell fish, etc. Also, high levels of proteins leads to more calcium in urine. Now, you know what type of diet leads to this stone.
Also, this stone commonly occurs in men suffering from gout or going through chemotherapy.
Magnesium Ammonium Phosphate Stones or Struvite
Struvite Stones by Joel Mills, Wikimedia, GNU free License
Struvite stone is the second most common one. It is formed due to infection in the urinary tract because of urea spitting organisms like Pseudomonas, mycoplasma, Proteus, etc. This mostly occur in women because of their smaller urethra. Any infection in the pelvic area can easily ascend to the urinary bladder and to the kidney. Leading to formation of stones.
These stones are soft but are not easily detectable.
Cystine stone
These types of stones are rare and happens in both men and women with a genetic disorder called "Cystinurea". This type as stone is very hard as it is made of sulfur. With this disorder, cystine leaks into the urine from the kidney. Consuming the food products like egg, fish, meat can aggravate this condition because they contain high sulfur.
Xanthine Stone
This form is absolutely rare and is due to inborn defect of the enzyme xanthine oxides. This enzyme helps in oxidation of xanthine to uric acid. As, the enzyme is defective, xanthine is excreted more into the urine. It is less soluble, leading to stone formation.
Prevention of Kidney Stones
Your dietary habits play a major role in prevention of stones. Let's see what some of those habits are:
Staying Hydrated
Dehydration is the most common factor for kidney stones. As I explained above, dehydration concentrates the solutes which leads to its supersaturation and the crystal formation. Believe me, your urine color tells a lot about the state of your health. Normally, it should be pale yellow or clear. If it is dark, that means your urine is concentrated, and you need to drink water asap. But how much water exactly is needed? Different people have different opinion on that. Some say 5 liters a day some say 10. But I would say, just drink water until your urine turns colorless. As, drinking too much can be harmful too.
Eating Calcium and Oxalate rich food at the same time
You might think just cutting out calcium rich food or oxalate rich food might reduce the risk of forming calcium oxalate stones. But that's not the case. Calcium oxalate stones are formed only when they bind together in the urine. Instead of cutting out any of them you need to consume both foods types at the same time. This leads to binding of calcium and oxalate in the guts instead of kidneys. Therefore, stones will be less likely to form.
Eat Less Salt
Too much salt in the diet increases the risk of kidney stones. As it prevents calcium from being reabsorbed by the kidney. This eventually leads to high level of urinary calcium, one of the cause of calcium oxalate stones. To lower the salt intake, you must read the food products label carefully. Some popular foods that must be avoided are, chips, crackers, canned foods, food containing MSG.
Avoid vitamin C Supplements
I am not talking about the vitamin C containing food, I am talking about the supplements. According to a study done in 2013, men taking vitamin C supplements doubled the risk of kidney stones.
Less Animal Proteins
If you are at risk of developing kidney stones or have already been treated once for it. They you must be limit consuming animal proteins. As they increase the uric acid levels and proteins favors the formation of calcium in the urine.
Lower the Caffeine Consumption
Caffeine but be consumed in a limited amount if you are at risk. Caffeine increases your metabolism and speeds of the process of dehydration. This can be very risky for at risk people who consume it daily.
The bottom line is, this preventive measure may or may not work, but they will surely reduce the risk. The Best option to prevent kidney stone is make some dietary changes and always stay hydrated. Drink water until your urine turns colorless and keep it consistent.
That's it for this article guys, I hope you liked it.
All images used are copyright free
References:
[1]https://en.wikipedia.org/wiki/Kidney_stone_disease
[2]https://en.wikipedia.org/wiki/Calculus_(medicine)
[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252394/
[4]https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755
[5]https://www.byramhealthcare.com/blogs/the-7-best-ways-to-prevent-kidney-stones
My Previous Articles:
those stones are terrifying. They are warning me literally. Time to drink more and more water first of all. +_+
Stay hydrated and relax :D
Very interesting article and important facts, will reduce my vit C supplement intake from now!
Thanks and regards
Chapper
The risks are real with vitamin C for an adult male above a certain are group. You can read this interesting article by Harvard https://www.health.harvard.edu/blog/high-dose-vitamin-c-linked-to-kidney-stones-in-men-201302055854
I beleive one of the major factor that predisposes one to nephrolithiasis aka kidney stone is consistent dehydration. Adequate water intake will help reduce the formation of those kidney stones.
Intake of vitamin C supplement could contribute but not necessarily a major indicator. You would agree with me that vitamin is as important as taking Fruits. But unfortunately, it is impossible to get the daily recommended dose of vitamin, about 95mg from fruit consumption alone hence the need to complement this deficit with Vitamin C supplement. Especially those engaged in strenuous Activities.
Dehydration leads to the formation of acidic urine and this in turn favours kidney stone formation especially Calcium oxalate Crystals as well urate Crystals.
The main key factor that have so Far favoured kidney stone formation from various research is dehydration.
It will interest you to know that most drugs contain some certain amount of calcium as a binder. Invariably, we get some quanties of calcium some of our Drugs we ingest.
I believe one could take vitamin C supplement but with enough water intake to Ensure adequate hydration.
Great article I must say, I hope to Read more of your awesome write ups
Kudos.
Dehydration is the most important factor indeed. I guess vitamin c supplement is a risk for a person who has a history of calcium oxalate stone. Upper intake level in those cases in about 1000mg and most of the vitamin C supplements contains 500 to 1000 mg which makes it a potential risk if they are consuming it in high doses.
But obviously, proper hydration is needed.
Thank you for your comment, I appericiate it !!
very helpful article.
Do milc products increase acid levels too? (when high in protein, like cheese,...)
Actually, that's very popular myth. Dietary calcium actually tends to decrease the risk of kidney stone [Note that i am talking about dietary calcium not urinary]. Oxalates are main risk factors. calcium needs to bind with oxalates in the stomach. If this does not happen, more free oxalates are secreted as wasted produced in the urine which increase the chances of stone formation.
So, milk products are actually recommended to decrease the risk of stones.
Good to know about the (de)hydration. I had a run of kidney stones a few years ago. Don't want to go through that again.
ooh.. so you already have been treated once. What type of stone was it? just curious :)
Stay hydrated.. that's the best way
From a medical and educational point of view, the content you share with us is an excellent contribution.
Thank you for socializing this type of information, which serves as guidance and prevention. I comment to them, that the region where I live is producing of meat and milk, and innumerable cases of renal calculations exist, I estimate that by the excessive consumption of milky products, within the habitual practices by which it is chosen to counteract and to avoid the formation of calculations, it is to consume much water, with the variant by beliefs that people usually incorporate in fasting a pinch of bicarbonate of sodium in the glass of water to ingest, this will be advisable. ?, I have this doubt, because relatively in my case I usually consume bicarbonate at intervals of 3 months to create pH balances in the metabolism.
Best regards @idoctor.
Thank you for the comment @lupafilotaxia
Sodium bicarbonate is advisable in the cases who have a history of kidney stones. As it makes the urine less acidic. Which can be helpful to slow the process of uric acid stone formation or even dissolve the existing one.
i don't think its harmful, Apart from that you can obviously use it to maintain pH balance.
Perfect, thanks for responding. So, things are indeed being done correctly, again thank you for your kind response.
Your post are always very interesting! Thanks for sharing with us.
!discovery 30
Thank you so much for your kind words!! :)
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This article is very complete, the truth is quite interesting, I have known several people who have suffered from this and it is very painful, especially when it comes to urination. I have also known that some people ingest natural products that help eliminate these stones but at the same time can be dangerous because when it comes to expelling the stones can cause damage to the urethra because it helps expel them, but not to disintegrate within the liver
Pain is the major thing regarding kidney stone if they are large enough. Most of them are small approx 5 mm which comes out through urination without even being noticed.
If a person tires very hard to expel it, it can tear the urethra, depending on the type of the stone. Most commly by calcium oxalate stone as it is spiky