Kidney Stones
What are kidney stones?
Kidney stones, also known as nephrolithiasis, urolithiasis or renal calculi, form when your urine contains an excess of crystal-forming substances like uric acid, oxalate and calcium.
This can be diluted by the fluid in the urine and at the same time your urine may lack the chemical substances that prevent crystals from sticking together – resulting in kidney stones.
Rogue culprits for kidney stones include obesity, dietary triggers such as nuts, colas, beetroot, chocolate, spinach and rhubarb – all these foods are high in oxalates and phosphates that contribute to kidney stones.
High sodium diets are also a trigger for kidney stones.
Dehydration and not drinking enough water is also linked to the development of kidney stones, while occasional drinking of citrus fruits, pineapple and orange juices may be preventative.
Gastric Bypass surgery, Inflammatory Bowel Disease or chronic Diarrhoea can also increase the risk of kidney stone formation.
In the past three decades, the incidence of kidney stones has soared in both men and women – largely due to factors such as diet and obesity but perhaps due to increased screening as well.
What are the symptoms and signs of kidney stones?
- A kidney stone does not usually cause pain until it passes into the ureter – the tube that connects the bladder and kidney.
- Smaller kidney stones may pass without pain, however larger stones can cause burning pain and the pain often comes in waves.
- This pain, usually when trying to pass urine – can be exquisite and unbearable. Many have described kidney stone pain as “a pain worse than childbirth”.
- Pain can radiate to the groin and lower abdomen.
- The pain can start as a dull ache but escalate quickly to sharp, severe cramping.
- You can also feel pain in the back or side or under the ribcage.
- Sometimes Kidney Stones can cause cloudy, foul-smelling urine, or pink, brown or red discolouration in the urine.
- The need for more and more frequent toilet trips is common.
- Fever, chills, nausea and vomiting can also be symptoms of Kidney Stones.
What are the different types of kidney stones?
There are generally four major types of kidney stones:
- Calcium Stones – These make up the bulk of all kidney stones, often worsened by dietary triggers such as nuts, chocolate, fruits and vegetables with high oxalate content.
- Struvite Stones – These can be a response to urinary tract infections
- Uric Acid Stones – These stones can be caused by too much protein in the diet, while people with metabolic syndrome or diabetes are also at higher risk of these stones. There are strong hereditary links too.
- Cystine Stones – These stones form in people with a genetic condition that causes the kidneys to excrete excessive amino acids. This condition is known as Cystinuria.
What is the treatment for kidney stones?
Your doctor will conduct blood tests, urine tests and CT scans or X-Rays to confirm a kidney stone diagnosis. You may also be asked to urinate through a strainer to “catch” stones you pass. Treatment for kidney stones includes:
- Go, Go H2O! – Drinking more water than usual will dilute urine and may prevent stones from forming in the first place. The lighter the colour of your urine when you wee, the more dilute your urine.
- Pain relieving medications such as paracetamol can help.
- Some special medications known as Alpha Blockers can help to relax the ureter muscles, making the passage of a Kidney Stone easier and less painful. These medications can include tamsulosin and dutasteride.
- Some patients with smaller stones suggest that Apple Cider Vinegar may help stones pass more easily while lemon juice is another home remedy.
- Kidney stones that are too large to pass on their own or cause bleeding or ongoing Urinary Tract Infections are most commonly treated with Extracorporeal Shockwave Lithotripsy (ESWL). This is ideally suited to stones that are composed of Calcium Oxalate (the most common type of stone), and to stones that are located in the kidney. In this procedure, ultrasound waves are used to blast the kidney stone into smaller pieces, which can then easily pass through urine.
- Other surgical procedures to remove larger stones include Percutaneous Nephrolithotomy (using a small telescope inserted through a small hole in your back). The insertion of a ureteric stent is another option and this relieves blockages. This is ideal for stones bigger than 2cm.
- After your procedure, you may be asked to reduce your intake of oxalate stone-forming foods which include nuts, chocolates, spinach, rhubarb and beetroot.
- Excessive amounts of purine foods – such as anchovies, tuna, herring, mussels, codfish, more than 200g a day of red meat, organ meat like liver, kidney and veal, venison and duck – should also be consumed cautiously and monitored.
Further Reading