Kidney stones

Kidney stones are usually made up of crystals of calcium oxalate, either alone or in combination with calcium phosphate. They can be found in the kidney itself or anywhere in the duct (ureter) that carries urine from the kidney to the bladder. Kidney stones can be as small as a tiny pebble or an inch or more in diameter. The compounds from which stones are formed are normally present in human urine but remain in solution due to control of acidity and the presence of various protective compounds. When these protective mechanisms are overwhelmed, stones may be allowed to form. There are usually no symptoms until the stone blocks the urinary tract resulting in excruciating pain until the stone passes. The rate of occurrence of kidney stones is increasing, and over 10 per cent of men and 5 per cent of women experience at least one kidney stone during their lifetime.

Causes of kidney stones

Although there are many types of kidney stones, the most common type contains calcium and occurs due to alterations in calcium metabolism, including absorption from the intestine, filtering from the kidneys or abnormalities in the hormones that regulate the use of calcium in the body.

Treatment of kidney stones

Treatment depends on the size, symptoms, location and cause of the kidney stone. If the stone is small and can be passed, drinking plenty of fluids may be enough. For kidney stones too large to be passed, a procedure known as lithotripsy is often used. During this procedure, shock waves are directed to the areas where the stone is located. The shock waves break it into fragments. After the treatment, the patient drinks a lot of water to flush out the stone fragments.

Diet and kidney stones

Diets which are low in fiber and high in refined carbohydrates, alcohol, animal protein, fat and salt lead to an increased risk of kidney stones. High intakes of calcium and vitamin D-enriched foods may also increase the risk. Vegetarians appear to have a decreased risk of developing kidney stones, as their diets areusually lower in protein and higher in green vegetables and grains. Drinking plenty of water can be a useful preventive measure.

Eating an alkaline diet that includes potatoes, vegetables and fruit (but not citrus fruit), and reducing protein intake will help to reduce the risk of uric acid stone recurrence. Some experts advise limiting intake of liver, kidneys, fish roe and sardines as these foods are high in purines which may contribute to stone formation.

To reduce the risk of calcium oxalate stones, it is helpful to avoid foods containing oxalates, such as spinach, rhubarb, beet, parsley, sorrel, and chocolate. People who have a tendency to form oxalate stones often secrete too much calcium in their urine, which reacts with oxalic acids to form the stones. In such people, calcium and sodium intakes should not be too high and restricting intake of dairy products is likely to be beneficial.

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