Kidney Stone Causes, Symptoms, Treatments, & Prevention.

“See one, do one, teach one”, our professors of surgery would tell us. I still remember the first time I saw a surgery to take out stones from a patient with kidney stones. He was a military officer. The sound of the stones clanging against the metallic tray as they were being removed and placed on the dish, sent shivers down my spine and left me wondering how the man had coped all along. 

When most people hear the words “kidney stones”, the first thought is “how did the stones get in there?” I was told growing up that swallowing guava seeds could give me kidney stones, as the seeds would end up in my kidneys. That was scary. As children, we believed those funny myths for a long time, at least I did, until I grew up. I later learnt that it wasn’t directly about what a person ate, but that the stones are formed inside the body and by the body. 

WHAT ARE KIDNEY STONES?

Kidney stones are hard objects, made up of millions of tiny crystals. Most kidney stones form on the interior surface of the kidney, where urine leaves the kidney tissue and enters the urinary collecting system. Kidney stones can be small, like a tiny pebble or grain of sand, but are often much larger.

The job of the kidneys is to maintain the body’s balance of water, minerals and salts. Urine is the product of this filtering process. Under certain conditions, substances normally dissolved in urine, such as calcium, oxalate and phosphate, become too concentrated and can separate out as crystals. A kidney stone develops when these crystals attach to one another, accumulating into a small mass, or stone.

TYPES OF KIDNEY STONES AND HOW THEY ARE FORMED

Kidney stones come in a various types, depending on what they are made of:

1. Calcium stones: Most kidney stones are composed of calcium and oxalate. Many people whose kidneys form calcium stones have too much calcium in their urine, a condition known as “hypercalciuria”. There are several reasons why hypercalciuria may occur. Some people absorb too much calcium from their intestines. Others absorb too much calcium from their bones. Still others have kidneys that do not correctly regulate the amount of calcium they release into their urine. There are some people who form calcium oxalate stones as a result of too much oxalate in the urine. In some cases, too much oxalate in the urine is a result of bowel disease, or sometimes, it may be a consequence of previous intestinal surgery. Calcium phosphate stones, another kind of calcium stone, are less common than calcium oxalate stones. For some people, calcium phosphate stones form as a result of a medical condition known as renal tubular acidosis.

2. Struvite stones: Some patients form stones that are made up of a mixture of magnesium, ammonium, phosphate and calcium carbonate, which is known as struvite. These stones form as a result of infection with certain types of bacteria that can produce ammonia. Ammonia acts to raise the pH of urine, which makes it alkaline and promotes the formation of struvite.

3. Uric acid stones: Uric acid is produced when the body breaks down protein. When the pH of urine drops below 5.5, urine becomes saturated with uric acid crystals. When there is too much uric acid in the urine, stones can form. Uric acid stones are more common in people who consume large amounts of protein, such as that found in red meat or poultry. People with gout can also form uric acid stones.

4. Cystine stones: Cystine stones are rare, and they form only in persons with an inherited metabolic disorder that causes high levels of cystine in the urine, a condition known as cystinuria.

WHAT MAKES A PERSON LIKELY TO HAVE KIDNEY STONES?

Anyone can get a kidney stone, but some people are more likely to have them. Generally, men get kidney stones more often than women do. You may also be more likely to have kidney stones if:

1. You have had kidney stones before.
2. Someone in your family has had kidney stones.
3. You don’t drink enough water.
4. You follow a diet high in protein, sodium and/or sugar.
5. You are overweight or obese.
6. You have had gastric bypass surgery or another intestinal surgery.
7. You have polycystic kidney disease or another cystic kidney disease.
8. You have a certain condition that causes your urine to contain high levels of cystine, oxalate, uric acid or calcium.
9. You have a condition that causes swelling or irritation in your bowel or your joints.
10. You take certain medicines, such as diuretics (water pills) or calcium-based antacids.

HOW COMMON ARE KIDNEY STONES?

Kidney stones can develop in 1 or both kidneys and most often affect people aged 30 to 60.

They’re quite common, with more than 1 in 10 people affected. Every year, there are about 100,000 cases of kidney stones in Nigeria.

WHAT ARE THE SYMPTOMS?

If you have a very small kidney stone that moves easily through your urinary tract, you may not have any symptoms, and may never know that you had a kidney stone. But, if you have a larger kidney stone, you may notice some of these symptoms:

1. Pain while urinating
2. Blood in your urine
3. Sharp pain in your back or lower abdomen
4. Nausea and vomiting.

If you are having any of these symptoms, contact your healthcare provider. You can speak with a doctor for free on the flexicare HMO plan by initiating a message via the AI health messenger here or via your dashboard on the website.

HOW ARE KIDNEY STONES TREATED?

The treatment for a kidney stone depends on:

1. The size of the stone
2. What it is made of
3. Whether it is causing pain and
4. Whether it is blocking your urinary tract.

To answer these questions and to figure out the right treatment for you, your doctor might ask you to have a urine test, blood test, x-ray and/or CT scan. 

If your test results show that your kidney stone is small, your doctor may tell you to take some medicine and drink plenty of fluids.

If your kidney stone is large, or if it is blocking your urinary tract, additional treatment with surgical procedures may be necessary. 

PREVENTING KIDNEY STONES

The best way to prevent most kidney stones is to drink enough fluid every day. It is generally advisable to drink eight to 12 cups of fluid every day. If you have kidney disease and need to limit fluids, ask your doctor how much fluid you should have each day. 

Limiting sodium and animal protein (meat, eggs) in your diet may also help to prevent kidney stones. If your doctor can find out what your kidney stone is made of, he or she may be able to give you specific diet recommendations to help prevent future kidney stones.

If you have a health condition that makes you more likely to have kidney stones, your doctor might tell you to take medicine to treat this condition.