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Kidney Stones: Prevention is Better than Cure

Submitted by on November 26, 2014 – 5:18 PM

imagesNephrolithiasis (also known as Renal calculi,Renal lithiasis and Kidney stones) is a condition characterized by the aggregation of solid mass , crystals, minerals and acid salts that form anywhere in the urinary tract extending from kidneys to bladder. These deposits can aquire different shapes at different sites and their presence inside the kidney is always an alarming sign as they can produce a variety of symptoms ranging from vague complaints to extreme pain and bleeding if they obstruct the passage of urine in the kidney or in the ureter.

 
There are mainly four types of renal calculi: (1) Calcium-containing stones (75%)  (2) Struvite (10%)  (3) Uric acid stones (10%)           (4) Cystine stones (rarer type). The epidemiology of kidney stones is sprouting up – not only is the incidence and prevalence increasing, but also the gender gap has lessened. The main factors driving these drastic changes include environmental factors, consumption of specific diet and obesity.

 

Risk Factors: The risk factors that contribute in production of stones can be broadly classified into:
(1) Factors that can be controlled:  Hydration, Specific diet,  Obesity
(2) Factors that cannot be controlled:  Age and gender,  Family History of stones , certain medical conditions, surgery

 

Contribution of diet in Stone Disease: The influence of diet on renal stone disease seems to be much more intricate than it was thought of in the past because of the interactions taking place between different nutrients and thus influencing the urinary parameters. Certain foods increase the risk for stones in people who have genetic or medical susceptibility, these foods include:Foods rich in high animal proteins.

 

Animal proteins are rich in amino acid Purine that breakdown in our body to form uric acid.Small amount of uric acid is in good health in the human body but when it exceeds the normal range it concentrates the urine that eventually leads to stone formation.
Omnivorous diets as a whole contribute richly in stone formation as compared to vegetable diet. It is necessary to restrict the protein diet to a safe range because it also affects parathyroid hormone causing increased plasma calcium, indirectly adding minerals to the urine.Calcium is the main ingredient of kidney stones.

 

As a general rule when we consume excess of calcium, the excess should be excreted via urine, some patients are vulnerable to develop kidney stones with excess of this mineral but that does not mean you should stop adding calcium to your diet because it is equally important for bone health.

 
Oxalates and Hyperoxaluria: Oxalic acid is a naturally occurring substance that binds with minerals like calcium and excreted through urine but when it is reabsorbed by the kidneys, crystalline stones are formed. The free usage of oxalates in diet is a different condition from hyperoxaluria that is completely under patient’s control. Sources of oxalate rich diet includes: Oxalate rich plant foods, Waste products of general metabolism,  Vitamin C supplement , Animal Proteins , Beverages.Hyperoxaluria is a genetic condition that causes oxalic acid deposition in kidneys leading to intra-renal stone formation.

 

Salts and Sodium: High salt intake can alter the sodium balance and this in excretes high amounts of calcium and lowers the citrate levels in urine increasing the risk of stone formation, therefore use of controlled sodium intake can help prevent stone disease.Junk food increases the risk of gallstones on the other hand it is known to be effectual factor in kidney stones development.

 
Binge eating, lower fiber diet and high carb-fat diet can all precede to acidic urine that increases urine concentration, decreases urinary citrate ,increases urinary calcium, all factors playing an important role in kidney stone formation.

 

Prevention: With combination of certain habits and lifestyle changes you can prevent the development of kidney stones.
• Increase oral hydration, the more you drink water the more harmful products are flushed out of your body decreasing risk of stone formation.
• Reduce diets rich in high animal proteins (meat).
• Avoid using excess of beverages in your diet because they contain shocking amounts of sugars that can harm kidneys by forming oxalates and lowering citrates.
• Vitamin B6 supplements can help binding oxalates in raw form and enhance its excretion via urine.
• Drinking citrus juice in the form of lemonade has shown to be effective in increasing urinary citrate and lowering calcium levels acting as stone inhibitor.
• Determine the salt content of your diet and limit the sodium intake.
• Maintain normal calcium and oxalate intake because restricting their intake has never shown beneficial effects on stone development.

 

References:
(1) http://www.webmd.com/kidney-stones/kidney-stones-what-increases-your-risk
(2) http://www.mayoclinic.org/diseases-conditions/kidney-stones/basics/prevention/con-20024829
(3) http://www.precisionnutrition.com/all-about-kidney-stones.

 

About the Author: Anam Mumtaz is a graduate of Karachi Medical and Dental College. She can be reached at [email protected]

About this article: This article is competing for the JPMS International Medical Writing Contest 2014.

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