Rockin Kidney Stones

Rockin’ Kidney Stones

Semi-noxious stones

Although kidney stones rarely cause permanent damage, they are one of the most painful conditions you can get. They form when high levels of certain minerals are out of balance in the kidneys. They range from smaller than a grain of sand to larger than a marble. The largest known kidney stone was 3 lbs! Tiny ones can pass quickly, but large ones can take hours, be excruciating, and can block the kidney from draining. A large stone can also cause bleeding in the urine. About 1 in 9 men and 1 in 20 women will get kidney stones by 70.

Kidney stones and age

Kidney stones often occur first between 25 and 45, though sometimes later. Often, later stone onset is linked to a hormone gland malfunction. This malfunction is called hyperparathyroidism. It happens when the tiny glands that control blood calcium get out of whack. This causes your blood calcium levels to skyrocket, which impairs kidneys and may result in kidney stones. This is usually diagnosed in the early 60s.

5 kinds of stones

There are 5 types of kidney stones, each with its causes.

• Calcium O stones (calcium oxalate)---about ¾ of all stones.

• Calcium P stones (calcium phosphate)---about 1 in 7 stones.

• Uric acid stones---about 1 in 10 stones.

• Cystine stones---caused by a disorder called cystinuria. Rare.

• Struvite stones---Rare.

Calcium duo

Calcium stones come in two types: Calcium O (oxalate) and Calcium P (phosphate), although the O stones are more common. These stones form when there is too much calcium in the pee. The high calcium levels don’t always show up in a blood test, as the kidneys can store higher amounts. Also, about half of the people who get calcium stones have low citrate levels in the kidneys. Citrate helps flush excess calcium.

Calcium O stones

Calcium O stones make up ¾ of all kidney stones. Calcium O stones are related to eating food high in oxalates. Spinach and rhubarb are the highest. Rice bran, buckwheat, almonds, and miso soup are also very high. Whole wheat, whole baked potatoes, cornmeal and grits, cocoa powder, cashews, and raspberries also have more than a full day’s O in one serving. Avoiding spinach and rhubarb and limiting high-O foods may reduce the risk of getting calcium O stones.

Calcium P stones

Calcium P stones are less common than the O stones, but are the second most common stones overall. There are 2 subtypes of Calcium P stones. Calcium P stones tend to grow faster and get bigger than calcium O stones. They can be caused by hormone imbalance (hyperparathyroidism) or kidney disease, but for most, there is no known cause. Many stones are a combination of the two calcium types sometimes mixed with other types.

Stones on acid

About 10% of stones are uric acid stones. Uric acid stones are caused by excess acidity in the urine. As we age, our pee tends to get more acidic. It is unknown why pee gets more acidic with age. There is no way to change the acidity of pee with diet or drugs. But these kinds of acid stones get more common as we age. Certain medical conditions, such as gout, increase the risk of these stones. Like gout, these stones are much more common in men.

C & S Stones

Struvite stones are caused by a bacterial infection in the urinary tract and kidneys. Often antibiotics are needed to get rid of the bacteria causing the stone. Any kidney stone can be partially an S stone, in which case the infections must be treated. Cystine stones are caused by an inherited disorder that causes an excess of a particular amino acid in the urine. Both types are rare compared to other types.

Risk factors

Kidney stones are more common in older people and those with family members with kidney stones. If you’ve had a kidney stone before, there is almost a 50% chance you’ll have another within 7 years. People with certain medical conditions, such as high blood pressure, diabetes, and obesity, are more likely to get kidney stones. Kidney stones are also more common when living in a hot place, as you get dehydrated more often. Having a few kidney stones increases the risk of developing kidney disease. Check with a doctor and keep an eye on kidney function.

Stones & Foods

Drink water

Kidney stones can be linked to dehydration, which leads to a concentration of minerals and salts in the urine. Drinking plenty of fluids can help reduce kidney stones. Water dilutes the minerals in the urine that can form stones. Although it’s hard to estimate pee volume, you should be peeing 1—2 litres a day. Any less, and your kidneys are stressed with higher concentrations of minerals. The top two types of stones are known to occur more often in summer, possibly due to dehydration. There is a strong link between not peeing enough and kidney stones.

Vitamins

Taking calcium and magnesium can reduce the risk of getting stones. Even though calcium is the primary type of stone, low calcium intake increases the risk of calcium O stones. Without enough calcium, your kidneys can’t flush out the O, and the O left in the kidney forms stones. Dairy is an excellent source of calcium. Calcium citrate and magnesium citrate are both helpful as the citrate grabs onto the O. Ideally, magnesium should be taken with any foods that contain a lot of O (see food list above). Potassium citrate may also have a beneficial effect in reducing Calcium O stones. Vitamin B6 might also help. High doses of vitamin C (more than 2,000 mg a day) increase the risk of kidney stones.

Salt, etc.

High intakes of salt increase the risk of kidney stones. Eating a lot of salt increases the calcium we pee out. This is because to get rid of the salt, the kidneys use calcium. Calcium is pulled out of the bloodstream and into the kidneys, lowering circulating calcium.

To limit this risk from salt, aim for a salt intake between 1,500 and 3,000 mg of sodium per day. Use the lower end of the range if you have salt-sensitive high blood pressure. Most of our salt comes from processed foods, namely food that comes in boxes, bags, and/or cans. Limit high-salt foods like bread and pasta, preserved meats, and canned foods. Also, a lot of grocery store chicken is injected with salt. Restaurant food almost always has a lot of salt. Salt-shaker salt is a small part of our salt intake.

Sugar is also linked to kidney stones. Avoid refined sugar as much as possible, especially sugars in pop and juice. Drinking a pop a day can increase your kidney stone risk by ⅓.

Fruits and veggies

Both fruits and veggies increase the amount of pee, as they contain a lot of water. Also, they tend to reduce the acidity of pee. They also have compounds that can block the formation of calcium crystals.

Meats

A diet high in meat, especially organ meats and seafood, can also be a risk factor. Meat has a substance called purine that creates an acid in the urine. This purine can also cause gout. A very low-carb diet can also trigger this acid in the urine. The effects of purine vary a lot from person to person. Dairy food seems to offset the impact. Real cheese may make meat healthier!

Drink

Both lemon and orange juice have been found to reduce the risk of kidney stones. Although lemon is acidic when digested, it makes urine less acidic. Lemons are also the best source of citrate, which helps prevent kidney stones. The citrate in lemons combines with calcium to prevent the formation of both calcium O and calcium P stones.

Also, mineral water is a good choice, as the magnesium and calcium in mineral water bind with O and reduce calcium O stones.

Tea

Tea is a medium-level source of O (oxalates) that can trigger kidney stones. Many tea drinkers drink tea every day, making it a major source of O for many people. Adding milk to the tea binds the O to the calcium, and it is then passed through the digestive tract. Drinking tea this way makes it a low-O food. But the O binding with the calcium also makes the calcium unavailable to the body. Studies show tea with milk reduces the risk of kidney stones by about 10%.

Passing stones

Stones can sit in the kidneys for a long time. They only cause pain when they race for the exit. Tiny stones can pass almost unnoticed. Stones smaller than 2 mm have a 97% likelihood of (painfully) passing on their own. A 5 mm stone only has a 50% chance of passing on its own. Larger than 6 mm, a stone has only a 1% chance of passage. The shape also matters when it comes to stones. Smooth stones pass much more easily than jagged ones.

Blocking stones

As the stone passes, even a partial blockage can decrease kidney function. This temporary reduction doesn’t cause permanent damage unless it lasts a few weeks. The blockage can also cause the kidney to swell, which adds to the pain. Sometimes the first symptom of kidney stones is a fever and bad-smelling pee. Once the stones are passing, drinking water doesn’t speed the passage.

Treatments

Stop the pain

When a kidney stone begins to pass, the first priority is pain relief, generally with the strongest pain relievers available. Some drugs may help the passage of stones, such as tamsulosin.

Look for the stone

Usually, an ultrasound or X-ray will show the stones. A CT scan can show the degree of blockage the stone is causing.

Remove the stone

If the stones are too large to pass, they must be removed. They can often be broken up by a shock wave device. Developed in the 1980s, these devices send a targeted high-energy sound wave at the stone to break it up. The stone is located with an X-ray or ultrasound. Once the stone is broken up, those tiny bits work their way out. This procedure requires no cutting surgery. Not all stones can be fragmented with shock waves, and massive stones don’t break up enough. About ¾ of stones are treated with shock waves.

Removal options

Another option is to put a small device up the exit to find and remove the stone. If that is impossible, a small incision is made in the back to remove the stone.

Stent it

Stents are sometimes used to allow the stone to pass more easily. A stent is a springy, hollow tube that opens up the passage. Stents for passing stones are placed in the tube from the kidney to the bladder. They are about 10” long. Generally, stents are used a week or so before surgery and a week or two after. In rare cases, a stent can be left in longer, but it must be changed every 3 months.

Gland check

After you have a stone, you should be checked to make sure your parathyroid gland is functioning properly. A problem with this gland can create high levels of calcium in the blood, which can trigger kidney stones.

Limit future stones

A few medications (thiazide & potassium citrate) might reduce the risk of future stones. If you’ve had recurring stones, talk with your doctor about your options.

Summary

You can’t reduce your kidney stone risk to zero. Some people naturally have a higher risk, but there are a few changes you can make to reduce the risk.

1. Drink plenty of water (mineral water and a squeeze of lemon is even better),

2. Get enough calcium and magnesium from food,

3. Eat fruits and vegetables,

4. Limit organ meats and seafood,

5. Limit sugar and salt, especially sugary drinks,

6. Put milk or cream in your tea if you drink it.

Keep your kidneys healthy and keep friends or family nearby in case you need their help. Wishing you a stone-free future.