Why Be Concerned About Kidney
Stones?
The most obvious reason to learn about kidney
stones and modify a person's behavior accordingly
is to avoid the intense pain which they cause. But
the most important reason is because kidney stones
can quickly lead to failure of the kidneys which is
life threatening.
A kidney stone that does not pass on out can block the
urinary tract. This blockage will probably cause pain
initially. But if medical attention is not received to
identify the cause of the pain and remove the blockage,
the pain is likely to gradually go away over a few days
time. This lack of pain may cause the sufferer to think
the crisis has passed when, in fact, the kidney which has
been blocked by the stone has shut down. If left
untreated in just a few days this shut down can lead to
permanent loss of function in that kidney. A kidney
stone can even rupture the collection system of the
kidney.
Definition
The medical terminology for kidney stones is
Nephrolithiasis or Renal Calculi . A kidney stone is a
solid lump (from as small as a grain of sand to as large
as the size a golf ball) made up of crystals that separate
from urine and build up on the inner surfaces of the
kidney.
There appears to be an increase in the number of cases
of kidney stones in recent years. About 7 to 21 people
out of every 10,000 (or less than two tenths of one
percent) of the population will have a kidney stone
attack each year. In 1985 there were 1 million cases of
kidney stones in the United States. These account for
about 7 to 10 of every 1000 hospital admissions (or
nearly one percent). Four out of five kidney stone cases
(80 percent) are among men; only 20 percent are
women. And more Caucasians have kidney stones than
African-Americans.
Location
Kidney stones usually are formed inside the kidney, but
they are sometimes found in the bladder or ureter. The
intense pain associated with kidney stones usually
occurs during the period of time that the stone is being
slowly moved along the small ureter between the kidney
and the bladder.
Causes of Kidney Stones
There are many potential causes of kidney stone
formation. In general they are the result of a
super concentration of chemicals in the urine that
results in crystals being formed. This may be brought on
by one or more of the following: a family genetic
predisposition to form stones; an excess of calcium or
certain other minerals in the diet (sometimes due to
local geographic water or soil conditions); intake of
excess uric acid, certain medications, Vitamin C, or
Vitamin D; a diet of fruits and vegetables high in
oxalate (a by product of metabolism); long term
dehydration (possibly due to inadequate intake of fluids)
and its resulting concentration of urine; urinary
infection; living in an area where high temperatures
cause sweating and loss of fluids; or, possibly, just
leading a sedentary (low physical activity) lifestyle.
The function of the kidneys is to eliminate byproducts
of metabolism. This means they are constantly
collecting the major ingredients for kidney stones including calcium, oxalate, and uric acid. Ideally these
minerals are kept in suspension until they are passed out
of the body. Too much metabolic byproducts in
insufficient fluid (urine) makes a person prone to kidney
stone formation.
The over concentration of metabolic byproducts in the
urine can cause these minerals to move out of
suspension and crystallize. These small crystals that
precipitate out of the super saturated urine will usually
pass on out through the urinary tract, but they may begin
to clump together. Any existing crystal makes it easier
for other crystals to form. If they stay in the kidney
very long, the crystals gradually grow larger and larger
until they become a kidney stone so large that it cannot
pass through the urinary tract.
Several underlying metabolic disorders may be the root
cause of excessive calcium and oxalate forming stones
in the kidney. Often doctors overlook the basic cause
because of the attention of the sufferer being on the
immediate cause of the pain leading the physician to be
primarily concerned with the extraction or dissolution of
the kidney stone causing the problem. The potential root
causes include, but are not limited to the
following:
A re-absorption of the calcium from the bones back
into the blood system which the kidneys then
filter out (resorptive hypercalciuria or
hyperparathyroidism).
The intestines absorb too much calcium from the
diet (absorptive hypercalciuria).
The kidneys filter out calcium from the blood but do
not allow the reabsorption of the calcium back into
the blood as it shoulsd while it is still in the tubule of
the kidney (renal hypercalciuria).
Several forms of bowel disease (ulcurative colitis,
regional enteritis, etc.) which can contribute to high
levels of urinary oxalate excretion.
Excess dietary intake of oxalate from foods such as
green leafy vegetables.
High levels of uric acid in the urine can act as a
breeding ground for calcium oxalate stones.
Or, in a reverse manner, the lack of certain stone
formation inhibitors normally found in the urine
may not be present in sufficient quantities and
thereby allow the formation of stones. One such
ingredient is citrate; another is magnesium.
Infection stones are indicators of the underlying
infection in the urinary tract.
Symptoms of Kidney Stones
Kidney stones may be formed, grow in size, and stay
immobile inside the kidney for years without any
warning pain or other indicators. Most people don't
know they are at risk for forming kidney stones until
one or more have been formed. A few people have and
pass small kidney stones without experiencing pain, but
that is not the usual case. More often the kidney stone
makes itself dramatically known when it begins to move
through the urinary tract.
A kidney stone attack has classic symptoms: the most
agonizing pain in the lower back just below the ribs
spreading around to the front of the abdomen and often
extending into the groin area. The pain may come in
waves as the stone tries to move through the tube
between the kidney and the bladder (the ureter).
Sometimes there will be blood in the urine. Often there
is nausea, fever and chills, and vomiting. The abdomen
or lower back may be painful to touch.
The severity of the pain is no indicator of the size of the
passing kidney stone. This pain is often described as the
worst pain a person has ever suffered even by woman
who have given birth. It is reported to be more painful
than gun shots, surgery, broken bones, or even burns.
The pain is not a result of the stone moving or tearing
the ureter as a sufferer might suspect. Rather, the pain is
caused by the dilating or stretching of the urinary tract
being blocked by the stone when it gets stuck in the
ureter.
During a kidney stone attack the sufferer should drink
large amounts of water (two to three quarts per day).
Stay active. Do not go to bed (except for normal sleep
periods). Physical activity may actually assist passage of
the kidney stones.