Kidney stones are one of the most common and worrying urinary system problems. Despite the severe pain and health complications they can cause, understanding how they form and identifying their causes is the first and most important step toward recovery.
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These stones form when minerals become concentrated in the urine and stick together to form hard crystals. Below is a comprehensive, simplified guide explaining their causes, symptoms, diagnosis and treatment based on size, along with the diet suited to preventing them, according to the health publication OnlyMyHealth.
How do kidney stones form?
The formation of stones goes through four basic stages that depend on the body's chemical balance:
Saturation: Urine becomes highly concentrated due to dehydration or elevated levels of calcium and oxalate, so the fluid cannot dissolve these minerals.
Crystal formation: Microscopic calcium and oxalate molecules stick together to form a small nucleus, the "seed" of the stone.
Absence of natural inhibitors: The body sometimes lacks natural substances that prevent crystallization, such as citrate. When levels drop, the crystals remain active and able to adhere.
Aggregation and growth: Small crystals gather and attach to the lining of the kidney, and layers build up over time until they become a hard stone with sharp edges.
Causes of kidney stones and risk factors
Not drinking enough water, which concentrates the urine and makes it easier for minerals to deposit.
A diet rich in oxalates, as excessive consumption of certain foods raises their level in the urine.
Excess salt, which pushes the kidneys to excrete more calcium in the urine, increasing the chances of it meeting oxalates and forming stones.
Certain medical conditions, such as obesity, overactive parathyroid glands, recurrent urinary tract infections, and digestive problems that affect the absorption of nutrients.
Warning signs of kidney stones
Symptoms vary depending on the stone's size and location in the urinary system, and include:
Severe, sharp pain in the side or lower back, known as renal colic.
Pain that radiates to the lower abdomen and groin.
Blood in the urine.
Frequent or sudden urges to urinate, or pain and burning during urination.
Nausea and vomiting.
If the pain is accompanied by fever and chills, persistent vomiting, or a complete inability to pass urine, go to the emergency room immediately to avoid a urinary blockage or kidney damage.
Diagnosing kidney stones
To confirm the presence of stones and determine their size and exact location, doctors order the following tests:
Imaging: A CT scan is the most precise, followed by ultrasound and X-ray.
Urine analysis: To detect blood, microscopic crystals, or signs of infection.
Blood tests: To check kidney function and levels of calcium and uric acid.
Treatment options for kidney stones
Medical treatment depends on the stone's size and its ability to pass on its own:
1. Small stones (under 5 mm)These often pass naturally by themselves. Treatment involves:
Drinking plenty of water (2.5 to 3 liters per day).
Pain relievers and anti-inflammatory drugs to manage renal colic.
Alpha-blocker medications that help relax the ureter muscles to ease the stone's passage.
2. Medium stones (5 to 10 mm)
These may pass naturally but sometimes need medical intervention if they cause a blockage or persistent pain. This may include supporting medications or shock wave lithotripsy.
3. Large stones (over 10 mm)
These require definite medicalintervention because they cannot pass through the ureter. Options include:
Shock wave lithotripsy (SWL): Sound waves are directed from outside the body to break the stone into very small pieces that can be passed in urine.
Ureteroscopy: A fine scope is inserted through the urinary tract to break the stone with a laser or retrieve it.
Percutaneous nephrolithotomy (PCNL): A minimally invasive surgery used for very large stones, through a small incision in the back to reach the kidney directly.
Ways to prevent stone formation
To prevent stones from forming again, adjusting eating habits is the cornerstone of treatment. Here are the key points of a preventive diet:
Increase fluid intake
Contrary to common belief, calcium should not be cut out. Eating calcium-rich foods such as yogurt, milk and cheese together with oxalate-containing foods causes them to bind to each other in the stomach and intestines first, and then leave the body with digestive waste without reaching the kidneys.
It is advisable to limit foods that contain very high levels of oxalates, most notably spinach, beetroot, nuts, chocolate and strong black tea.
Reduce salt intake: Sodium intake should not exceed 2,000 mg a day (roughly one teaspoon of table salt). Excess salt prevents the kidneys from reabsorbing calcium, causing it to be pulled from the blood and pumped into the urine, where it meets oxalates waiting for it.
Include citrus fruits in the daily diet: Make a habit of drinking fresh lemon or orange juice regularly, as citrus fruits are rich in citrate, a natural substance that binds to calcium.
Moderate animal protein: Eating too much red meat, poultry and seafood increases the acidity of urine and reduces protective citrate levels, creating an ideal environment for stones to grow.
In conclusion, calcium oxalate stones are a common problem, but they can be effectively controlled and prevented from recurring through drinking plenty of water, regulating diet, and medical follow-up to protect the health and long-term function of the kidneys.
