Twenty-six-year-old Richard (name changed upon request), who works in the marine industry in the United States, was first diagnosed with a kidney stone in November 2016.
Since the 9mm stone couldn’t pass on its own, doctors recommended that Richard undergo a laser lithotripsy procedure (a laser treatment through which stones from the kidney, bladder, urethra and ureters are removed by breaking them down into tiny fragments).
“The hardest part of having stones is the effect on my daily life and work,” Richard tells Happiest Health. “I was unable to work because of the pain and nausea. I lost a significant amount of weight and appeared sickly to co-workers when I returned after healing from the lithotripsy.”
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In 2021, Richard was diagnosed with kidney stones again, throwing his life out of gear once more.
“The pain during the first episode was unbearable,” he says. “I lost 20-30 pounds (about 9-13kg) through the entire process until returning to work. The second stones were very uncomfortable. However, I was able to manage.”
Richard says that during the second episode, he was able to spend time at home, dealing with the symptoms of kidney problem. “It would’ve been very uncomfortable if I had been working because of the constant sensation of needing to urinate,” he says.
Causes of kidney stones
Dr A Santosh Kumar, a nephrologist with Kamineni Hospitals, LB Nagar, Hyderabad, says that the crystallization of high-concentration excretory products in the urine is what leads to the formation of kidney stones.
Dr Tarun Javali, professor and head of department of urology, andrology, renal transplant and robotic surgery, MS Ramaiah Medical College Hospital, Bengaluru, says that there are four different types of kidney stones that form in the human body — calcium stones, struvite (magnesium ammonium phosphate) stones, uric acid stones and cystine (amino acid) stones.
Symptoms of kidney stones
According to Dr Javali, a kidney stone will usually not cause symptoms until it moves around within the kidney or passes into one of the ureters. He says some of the common symptoms include:
- Severe, sharp pain in the side and back, below the ribs
- Pain that radiates to the lower abdomen and groin
- Pain that comes in waves and fluctuates in intensity
- Pain or burning sensation while urinating
- Nausea and vomiting associated with pain
Dr Javali says that a suspected kidney stone can be diagnosed by clinical examination, ultrasound sonography and a CT (computerized tomography) scan.
Dr Kumar says that while an ultrasound is the most sensitive in terms of detecting stones, an X-ray can detect the presence of calcium stones and a CT scan can detect both the size and the location of the stone, which helps doctors in understanding the type of treatment method to be adopted.
Who is at higher risk of developing kidney stones?
According to Dr Javali, one of the factors that can increase the risk is a family or personal history of kidney stones. If someone in the family has had kidney stones or if the person has had one or more kidney stones in the past, there is increased risk of developing another, he says.
This is true for Richard, who, after his first two episodes of kidney stones, is currently experiencing all the symptoms of another episode: pains, nausea and lack of appetite.
“[During] the current episode, I haven’t passed the stone yet to my knowledge,” he says. “The pain is similar in intensity and location to my previous stones. The pain subsided, but I’m seeing a doctor later this week for verification.
“This most recent episode began while I was on vacation, and I spent a good amount of time lying in bed because it made me feel better. I missed out on some family activities due to the pain. Very frustrating.”
Dr Javali says other factors that can put a person at higher risk of developing kidney stones include:
- Dehydration: Not drinking enough water each day can increase the risk of kidney stones. People who live in warm, dry climates and those who sweat a lot may be at higher risk of developing kidney stones than others
- Certain diets: Eating a diet that’s high in protein, sodium (salt) and sugar may increase the risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much salt in the diet increases the amount of calcium the kidneys must filter and significantly increases the risk of kidney stones
- Obesity: High body mass index, large waist size and weight gain have been linked to an increased risk of kidney stones
- Digestive diseases and surgery: Gastric bypass surgery, inflammatory bowel disease or chronic diarrhoea can cause changes in the digestive process that affect the absorption of calcium and water, increasing the amounts of stone-forming substances in the urine
Dr Javali says that certain other medical conditions — such as renal tubular acidosis (a condition where the kidneys fail to remove acids from the blood into the urine, leading to accumulation of acid in the body), cystinuria (an inherited metabolic disorder where buildup of amino acid cystine occurs in the urine), hyperparathyroidism (when the parathyroid glands create high amounts of parathyroid hormone in the bloodstream) and repeated urinary tract infections — can also increase the risk of getting kidney stones.
“Certain supplements (such as vitamin C, dietary supplements) and medications — such as laxatives (when used excessively), calcium-based antacids and certain medications used to treat migraines or depression — can increase your risk of kidney stones,” he says.
Richard, meanwhile, says that consumption of too many energy drinks and dehydration may have contributed to him developing stones. “Energy drinks, coffee and some common foods are high in oxalate. It’s possible, if not likely, that the drinks mixed with dehydration from exertion could have led to the formation of the stones.”
The size of the stone is what determines how one is treated, Dr Kumar says.
“Smaller stones with a size lesser than 4mm have a 90 per cent chance of coming out naturally, while stones larger than 6mm have only a 10 per cent chance of coming out naturally,” he says. “Medications to decrease pain and relax the ureters help in passing the small stone at the lower third (lower end of the ureter). Surgery is an option for stones which are not passing spontaneously or with medication.”
Dr Javali says that most small kidney stones won’t require invasive treatment. He says that one may be able to pass a small stone by drinking water and taking painkillers. Several treatment methods are available for larger stones, he says.
The treatment Richard received during his first episode with the 9mm stone was laser lithotripsy. “The first attempt was unsuccessful due to inflammation and swelling, which meant they placed a stent (a small tube placed in the ureter to allow urine to pass from the kidney to the bladder), and I went back a week later for another attempt,” he says. “The second attempt was successful, and a stent was placed afterwards. The second episode required no medical intervention as I passed the stones myself with a great deal of discomfort.”
Richard says that he is now unable to undergo another lithotripsy or a similar procedure because he has a medical device installed that prohibits such procedures.
The US National Kidney Foundation, a not-for-profit group recommends the following ways to keep kidney stones at bay:
- Stay well hydrated, especially when engaging in exercise or activities that induce a lot of sweat
- Cut back on sodium (salt-rich) foods in your diet and pair calcium-rich foods with oxalate-rich foods
- Add lemon juice concentrate mixed with water to your diet
- Follow the advice of nephrologists and urinary specialists when it comes to taking medications and making diet adjustments
Scary! Helpful read about kidney stone.