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Kidney Stones (Urolithiasis)
  Kidney Stones (Urolithiasis)
 Signs, symptoms, indicators
 Conditions that suggest it
 Contributing risk factors
 It can lead to...
 Treatment recommendations
 


Kidney stones are painful urinary disorders that start as salt/chemical crystals which precipitate out from urine. Under normal circumstances, the urine contains substances that prevent crystallization but for patients with this condition, these inhibitory substances are ineffective. Tiny crystals will pass out along with the urinary flow without causing problems. At least 1% of people will pass a kidney stone during their lifetime, producing some of the most severe pain possible. Kidney stones may contain various forms of salts - the most common is calcium in combination with either phosphate or oxalate. These salts are an essential part of our daily dietary intake and requirement. Other types of stones are the struvite stone (caused by infection), uric acid stone and cystine stone.

Causes & Development


The reasons why some people develop kidney stones are not fully understood. Aside from more obvious risk factors, metabolic conditions e.g. hyperparathyroidism, cystinuria (inherited disease), and hyperoxaluria (inherited disease) are also common causes of stone formation.





Signs, symptoms & indicators of Kidney Stones (Urolithiasis):
Symptoms - Abdominal Pain  Pain at side(s) of abdomen
  Pain at lower front of abdomen
 Kidney stones are characterized by (often extreme) pain at the site where the stone is causing irritation i.e. back and sides of the abdomen, lower front of the abdomen and groin area.

  (Severe) pain under right side of ribs

Symptoms - Metabolic

  Moderate/mild unexplained fevers or unexplained fevers that hit hard or unexplained high fevers

Symptoms - Sleep

  Recent/chronic/acute night sweats

Symptoms - Urinary

  (Recent onset) blood in urine
 The bleeding may be caused by abrasion along the urinary tract as the stone travels.

  Inguinal pain
  (Very) painful urination
 Painful and/or difficult urination is a common sign of a kidney stone.

  (Very) weak urine stream

Conditions that suggest Kidney Stones (Urolithiasis):
Organ Health  Kidney Disease
 A kidney stone that is obstructing will cause damage to the kidneys in the long run if left untreated and may even lead to end stage kidney failure. Anyone with a past history of kidney stones should have regular screening performed as the recurrence rate is high.

Skin-Hair-Nails

  Night Sweats

Symptoms - Urinary

  Kidney stones (confirmed)

Risk factors for Kidney Stones (Urolithiasis):
Autoimmune  Ulcerative Colitis
 When the immune system triggers inflammation in other parts of the body because of ulcerative colitis, kidney stones may result. This influence is usually mild and stones may not be a problem once the colitis is treated.

  Sarcoidosis
 Kidney stone formation can be a sign.

Diet

  Excess Protein Consumption
 High protein intakes may lead to loss of calcium, leading in turn to the development of kidney stones.

Family History

  Kidney stones in family members
 There is a strong familial predisposition to kidney stones.

Hormones

  Hyperparathyroidism
 Increased calcium and phosphorous excretion in the urine may cause kidney stones.

Musculo-Skeletal

  Gout / Hyperuricemia
 Gout (excess uric acid) is a common cause of kidney stones.

Nutrients

  Potassium Need
 When potassium levels fall too low, urine citrate also drops, decreasing your protection against stones.

Supplements and Medications

  (Discontinued) diuretic use
 Excessive intake of diuretics may give rise to excess calcium in the urine.

  Much vitamin D supplementation
 Excessive intake of vitamin D may give rise to excess calcium in the urine.

Symptoms - Food - Beverages

  Insufficient water consumption
 Restricted water consumption is an important causative factor.

Symptoms - Food - General

  Short-term/long-term low-carb dieting or discontinued low-carb diet
 The American Academy of Family Physicians notes that high animal protein intake is largely responsible for the high prevalence of kidney stones in the United States, which can cause severe pain or even urinary obstruction and kidney damage. Plant protein did not seem to have a harmful effect. [American Family Physician 60 (1999): p.2269]

Symptoms - Urinary

  History of kidney stones

Kidney Stones (Urolithiasis) can lead to:
Organ Health  Kidney Disease
 A kidney stone that is obstructing will cause damage to the kidneys in the long run if left untreated and may even lead to end stage kidney failure. Anyone with a past history of kidney stones should have regular screening performed as the recurrence rate is high.

Recommendations and treatments for Kidney Stones (Urolithiasis):
Botanical  Hydrangea
 A Dr. Scudder, writing in 1874, wrote: "[Hydrangea] is a valuable remedy in diseases of urinary apparatus. It gives tone to the kidneys, improving their functional activity, and thus tends to arrest the formation of urinary deposits and calculi. It relieves irritation of the bladder and urethra and hence proves serviceable in cases of gravel."

A Dr. Ellingwood wrote, in 1905: "About the year 1830 experiments were conducted to prove [Hydrangea's] influence in relieving pain caused by the presence and passage of urinary calculi, and favourable reports were made of its direct usefulness. Its influence controlled the pain in a satisfactory manner, relieved general distress, and soothed irritation."

Diet

  Increased Water Consumption
 Prevention is very important especially in those with a high likelihood of developing this condition since the recurrence rate of stone formation is very high. Drinking a lot of water is the best preventative measure: drink enough to produce approximately 2 liters (one-half gallon) of urine per day. Adequate fluid intake helps prevent kidney stone problems by allowing most small stones to pass through.

  Dairy Products Avoidance
 Those with a tendency to form calcium stones may want to avoid foods rich in calcium, such as dairy products.

  Caffeine/Coffee Avoidance
 A study published September, 2004 in the journal Urology suggests people prone to kidney stones should limit their intake of caffeine and cut down on the amount of coffee they drink. People who consumed caffeine in amounts equal to two cups of coffee showed elevated levels of calcium in their urine, which can increase the risk of developing stones, especially for people prone to stones. "Caffeine consumption may modestly increase risk of calcium oxalate stone formation," concluded the researchers.

  Oxalate Avoidance
 Those prone to getting calcium oxalate stones are advised to avoid the consumption of foods high in oxalates.

Drug

  Conventional Drug Use
 For prevention of stone formation, medical therapy is available for those with known predisposing conditions. For those with stones, pain-killers (as prescribed by a doctor) can provide great relief. In addition, some medications may help break down larger stones.

Mineral

  Magnesium
 By increasing calcium solubility (especially in the urine) and reducing calcium absorption, magnesium can help prevent kidney stones, especially those composed of calcium oxalate. Research has shown this effect in a high percentage of people who form kidney stones regularly. It is thought that calcium oxalate stones are most likely to form in people who are magnesium deficient, so it may just be correcting that deficiency.

  Multiple Mineral Supplementation

Not recommended:
  Calcium
 High levels of urinary calcium, due to an excess of non-absorbable calcium being consumed, can cause crystallization and subsequent stone formation. Those with a tendency to form calcium stones are advised to abstain from taking non-prescribed calcium pill supplements.

Surgery/Invasive

  Surgery
 Surgical intervention - cystoscope or open surgery - may be required if other physical intervention, such as shockwave therapy (F-SWL) to break up stone(s) is unsuccessful.

Vitamins

  Vitamin B6 (Pyridoxine)
 Vitamin B6 deficiency leads to an increase in kidney stones as a result of elevated urinary oxalate levels. Vitamin B6 supplementation inhibits the production of oxalate in the body and can reduce elevated urinary oxalate in some stone formers who are not necessarily B6 deficient.


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
May do some good
Likely to help
Highly recommended
May have adverse consequences


GLOSSARY

Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.

Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.

Chronic Renal Failure (Chronic Renal Insufficiency, Kidney Failure, Renal Insufficiency)
(CRF) Irreversible, progressive impaired kidney function. The early stage, when the kidneys no longer function properly but do not yet require dialysis, is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to diagnose, as symptoms are not usually apparent until kidney disease has progressed significantly. Common symptoms include a frequent need to urinate and swelling, as well as possible anemia, fatigue, weakness, headaches and loss of appetite. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxic metabolites, normally filtered out of the blood by the kidneys, build up to harmful levels. Over time (up to 10 or 20 years), CRF generally progresses from CRI to End-Stage Renal Disease (ESRD, also known as Kidney Failure). Patients with ESRD no longer have kidney function adequate to sustain life and require dialysis or kidney transplantation. Without proper treatment, ESRD is fatal.

Colitis
Colon inflammation, usually involving the mucus membranes. Mucus colitis is a type with cramps, periods of constipation, and copious discharge of mucus with feces. Ulcerative colitis has pain, inflammation, ulceration, fever, and bleeding, all interspersed at various times - a long and serious illness.

Cup (Cups)
A unit of volume measurement equal to 8 fluid oz, or roughly 250ml. It also equals 1/2 pint, 1/4 quart and 1/16 gallon.

Cystine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. Cystine is a structural component of tissues and hormones. Interconvertible with L-Cysteine.

Diuretic (Diuretics)
An agent increasing urine flow, causing the kidneys to excrete more than the usual amount of sodium, potassium and water.

Gout
A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.

Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).

Kidney Stone (Kidney Gravel, Kidney Stones)
A stone (concretion) in the kidney. If the stone is large enough to block the tube (ureter) and stop the flow of urine from the kidney, it must be removed by surgery or other methods. Also called Renal Calculus. Symptoms usually begin with intense waves of pain as a stone moves in the urinary tract. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin. The pain may continue if the stone is too large to pass; blood may appear in the urine and there may be the need to urinate more often or a burning sensation during urination. If fever and chills accompany any of these symptoms, an infection may be present and a doctor should be seen immediately.

Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.

Liter (Liters, Litre, Litres)
A metric measure of volume equivalent to 1.057 liquid quarts or 0.2642 gallons.

Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.

Potassium
A mineral that serves as an electrolyte and is involved in the balance of fluid within the body. Our bodies contain more than twice as much potassium as sodium (typically 9oz versus 4oz). About 98% of total body potassium is inside our cells. Potassium is the principal cation (positive ion) of the fluid within cells and is important in controlling the activity of the heart, muscles, nervous system and just about every cell in the body. Potassium regulates the water balance and acid-base balance in the blood and tissues. Evidence is showing that potassium is also involved in bone calcification. Potassium is a cofactor in many reactions, especially those involving energy production and muscle building.

Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Ulcerative Colitis (Colitis Ulcerosa)
Ulceration of the colon and rectum, usually long-term and characterized by rectal bleeding or blood in the stool, frequent urgent diarrhea/bowel movements each day, abdominal pain.

Uric Acid (Hyperuricemia)
The final end product of certain native or dietary proteins, especially the nucleoproteins found in the nucleus of cells. Unlike the much smaller nitrogenous waste product urea, which is mostly recycled to form many amino acids, uric acid is an unrecycleable metabolite that must be excreted: nucleoprotein to purine to uric acid to the outside in the urine or the sweat. Hyperuricemia: Having elevated blood uric acid, either from a rapid rate of cell breakdown and synthesis (such as might occur from fasting, heavy training, trauma or any number of major diseases), a high consumption of organ meats, glandular supplements or spirulina, or the inability (usually hereditary) to excrete uric acid in the urine as fast as it is produced, even though production itself is not elevated.

Urinary Calculi
Concretions in the urethra.

Urinary Tract (UT)
The kidneys and the lower urinary tract, which includes the ureters, bladder, and urethra.

Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.

Vitamin D
A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.




Last updated: Oct 08, 2008


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