Kidney Stones (Urolithiasis)

Kidney Stones (Urolithiasis): Overview

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 and 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.

Kidney Stones

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Signs, symptoms & indicators of Kidney Stones (Urolithiasis):

Symptoms - Abdomen

Severe lower front abdominal pain is often a sign or symptom of Kidney Stones (Urolithiasis)Serious/severe lower front abdominal pain or lower front abdominal discomfort
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.

Symptoms - Metabolic

Symptoms - Sleep

Symptoms - Urinary

(Recent onset) blood in urine is a sign or symptom of Kidney Stones (Urolithiasis)(Recent onset) blood in urine
The bleeding may be caused by abrasion along the urinary tract as the stone travels.
(Very/slightly) painful urination is often a sign or symptom of Kidney Stones (Urolithiasis)(Very/slightly) painful urination
Painful and/or difficult urination is a common sign of a kidney stone.

Conditions that suggest Kidney Stones (Urolithiasis):

Organ Health

Kidney Disease may suggest Kidney Stones (Urolithiasis)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

Symptoms - Urinary

Risk factors for Kidney Stones (Urolithiasis):

Autoimmune

Ulcerative Colitis may increase risk of Kidney Stones (Urolithiasis)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 may increase risk of Kidney Stones (Urolithiasis)Sarcoidosis
Kidney stone formation can be a sign.

Diet

Excess Protein Consumption may increase risk of Kidney Stones (Urolithiasis)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 often increases risk of Kidney Stones (Urolithiasis)Kidney stones in family members
There is a strong familial predisposition to kidney stones.

Hormones

Hyperparathyroidism often increases risk of Kidney Stones (Urolithiasis)Hyperparathyroidism
Increased calcium and phosphorous excretion in the urine may cause kidney stones.

Musculo-Skeletal

Gout / Hyperuricemia may increase risk of Kidney Stones (Urolithiasis)Gout / Hyperuricemia
Gout (excess uric acid) is a common cause of kidney stones.

Nutrients

Potassium Need may increase risk of Kidney Stones (Urolithiasis)Potassium Need
When potassium levels fall too low, urine citrate also drops, decreasing your protection against stones.

Supplements and Medications

(Discontinued) diuretic use may increase risk of Kidney Stones (Urolithiasis)(Discontinued) diuretic use
Excessive intake of diuretics may give rise to excess calcium in the urine.
Much vitamin D supplementation may increase risk of Kidney Stones (Urolithiasis)Much vitamin D supplementation
Excessive intake of vitamin D may give rise to excess calcium in the urine.

Symptoms - Food - Beverages

Insufficient water consumption often increases risk of Kidney Stones (Urolithiasis)Insufficient water consumption
Restricted water consumption is an important causative factor.

Symptoms - Food - General

Long-term low-carb dieting may increase risk of Kidney Stones (Urolithiasis)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

Kidney Stones (Urolithiasis) can lead to:

Organ Health

Kidney Stones (Urolithiasis) often leads to Kidney DiseaseKidney 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 for Kidney Stones (Urolithiasis):

Botanical

Hydrangea often helps with Kidney Stones (Urolithiasis)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 is highly recommended for Kidney Stones (Urolithiasis)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 often helps with Kidney Stones (Urolithiasis)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 often helps with Kidney Stones (Urolithiasis)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 often helps with Kidney Stones (Urolithiasis)Oxalate Avoidance
Those prone to getting calcium oxalate stones are advised to avoid the consumption of foods high in oxalates.

Drug

Conventional Drug Use often helps with Kidney Stones (Urolithiasis)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.
Diuretics often helps with Kidney Stones (Urolithiasis)Diuretics
Thiazides lower urinary calcium excretion, which helps prevent calcium-based kidney stone formation.

Mineral

Magnesium is highly recommended for Kidney Stones (Urolithiasis)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.
Phosphorus may help with Kidney Stones (Urolithiasis)Phosphorus
Phosphorus is used clinically to treat calcium-based kidney stones.
Not recommended:
Calcium is sometimes not recommended for Kidney Stones (Urolithiasis)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 often helps with Kidney Stones (Urolithiasis)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) may help with Kidney Stones (Urolithiasis)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: may be a sign or symptom of; may suggest; may increase risk of
Weak or unproven link:
may be a sign or symptom of; may suggest; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often suggests; often increases risk of; often leads to
Strong or generally accepted link:
is often a sign or symptom of; often suggests; often increases risk of; often leads to
Definite or direct link: is a sign or symptom of; strongly suggests
Definite or direct link:
is a sign or symptom of; strongly suggests
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Very useful: is highly recommended for
Very useful:
is highly recommended for
Caution: is sometimes not recommended for
Caution:
is sometimes not recommended for