Be kind to your kidneys

Kidney stones can be excruciatingly painful and cases are on the increase, discovers Michele O’connor

Kidney stones are more common than people think – and can bring pain like you’ve never experienced before. “They start as crystals in the urine which, over time, can build up to form a stone,” says Fadi Housami, urologist and lead stone surgeon at Aintree University Hospital and The Sefton Suite private hospital.

Kidney stones come in a variety of sizes, shapes and colours. Some are like grains of sand but others can grow to the size of a golf ball.

While a family history of stones and pre-existing conditions, such as diabetes, makes people more prone to developing them, cases are rising.

Data suggests an increase from 10 to 14 per cent – which means one in seven people will require hospital admission or treatment.

Why are rates rising?

“A combination of obesity, poor hydration, high blood pressure and a lack of exercise have led to a surge,” says professor of urology Bhaskar Somani, at University Hospital Southampton NHS Foundation Trust. They are primarily found in developed countries, probably because diets are rich in saturated fat, animal protein, sugar and salt, which increase the risk of crystals forming. It is exacerbated by not drinking enough water – and too much caffeine and alcohol.

“Crystals are more likely to form in concentrated urine due to reduced fluid intake,” explains Mr Housami. Inactivity also plays a part. “A sedentary lifestyle means that crystals are less likely to move and pass spontaneously.” What’s more, patients who have already had a stone have a 50 per cent chance of another one within 10 years.

Signs and symptoms

“Some patients with kidney stones have no symptoms at all and stones may be found incidentally on a scan performed for other reasons,” explains Mr Housami.

However, patients typically experience discomfort in the flank (the area either side of the lower back), a burning pain when passing urine and blood in the urine.

If a stone moves from the kidney to the ureter (the tube that connects the kidney to the bladder), it can cause waves of excruciating pain, known as renal colic, in the back, abdomen, groin and/or genitals.

Treatment

“Treatment options depend on the symptoms, location, size and density of the stone, as well as the potential risk to the kidney,” explains Mr Housami.

There’s every chance a tiny stone will pass in urine on its own, although pain relief may be required.

Slightly larger stones require medical intervention.

Methods include external shock wave lithotripsy (ESWL), which involves using sound wave vibrations to break up the stones; sending a scope up the urinary tract (ureteroscopy) to break up the stone using a laser, or surgically removing the stone through an incision made in the back.

Prevention is better than cure

„ Drink more water: Aim for two to 2.5 litres continuously throughout the day, rather than going from periods of dehydration to drinking lots in one go.

If you get stones regularly, fresh lemon or orange juice can increase citrate and alkaline levels in the urine, which could prevent certain types forming.

„ Keep an eye on the colour of your urine It should be reasonably dilute – light yellow in colour.

„ Certain foods and drinks can increase your risk Sugary drinks contain large amounts of fructose corn syrup which has a strong association with kidney stones formed from calcium oxalate – the most common kind.

High-oxalate foods include beetroot, spinach, Swiss chard and rhubarb. Reduce salt and avoid high-protein diets.

„ Maintain a healthy weight

Obesity doubles the risk of kidney stones in women and increases it by 30 per cent for men.

„ Get five-a-day, and drink milk

There’s evidence that the potassium in fruit and vegetables and dairy products lower the risk of stones.