Kidney Stones (Urolithiasis)

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.

The reasons why some people develop kidney stones are not fully understood. There is certainly a strong familial predisposition to this condition, and restricted water consumption is another important factor. High levels of urinary calcium, due to an excess of non-absorbable calcium being consumed, can cause crystallization and subsequent stone formation. Metabolic conditions e.g. hyperparathyroidism, cystinuria (inherited disease), and hyperoxaluria (inherited disease) are also common causes of stone formation.

Treatment

  • With plenty of water, most stones can pass through if small.
  • Pain-killers (as prescribed by the doctor)
  • Some medications may help ‘breakdown’ larger stone
  • Shockwave therapy (F-SWL) to break the stone
  • Surgical intervention – cystoscope or open surgery

Prevention

Prevention is very important especially in those with a high likelihood of developing this condition. Recurrence rate for stone formation is very high.

  • Drinking a lot of water is best (enough to produce about 2 liters of urine a day).
  • Those with a tendency to form calcium stones may want to avoid foods rich in calcium (dairy products) and abstain from taking non-prescribed calcium pill supplements.
  • Those prone to get calcium oxalate stones may be advised to avoid the consumption of foods high in oxalates (cola, coffee, chocolate, nuts, spinach, strawberries, wheat bran, tea)
  • Medical therapy is available for those with known conditions that predispose to stone formation.

 


Signs, symptoms & indicators of Kidney Stones (Urolithiasis)

Symptoms - Metabolic  

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



 

Having a slight/having a moderate/having a high fever



Symptoms - Sleep  

Acute/recent night sweats



Counter Indicators
Symptoms - Sleep  

Chronic night sweats



Symptoms - Urinary  

Having blood in urine

The bleeding may be caused by abrasion along the urinary tract as the stone travels.



 

(Very) painful urination

Painful and/or difficult urination is a common sign of a kidney stone.




Conditions that suggest Kidney Stones (Urolithiasis)

Organ Health  

Kidney Weakness / 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  



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.



Diet  

Excess Protein Consumption

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



 


Hormones  


Infections  

Nanobacteria Infection

Tiny little bacteria that build a mineral shell for themselves could be the cause of kidney stones, Finnish researchers recently discovered. They said they found the bacteria, known as nanobacteria because of their small size, in human blood serum and also in kidney stones.

“Nanobacteria are the smallest cell-walled bacteria, only recently discovered in human and cow blood and commercial cell culture serum,” they wrote in their report in the Proceedings of the National Academy of Sciences. They found nanobacteria in both human and cow serum. When they let the serum sit in a test tube for a little while, the bacteria settled on the bottom. They quickly developed a thick shell. “These apatite shelters … were apparently the dwelling place of the organisms,” they wrote. These could be the starting points of kidney stones, which build up layer by layer, something like a pearl forming on a piece of sand inside an oyster. So they looked at kidney stones.

“We performed a pilot survey on 30 human kidney stones to assess whether nanobacteria might be found.” Tests showed they were in all 30 kidney stones. Blood serum itself, they said, contains chemicals that suppress the formation of mineral layers. But they said they had found earlier that nanobacteria can be transported from the blood to the kidneys.



Musculo-Skeletal  

Gout / Hyperuricemia

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



Supplements and Medications  

(Past) diuretic use

Excessive intake of diuretics may give rise to excess calcium in the urine.



 

Vitamin D supplementation

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



Symptoms - Urinary  

History of kidney stones



Counter Indicators
Symptoms - Urinary  

Absence of blood in urine

The bleeding may be caused by abrasion along the urinary tract as the stone travels.




Kidney Stones (Urolithiasis) suggests the following may be present

Diet  



Kidney Stones (Urolithiasis) can lead to

Organ Health  

Kidney Weakness / 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 (Hydrangea arborescens)

Hydrangea is best known for its solvent properties that help break down and prevent further formation of stones and deposits in the urinary system. Hydrangea has been used for hundreds of years in folk medicine to contribute to the elimination of deposits in the bladder and kidneys.



 

Gravel root (Eupatorium pupureum)

Gravel root is used primarily for kidney stones or ‘gravel’.



 


 


 


Diet  

Increased Water Consumption

Adequate fluid intake helps prevent kidney stones.



 

Oxalate Avoidance

The most common type of stone contains calcium in combination with either oxalate or phosphate. These chemicals are part of a person’s normal diet and make up important parts of the body, such as bones and muscles. Oxalate avoidance / reduction in the diet can help prevent subsequent stone formation in those who tend to form calcium oxalate stones.



 

Vegetarian/Vegan Diet

Sixty men with recurrent kidney stones who were on a low animal protein and low salt diet were compared with 60 men who were on a low calcium diet. It was found during a 5 year followup that only 12 out of 60 men on the low animal protein, low salt diet had a recurrence of kidney stones while 23 of 60 men on the low calcium diet had a recurrence. [NEJM January 10, 2002;346(2): pp. 77-84]



 

Pumpkin Seeds

Two Thailand studies have suggested that eating pumpkin seeds as a snack can help prevent the most common type of kidney stone. The mechanism of action has not been identified. Approximately 5-10gm per day of pumpkin seeds are needed for stone prevention.



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.



 

Potassium

Urocit-K is a patented formulation of potassium citrate. Urocit-K is available in slow-release wax-matrix tablets in 540 mg and 1080 mg strengths. Urocit-K is indicated for the treatment of calcium and uric acid kidney stones. UROCIT-K is clinically proven to inhibit the formation of most stones in over 90% of patients.



 


Physical Medicine  

Ultrasound

Lithotripsy uses ultrasound waves to break up kidney stones and gallstones. The treatment is performed in hospital using special equipment and is becoming more and more common.



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
Strongly counter-indicative
May do some good
Likely to help
Highly recommended

Glossary

Kidney Stone

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.

Calcium

The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and 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.

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.

Metabolism

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.

Chronic Renal Failure

(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.

Immune System

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.

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.

Colitis

Inflammation of the colon.

Protein

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.

Bacteria

Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Mineral

Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.

Serum

The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Gout

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

Diuretic

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

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.

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