When a young manager suddenly collapsed in office, clutching at his groin while writhing in pain, his colleagues were aghast. They rushed him to hospital, where the doctor in the emergency room checked him before advising that he be admitted. It turned out that he had kidney stones, clinically know as renal calculi. The excruciating pain had been caused by one such descending into the ureter. Neither the patient, nor his family and friends had a clue how these developed. It was all the more puzzling because he followed a healthy routine, and exercised regularly. March is kidney month, which makes it vital for you to consider the ways and means to keep your kidneys healthy.
Renal calculi, or kidney stones develop from the dissolved salts and minerals like calcium, potassium, and sodium in your urine, which crystallize, stick together, and harden to form stones in your kidney. They are also called renal lithiasis or nephrolithiasis. Calcium stones usually derive from calcium oxalate or calcium phosphate. Though they usually form in the cavities in your kidneys, trouble starts when they become bigger, and begin interfering with the flow of urine, or as cited above, descend into the ureter. The smaller ones might even pass through your urine without your noticing. However, the larger ones could grow to the size of golf balls. All of them have sharp edges.
The primary function of your kidneys is to eliminate waste, and control the levels of calcium, potassium, and sodium in your urine. Calcium stones which occur in the form of calcium phosphate are more common in metabolic diseases like renal tubular acidosis; and with taking certain vaccinations like topiramate (Topamax) used to treat migraine headaches or seizure. A high sodium diet increases the amount of calcium to be filtered by your kidneys, which increases the chances of kidney stones. Drinking too little water is the biggest cause of the formation of kidney stones. It causes retention of dissolved minerals, and prevents elimination of uric acids and other wastes. The latter crystallizes to form uric acid stones. Too much uric acid could be caused by a diet that is high in animal protein and low in fruits and vegetables; type 2 diabetes i.e. high blood sugar; gout; being overweight; and chronic diarrhea.
Magnesium ammonium phosphate (struvite) stones usually originate from chronic urinary tract infections (UTIs); long-term usage of tubes to empty bladders; or when people have difficulty in evacuating their bladder due to neurological reasons like spina bifida, multiple sclerosis, or paralysis. Though cystine is an amino acid — one of the building blocks of protein — when the kidneys do not reabsorb cystine from the urine, the high amounts of cystine in the urine cause cystine stones to form. Prolonged usage of energy drinks could cause kidney stones.
Some of the other risk factors include taking too many painkillers, calcium loaded antacids, or diuretics can cause serious kidney damage leading to calculi. Being overweight; having a diet overloaded with salt, proteins, and sugar; having a personal or family history of kidney stones; if you have had gastric bypass surgery or another intestinal surgery, have polycystic kidney disease, or another cystic kidney disease. High calcium levels in the blood and urine can be caused by hyperparathyroidism — abnormal growth of one or more of the parathyroid glands — which control calcium metabolism, or when you have ailments like medullary sponge kidney, Crohn’s disease, or Dent’s disease.
Unexplained nausea, vomiting; sudden sharp shooting pains in the groin, lower abdomen, or lower back; painful micturition; or pain that comes in waves and of fluctuating intensity should alert you to kidney damage. When there is a fever or chills accompanying the pain; it is a signal of some serious health issue which could range from infection to renal calculi and chronic kidney disease. Changes in urine which you should take note of include passing blood in your urine; changes in color to red, brown, or pink; urine that foams on passing, or is cloudy and/or foul smelling.
Changes in the frequency and quantity of urine should also be noted. Are you urinating frequently without a proportionate increase in fluid intake, or urinating less? If there is a burning sensation too, it is probably more than an infection. Is there a persistent urge to go and relieve yourself? See a doctor immediately to identify whether there are kidney stones, or whether some other kidney disease, or even diabetes has affected you.
Prevention is far simpler than it might seem. Follow a healthy diet with adequate helpings of vegetables and fruits; limit intake of animal protein; lose weight; drink plenty of fluids; stop smoking; keep your blood pressure and sugar levels healthy. Avoid foods laden with carbs and sodium. Maintain the pH balance within your body to prevent it becoming acidic.
Usually, blood in the urine and/or sharp pains which cause the patient to double up are the red flags which alert your doctor. Typically, an x-ray — intravenous pyelogram or CT urogram — are carried out as the dye travels through your kidneys and bladder. Alternatively, a computerized tomography (CT) scan, or an ultrasound are carried out to identify the existence and location of the kidney stones, if there is an emergency. However, your doctor might prefer to test your blood for calcium and/or uric acid levels. A 24-hour urine collection, collected over two separate days, is tested to see if there is presence of too many stone-forming minerals or too few stone-preventing substances.
This is one health issue which often responds better to natural and home remedies, thereby circumventing the need for medical or surgical intervention. However, the doctor might give you some medication for pain relief, and/or some alpha blocker which relaxes the muscles in your ureter to aid urination. If the stones are very small, and there is no obstruction of the ureter; then most doctors will advise drinking plenty of fluids to literally flush out the stones in the urine. Some people take it as the doctor’s approval to drink bottles of chilled beer in the blazing summer months. It isn’t. The doctor said fluids — plain water, green tea, fresh fruit juices (except pineapple juice which is full of oxalic acid; dairy drinks like milk; lassi, chhachh; the water from boiled lentils, clear soups are some of your choices. Since Vitamin C aids the removal of uric acid in the urine; the juices of citrus fruits are an excellent choice.
Barley water, with or without the juice of limes, increases urine output naturally. Another method is to soak kulthi dal or kulottho kolai in boiling water, cover and keep overnight. Drink the water first thing in the morning. It breaks larger kidney stones into smaller ones, and helps the smaller ones get flushed out of your system.
If there is any major blockage or several large calculi; your doctor might opt for shock wave lithotripsy, which breaks down the stones into tiny fragments, which then pass out of the body through the urine. Surgical interventions include ureteroscopy, parathyroid gland surgery, and percutaneous nephrolithotomy.