Stoned: Everything You Need to Know About Kidney Stones

At three in the morning, she found herself doubled over on the bathroom floor, grappling with pain so fierce it took her breath away. "It felt like someone was twisting a knife in my back while simultaneously punching me in the gut," she recounted.

Graphic? Yes. An exaggeration? Definitely not!

Renal colic—what doctors call the intense, sometimes unbearable pain due to kidney stones—is described as the worst pain that patients experience. Some women even compare it to the pain they experience during childbirth. It’s not surprising that passing a kidney stone is the 9th most common reason people end up in the emergency room.

Imagine a sharp, jagged pebble trying to squeeze through a tiny, tender tube in your body. That's what happens when a kidney stone exits the kidney and makes its way down the ureter to the urinary bladder. 

Given the severe pain kidney stones can cause, one would want to avoid this experience. Here, we'll learn how kidney stones are formed, uncover the keys to preventing them, and discuss the best strategies for treatment as soon as they're detected.

Nephrolithiasis, or kidney stones, affects about 12% of people worldwide. 

The kidneys' main job is cleaning the blood, creating urine from waste and extra fluids. When there's too much waste (like calcium, oxalate, and uric acid in the blood) and insufficient fluid to dilute it, crystals start forming. Unless they are expelled through the urine, these crystals combine with other waste material to form a stone, which can range significantly in size—from as tiny as a grain of sand to as big as a golf ball.

The most common type of stone, found in about 80% of cases, is the calcium stone, primarily made of calcium oxalate. Other types include uric acid stones, struvite stones, and cystine stones. It's interesting to note that a person could have stones of different crystal types.

While anyone can get kidney stones, men face this issue more often than women. 

Your health, lifestyle, and even the makeup of your urine can influence your risk factors for developing kidney stones. 

• If you've had kidney stones before, your chance of getting them again jumps by 15% within a year and by 50% over the next ten years.
• A family history of kidney stones makes you 2.5 times more likely to develop them.
• Urinary tract infections, especially with certain bacteria, can change your urine in a way that favours the formation of struvite stones.
• Consuming large quantities of animal proteins, such as those found in meats, can increase uric acid levels and acidity in urine, raising the risk for uric acid stones. Similarly, low-carb and high-salt diets, along with processed foods high in sugar, contribute to the problem by straining the kidneys.
• Lack of fluid intake, especially in warmer climates due to global warming, enhances the risk of dehydration, which oversaturates the urine. Low calcium intake combined with dehydration leads to the formation of calcium oxalate stones. 
• A history of diabetes, obesity, gout, or high blood pressure also ups your chances.
• Having acidic urine, with a pH below 5.5, helps uric acid stones to form, especially if you often have diarrhoea or gout.
• A rare genetic condition called cystinuria causes excessive cystine (an amino acid and building block of protein) to leak into the urine, forming cystine stones that tend to recur multiple times. 

Sometimes, small stones pass through quite easily, and you might never realise they were there. Larger stones may get stuck, blocking urine flow and causing kidney stone symptoms like painful urination, blood in your urine, and severe pain in your back or lower abdomen (known as renal colic). These symptoms are often accompanied by nausea, fever and chills, foul-smelling or cloudy urine, and vomiting. 

Kidney stone symptoms may last 2-3 weeks as the stone passes through the urinary system if it is small enough to move and be expelled through the urine. Passing a kidney stone typically unfolds in stages—from initial pain as it moves from the kidney, lessening discomfort once it reaches the bladder, to the final push through the urethra—taking anywhere from 1 to 4 weeks, with larger stones possibly needing medical intervention. 

If left untreated, a kidney stone causes significant damage to the urinary system. Here’s what might happen:

• If a stone gets stuck, it can potentially block the urine flow, making it easier for infections to develop since the accumulated urine creates a breeding ground for bacteria. This causes urinary tract infections (UTIs) or, more seriously, kidney infections (pyelonephritis).
• If the blockage isn’t cleared over time, it can start to harm the kidneys. The pressure from backed-up urine can damage the kidneys’ delicate filtering system, leading to kidney function loss (renal insufficiency).
• Kidney stones cause the kidney to swell (hydronephrosis) as urine builds up, leading to discomfort and, over time, acute or chronic renal failure. 

Do:

• Aim for at least eight glasses of water a day to keep urine diluted and flush out waste products that could form stones. The Stanley Cup craze, with everyone rushing to buy these trendy tumblers, reflects a rising awareness about hydration among Gen Z, even if it's the appeal of a viral cup driving this trend.
• Include foods high in calcium (like dairy and leafy greens) to bind with oxalate in the gut, reducing stone risk.
• Talk to your doctor about medications to help manage your risk factors for calcium oxalate or uric acid stone formation.

Don't:

• Overconsume salt, as high sodium levels in processed and fast food lead to dehydration.
• Eat too many oxalate-rich foods like spinach, chocolate, and nuts have high oxalate levels, which can contribute to stone formation.
• Overload on animal proteins, as these in large amounts, can increase the risk of purine stones due to higher acid levels in the urine.

Kidney stone treatment often involves medications to manage symptoms and help the stone pass through the urinary system. Doctors may prescribe medication to alleviate severe renal colic, relax the muscles in the ureter walls, making it easier for the stone to pass through. In cases where infection is a risk doctors will prescribe additional medication to support their patient. In severe cases, surgical procedures may be advised.

Navigating the journey with kidney stones might seem daunting at first, but with modern medical advances and a deeper understanding of prevention strategies, there's a clear path forward. Remember, every step taken towards better hydration, healthier eating, and regular check-ups is a step away from the discomfort of kidney stones and a step towards a healthier, happier you.