What Are The First Signs Of Kidney Stones?

If you ever feel tired, just remember that you have more than 1 million nephrons working in each of your kidneys to filter toxins out of your blood, convert blood into urine to excrete numerous toxic substances, reabsorb nutrients, and maintain the body’s homeostatic functions. 

“So, every day is a good day if you take care of your kidneys!”

You will agree with me as you go through this article and learn how important your kidneys are! We will also understand the risk factors and preventive care for kidney stones. 

Why are kidneys so important?

I don’t have to introduce these two little bean-shaped organs that keep our body free from toxins. 

The major job of your kidneys is flushing out toxic waste from your blood and converting it to urine, which is then carried out from the ureters to the bladder. 

The renal system filters approximately 200 litres of fluid a day from renal blood flow. Kidneys are known to support all major body functions:

• They flush out toxic substances.
• They maintain body temperature.
• Maintain pH levels in the bloodstream.
• Regulate hormones (vitamin D and erythropoietin).
• Reabsorb electrolytes, minerals, and amino acids and control the production of red blood cells. 
• Maintain homeostatic functions like blood pressure, glomerular rate (GFR) that determine osmotic and hydrostatic force in the glomerular membrane. 
• Remove drugs from the body (drug excretion) after its absorption, distribution, and metabolism.

(Ogobuiro & Tuma, 2023) 

Kidney stones – A major health concern?

It is observed that there are increased cases of kidney stone disease every year. Untreated or prolonged kidney stone diseases can convert into nephrological issues in the later stages. 

Kidney stones have a risk of developing into chronic kidney disease and urinary tract infections. If you have one stone, there is a risk of developing another stone in the next 5 years.

Children as young as 5 years are also affected by kidney stones.

The symptoms of renal calculi or kidney stones are:

• Severe pain on either side of your lower back.
• Fever and chills.
• Pain in your stomach.
• Nausea and vomiting.
• Cloudy urine or foul-smelling urine. 

Types of kidney stones:

• Calcium oxalate stones: These are the most common type of kidney stones and occur when there are high amounts of oxalates that are not absorbed in the gut, the reason being decreased calcium levels in the body. This excessive oxalate is transported to the kidneys to form calcium oxalate stones by using the calcium in the urine.  

(Kidney Stones | Johns Hopkins Medicine, n.d.)

• Uric acid stones: This condition can also run in families where high amounts of uric acid in the body lead to crystallization. A diet high in animal protein accompanied by accumulation of uric acid and insufficient water intake risks the kidneys to form uric acid crystals. 
• Struvite: These are caused by infections and these conditions are rare.
• Cystine: This can occur due to a condition called cystinuria. 

(Kidney Stones - Symptoms, Causes, Types, and Treatment | National Kidney Foundation, n.d.)

The science behind kidney stones?

Kidney stones are also called urolithiasis, nephrolithiasis, or renal calculi. These stones are formed by the crystallization of insoluble organic components, lipids, and numerous anions in a specific condition where the urine is also supersaturated (not enough fluids in the urine). 

The etiology of kidney stones is dependent on the inhibitors and the promoters of stone formation. And what are they? 

Inhibitors are those components that inhibit the process of stone formation. Citrates, pyrophosphates, magnesium, glycosaminoglycans, and potassium are some inhibitory components. 

Promoters are those components that enhance the likelihood of stone formation. Low urine volume, low urine pH, glycolipids, phospholipids, accumulated oxalate, cystine, uric acid, calcium, and sodium are known to promote stone formation. 

Accumulated toxins trigger apoptosis (cell death) in renal tubular cells, leading to oxidative stress and reactive oxygen species. These actions promote nucleation (the first step of stone formation), crystallization, and finally stone formation. (Alelign & Petros, 2018)

What habits can cause kidney stones?

The risk of having kidney stones occurs due to various possibilities. Genetics and lifestyle are two major factors influencing this condition. 

Habits like:

1. Insufficient and low intake of water and fluids can decrease the pH levels of the urine and increase the acidic levels in the bloodstream. This in turn contributes to supersaturated urine which is a breeding ground for stone formation. 
2. A high consumption of animal protein induces accumulated uric acid levels leading to uric acid stones.
3. Excessive consumption of salt and sodium is a detrimental factor. 
4. Family history and genetic makeup that create an imbalance in the inhibitory components of stone formation.
5. Unhealthy lifestyle and habits that accelerate stone formation in the kidneys.
6. Sudden weight loss, surgeries, infections, and obesity might increase the risk of stone formation.
7. A decreased intake of dietary calcium and an increase in oxalate-rich foods can promote stone formation.
8. Intake of purine-rich foods might put you at risk of kidney stones.
9. Excessive sugar and fructose might lead to kidney stone formation.
10. Kidney cell damage, decreased GFR rate, and renal tube dysfunctions also lead to stone formations. 

(Ferraro et al., 2020)

How to prevent kidney stones?

Some health issues should be addressed from a public health perspective. However, one must also consider personal health goals like adhering to healthy lifestyle changes that can lower the risk of kidney stone formation. 

• Treatment for kidney stones as soon as you identify your symptoms is very important. Delayed interruptions will only aggravate the health consequences. 
• The primary treatment recommended by many research experts is lifestyle changes and approved nutrition.
• Taking public health seriously and making interventions in public health care through media, communication, health kiosks, and public awareness on kidney health will help to sail through some of the challenges. 
• Increasing your water and fluid intake, and reducing raw food consumption, especially when you have a family history of kidney stones.
• Reduced intake of raw food, and raw vegetables as they might promote oxalate accumulation that initiates the process of stone formation. 
• Avoiding high sodium intake and animal protein to bring down the risks.
• Increasing dietary calcium and reducing large doses of vitamin C can prevent the risk of renal calculi. 
• However, there is a concern related to supplemental calcium and vitamin D. People with a risk of renal stones or with a family history of renal stones must monitor their supplemental dosage of calcium and vitamin D as hypercalcemia can increase the chances of kidney stone formation. 

(Peerapen & Thongboonkerd, 2023)

Let us debunk some myths

Can calcium supplements cause kidney stones?

A contradictory belief that says calcium can increase stone formation in kidneys. Calcium is an essential part of our everyday health, and in fact, dietary calcium is known to reduce the risk of calcium oxalate stones. 

However, excessive supplemental calcium can be detrimental to kidney health and in cases where supplemental calcium is a need, one must always consume the supplement along with a meal and any changes in the calcium levels should be monitored with regular tests. 

(Sorensen, 2014)

Do tomatoes cause kidney stones?

Eating tomatoes will not affect kidney stone formation. Cooking, boiling, or steaming is an essential step to be followed to reduce oxalate content. 

Can eating spinach increase the chances of having kidney stones?

Spinach is rich in both calcium and oxalates. Calcium in the intestines is a key mineral that binds to oxalates and is flushed out of the system. While lack of intestinal calcium can lead to oxalates being transported to the kidneys.

Cooked Spinach solely is not responsible for kidney stone formation. 

However, eating raw foods or raw spinach without cooking, steaming, or blanching might increase the risk of anti-nutrients like oxalates that can cause kidney stones. 

Takeaway

The risk of kidney stones is affected by many factors like your diet, your dietary calcium intake, your water and fluid intake, acidic conditions in the body, and your genetic makeup. 

My very first statement “Every day is a good day if you take care of your kidneys” holds true only if you take good care of your kidney health daily. 

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References

Alelign, T., & Petros, B. (2018). Kidney Stone Disease: An Update on Current Concepts. Advances in Urology, 2018. https://doi.org/10.1155/2018/3068365

Ferraro, P. M., Bargagli, M., Trinchieri, A., & Gambaro, G. (2020). Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian–Vegan Diets. Nutrients, 12(3). https://doi.org/10.3390/NU12030779

Kidney Stones | Johns Hopkins Medicine. (n.d.). Retrieved May 1, 2024, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/kidney-stones

Kidney stones - Symptoms, causes, types, and treatment | National Kidney Foundation. (n.d.). Retrieved May 1, 2024, from https://www.kidney.org/atoz/content/kidneystones

Ogobuiro, I., & Tuma, F. (2023). Physiology, Renal. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK538339/

Peerapen, P., & Thongboonkerd, V. (2023). Kidney Stone Prevention. Advances in Nutrition, 14(3), 555–569. https://doi.org/10.1016/J.ADVNUT.2023.03.002

Sorensen, M. D. (2014). Calcium intake and urinary stone disease. Translational Andrology and Urology, 3(3), 235. https://doi.org/10.3978/J.ISSN.2223-4683.2014.06.05