Kidney stones - a cause of serious pain

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I suspect that kidney stones are one of the prices Homo Sapiens paid when he moved from four legs to two. Being vertical means that the kidneys do not drain quite so well, urine stagnates and this increases the risk of infection and stone formation. This can be seen in this Urinary system diagram where one can see that gravity is unable to "do its job" because of the orientation of the kidneys and ureter.

The problem with kidney stones

The trouble with kidney stones is that there are usually no early warning symptoms! They form in the kidney and cause problems when they pass into the smaller ureter where they get stuck, causing severe pain. Indeed ureteric colic is one of the worst pains one can have and usually needs morphine like drugs to numb the pain. One has to hope the stone will pass, assisted by drinking lots of water and having pain killing injections. Operative assistance may be necessary to get the stone out. The important thing is to catch the stone for analysis so that one can find out why the stone formed and what it was made from - so pee through a sieve and catch any fragments. These can then be sent off for analysis (I can arrange for this test to be done).

Why did you get a kidney stone?

One then wants to know why there is a stone? Primary stones can form either from calcium, uric acid or a combination of the two. I believe the calcium stone results from:

  • Western unbalanced diets. There is so much emphasis on having enough calcium that there are not enough other micro-nutrients to balance things out - especially vitamin D, magnesium and vitamin C - see Nutritional Supplements
  • Calcium stones may be caused by high levels of calcium in the blood secondary to an overactive parathyroid gland or "hot nodule".
  • Uric acid stones come from high levels of uric acid in the blood. Uric acid is the most important antioxidant in the blood stream and so high levels are desirable, except when this results in uric acid stones or gout! High uric acid may occur when antioxidant status is poor and so this may be worth exploring - see Antioxidants.
  • Anything which causes stagnation of urine in the urinary tract.

So primary stones need further investigation with a serum calcium, uric acid, urinary pH and possibly parathormone levels.

Secondary stones arise as a result of chronic inflammation and are mostly phosphate or sometimes ammonium urate. Secondary stones need investigation to look for the primary inflammation - usually chronic infection or allergy - see Irritable Bladder Syndrome or Allergic Bladder

Vitamin C and kidney stones

There is a well perpetuated myth that vitamin C results in kidney stones. This is based on one person who took large doses of ascorbic acid! There was no direct evidence to link the two!

What to do about oxalates?

Calcium oxalate may cause kidney stones. Measuring oxalates in urine helps to diagnose but some have normal levels. The principles of treatment are:

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