A renal calculus (or kidney stones) is a health hazard which is not very uncommon to find. One in ten people will tell you that they have had stones (of variable sizes) in their kidneys at some point of time in their lives! However common a renal stone may be, people tend to ignore taking prevention for it, until they find one in their own belly!
A renal calculus, if mismanaged or undetected for long time, may lead to disastrous consequences, eventually causing renal failure. Prevention, early diagnosis and timely intervention remain the key in the management of renal calculi.
Some important points about prevention of renal stones are:
- Drink plenty of fluid: Doctors keep on saying this, a plea, not always complied by their patients. The more concentrated your urine is, more are the chances of formation of crystals (of calcium oxalate, uric acid, etc), eventually leading to formation of stones. So, it is important to stay well hydrated, and most of such hydration should be from water.
- How much of water is enough? It depends, not only on prevailing weather but also on your routine (in terms of exertion). Hotter weather requires more fluids to make up for the loss of fluid via sweating. Generally recommended fluid intake is a minimum of 2.5 liters a day. As I said, it depends on weather and body requirement. A good indicator about sufficient hydration is the color of urine, which should be pale white rather than yellowish.
- Don’t cut on calcium: People with calcium oxalate stones tend to cut on their calcium diet, which is a huge mistake, for it actually increases the risk of having a calcium stone. Rather than cutting on calcium, reduce the consumption of substances that increase the level of calcium in blood and urine. Caffeine and sodium, hence, should be reduced in diet. Reduced consumption of food products like chocolates, coffee, junk food, etc is advisable. Take natural sources of calcium rather than supplements to fulfill your calcium needs.
- Don’t follow zero oxalate theory: While reduction in consumption of oxalate rich food (chocolate, nuts, black tea, spinach, colocasia, rhubarb, beets, etc) is advised for calcium oxalate stones, taking no oxalate at all is not necessarily good for health. Instead, take moderate amount of oxalate and calcium rich food together so that calcium and oxalate binds in stomach and intestine itself, rather than in the kidneys (during urine formation) which causes stone formation.
- Uric Acid Stones: Those at risk of uric acid stones are advised to moderate the consumption of food rich in uric acid (animal protein, red wine, etc). Increased daily fluid intake will help. Your doctor may prescribe you potassium citrate to make your urine alkaline. Avoid alcohol, crash diets, sprouts, etc as they increase uric acid level in the blood. Taking a vitamin C supplement or drinking lemonade (citrus fruits are natural sources of citrate) also tends to help against formation of uric acid stones.
- One stone may lead to another: Having their kidney stones removed through medication or surgery, people tend to relax that they can live a normal life (in terms of food intake) now. However, it is not always true! Recurrent kidney stones are not uncommon, and people at risk of stone formation continue to remain at risk even after the stone has been removed. Studies show that 30 to 50% of people tend to have another stone within five years if dietary changes are not made. So, the takeaway here is, don’t remove the alert sign!
- Struvite stones: These stones are caused by recurring urinary tract bacterial infections. Your doctor may put on you on long term antibiotics to counter those infections, for complete eradication of infection.
- Do not take too much of sugar: Taking too much of unhealthy sugar (e.g. carbonated beverages) can put you at increased risk of stone formation as it interferes with normal absorption of calcium and magnesium.
Renal stones are preventable if one is aware it. Taken casually, renal stones can prove to be disastrous, lowering the quality of life in long term. So, the message is, be aware, stay at guard if you are at risk, drink plenty of water, limit sugar and salt, don’t fret over it, be positive in outlook, wear a smile on your face, and drink lemonade!
-Dr. Vikas Panwar