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Causes
of Kidney Stones
There are many potential causes of kidney stone
formation. In general they are the result of a
super concentration of chemicals in the urine that
results in crystals being formed. This may be
brought on by one or more of the following:
- a family
genetic predisposition to form stones;
- an excess of
calcium or certain other minerals in the diet
(sometimes due to local geographic water or soil
conditions);
- intake of
excess uric acid, certain medications, Vitamin
C, or Vitamin D;
- a diet of
fruits and vegetables high in oxalate (a by
product of metabolism);
- long term
dehydration (possibly due to inadequate intake
of fluids) and its resulting concentration of
urine;
- urinary
infection;
- living in an
area where high temperatures cause sweating and
loss of fluids; or
- possibly,
just leading a sedentary (low physical activity)
lifestyle.
The function of
the kidneys is to eliminate byproducts of
metabolism. (The kidney's parts and workings are
explained in detail and wonderfully illustrated at
How
the Kidney
Works.)
This means they are constantly collecting the major
ingredients for kidney stones - including calcium,
oxalate, and uric acid. Ideally these minerals are
kept in suspension until they are passed out of the
body. Too much metabolic byproducts in insufficient
fluid (urine) makes a person prone to kidney stone
formation.
The over
concentration of metabolic byproducts in the urine
can cause these minerals to move out of suspension
and crystallize. These small crystals that
precipitate out of the super saturated urine will
usually pass on out through the urinary tract, but
they may begin to clump together. Any existing
crystal makes it easier for other crystals to form.
If they stay in the kidney very long, the crystals
gradually grow larger and larger until they become
a kidney stone so large that it cannot pass through
the urinary tract such as the one in this
PHOTO
of a kidney
stone by
the UCLA medical school.
Several
underlying metabolic disorders may be the root
cause of excessive calcium and oxalate forming
stones in the kidney. Often doctors overlook the
basic cause because of the attention of the
sufferer being on the immediate cause of the pain
leading the physician to be primarily concerned
with the extraction or dissolution of the kidney
stone causing the problem. The potential root
causes include, but are not limited to the
following:
- A
re-absorption of the calcium from the bones back
into the blood system which the kidneys then
filter out (resorptive hypercalciuria or
hyperparathyroidism).
- The
intestines absorb too much calcium from the diet
(absorptive hypercalciuria).
- The kidneys
filter out calcium from the blood but do not
allow the reaborption of the calcium back into
the blood as it should while it is still in the
tubule of the kidney (renal
hypercalciuria).
- Several
forms of bowel disease (ulcurative colitis,
regional enteritis, etc.) which can contribute
to high levels of urinary oxalate
excretion.
- Excess
dietary intake of oxalate from foods such as
green leafy vegatables. (See list of high
oxalate foods later in this
article.)
- High levels
of uric acid in the urine can act as a breeding
ground for calcium oxalate stones.
- Or, in a
reverse manner, the lack of certain stone
formation inhibitors normally found in the urine
may not be present in sufficient quantities and
thereby allow the formation of stones. One such
indigredient is citrate (which this author is
deficient in); another is magnesium.
- Infection
stones are indicators of the underlying
infection in the urinary tract.
Symptoms
of Kidney Stones
Kidney stones may be formed, grow in size, and stay
immobile inside the kidney for years without any
warning pain or other indicators. Most people don't
know they are at risk for forming kidney stones
until one or more have been formed. A few people
have and pass small kidney stones without
experiencing pain, but that is not the usual case.
More often the kidney stone makes itself
dramatically known when it begins to move through
the urinary tract.
A kidney
stone attack has classic symptoms: the most
agonizing pain in the lower back just below the
ribs spreading around to the front of the abdomen
and often extending into the groin area. The pain
may come in waves as the stone tries to move
through the tube between the kidney and the bladder
(the ureter). Sometimes there will be blood in the
urine. Often there is nausea, fever and chills, and
vomiting. The abdomen or lower back may be painful
to touch.
The severity of
the pain is no indicator of the size of the passing
kidney stone. This pain is often described as the
worst pain a person has ever suffered even by women
who have given birth. It is reported to be more
painful than gun shots, surgery, broken bones, or
even burns. The pain is not a result of the stone
moving or tearing the ureter as a sufferer might
suspect. Rather, the pain is caused by the dilating
or stretching of the urinary tract being blocked by
the stone when it gets stuck in the
ureter.
More than one
million people in the United States are
hospitalized each year because of kidney stone
attacks. A suffer should call their doctor or go to
the hospital emergency room if they experience
severe or persistent bleeding, if the pain
continues to be severe, unrelenting and persistent,
or if fever and chills or nausea and vomiting
develop.
During a kidney
stone attack the sufferer should drink large
amounts of water (two to three quarts per day).
Stay active. Do not go to bed (except for normal
sleep periods). Physical activity may actually
assist passage of the kidney stones.
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