DEFINITION

Kidney Stones, also known as renal colic, are accumulations of mineral salts that can lodge anywhere along the course of the urinary tract.

DESCRIPTION

Human urine is usually saturated to the limit with calcium oxalate, uric acid and phosphates. Normally, due to various protective compounds and natural mechanisms that control the acidity of urine, these substances remain suspended in solution. However, if these protective factors are overwhelmed, the substances may crystallise and these crystals clump together. This eventually forms Kidney Stones, sometimes large enough to restrict urinary flow.

Calcium stones (composed of calcium oxalate) make up 60 to 80% of diagnosed stones. It is suggested that they are caused by excessive absorption of calcium from the intestine, hyperthyroidism, high vitamin D intake, milk-alkali syndrome, multiple myeloma, excessive consumption of refined carbohydrates, aluminium salts and prolonged immobility. Chocolate, coke, tea, cooked spinach, rhubarb and pears in the diet may also cause excessive oxalates. Uric acid stones form when the volume of urine excreted is too low or blood levels of uric acid are too high. These stones are associated with gout. They are also caused by excessive purine intake (purines are in red and organ meats, alcohol, shellfish and yeast) and anti-cancer drugs. Struvite stones (composed of magnesium ammonium phosphate) are unrelated to metabolism and are caused by infection. They are often associated with recurrent urinary tract infection. Cystine stones are associated with hereditary cystinuria (excessive levels of cystine in the blood). It is a rare congenital defect that can cause stones composed of the amino acid cysteine to form in the kidney or bladder. Other causes - Vitamin B6 deficiency may be associated with Kidney Stones. - Persistent slight dehydration is one of the prime reasons for Kidney Stones forming. - Milk-alkali syndrome may cause Kidney Stones. This is an over-consumption of milk or antacids. The theory is that milk is fortified with vitamin D, which results in an increased absorption of calcium and increased urinary calcium concentration. The other theory is that antacids are composed of calcium carbonate, which may cause Kidney Stones.

SIGNS AND SYMPTOMS

Kidney Stones may be asymptomatic or cause intermittent, dragging pain in the lower back. Severe intermittent pain starting in the kidney area and radiating across the abdomen and sometimes in the genital and inner thigh area is a classic sign of renal colic. The pain is usually of sudden onset and can last for hours. Other symptoms include chills, fever - adults, nausea and vomiting and a frequent desire to urinate. Renal colic is often described as one of the most severe pains ever experienced. Urinary tract infection can be a complication of Kidney Stones.

TREATMENT OPTIONS

- Always consult your Doctor for diagnosis and advice. It is very important that a patient who has any back pain, or has any blood in the urine see a Doctor without delay. - Effective treatment requires identification of the stone type. - Open surgery is often not necessary, as other methods are now available. Discuss your options with your Doctor. - Once existing stones have been treated, prevention becomes the priority. - Close attention should be paid to your diet as advised by your Doctor or Dietitian. - Dilution of the urine is an effective way to help prevent most Kidney Stones by increasing water intake to at least 6 to 8 glasses per day.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice. 1) Follow the Diet Hints. If the stones have been found to be made up of oxalate, certain foods to be avoided include rhubarb, spinach, peanuts and chocolate. These are all high in oxalic acid. 2) If you have any pain, ask your Pharmacist to recommend a product appropriate for your needs. 3) Drink at least 2 litres of water a day. As most stones are formed during the night, drinking several glasses before bed is recommended. Your Pharmacist may be able to advise you on selection of a water filter. 4) Urinary alkalising powder such as Ural may assist in relieving painful urination. Dissolve a sachet in a glass of water and drink three times a day. Ask your Pharmacist for advice. 5) Consider some nutritional supplements if the diet is inadequate. Some suggestions include magnesium, co-enzyme Q10 and vitamin B6. Garlic has a natural antibacterial action and may be of benefit if infection is present. Cranberry also has antibacterial properties and also has a deodorising effect on the urine. A magnesium supplement, taken regularly, may help to make the Kidney Stone more soluble. A dose of between 300 to 400 mg per day may help to reduce the risk of stone formation.

DIET HINTS

Diet should focus on avoiding oxalates, sodium and purines. See the Kidney Stones Diet on the HealthPoint for detailed information.

VITAMINS/MINERALS/HERBS

Nutrition supplements are only to be used if the dietary vitamin intake is inadequate. - Potassium is thought to be beneficial for Kidney Stones as it may decrease the risk of kidney stones by inhibiting calcium crystallization, which contribute to stone formation. - Magnesium may prevent the formation of calcium oxalate crystals. A deficiency of magnesium may increase the risk of calcium stones. Magnesium may lower the levels of oxalates in the urine. - Vitamin B6 may reduce calcium-oxalate levels and studies have shown that people with kidney stones are often deficient in Vitamin B6. - Uva ursi is a diuretic herb with can relieve kidney stone pain, cleanse the urinary tract and help fight infection. - Horstail is a diuretic herb which can be useful with kidney ailments. - Juniper berry is a strong diuretic kidney cleanser. - Cranberry may be useful in the treatment of kidney stones as studies have shown it can reduce urinary calcium levels in people with a history of kidney stones. Cranberry can also be useful in the prevention of urinary tract infections.

ORGANISATIONS and SUPPORT GROUPS