Kidney Stones: Why do some people develop kidney stones

On World Kidney Day, let’s discuss an important topic that afflicts millions across the world. India accounts for 12% of the global prevalence of this health complication.

It’s about kidney stones, which are very common in India and are relatively more common in North India.

Kidney stones, also known as renal stones, are solid deposits that form within the kidneys when minerals and salts in urine crystallize.These are often painful but sometimes can be silent and lead to renal failure, says Dr. Ahmed Kamaal, Senior Consultant, Urology, Amrita Hospital, Faridabad.

“Prevalence of renal stones in India is around 12% while recurrence rates of symptomatic stones are high at more than 50% within 5 years of a first episode, suggesting that identifiable high-risk group of patients may experience common pathways in the pathogenesis of stone formation that can be targeted for prevention,” Dr. Kamaal says.

What causes kidney stones?

“Kidney stones have a variety of causes, and it is not always possible to pinpoint a cause in every case,” says Dr. Kushal Banerjee, Senior Homeopath, Dr. Kalyan Banerjee’s Clinic.

Fault lies in what one eats
“Being overweight, lack of physical activity, not drinking adequate amounts of fluids, repeated urinary infections, taking excessive nutritional supplements, and excessive consumption of aerated beverages are some causes. Drugs like aspirin, some antacids, diuretics (drugs that remove fluid), certain antibiotics, and anti-epileptics may also cause kidney stones. A family history of kidney stones and a previous history of kidney stones also increase the risk of developing them. Certain congenital deformities of the excretory system may also increase chances of kidney stones,” Dr. Banerjee adds.

He blames an unhealthy diet as another primary reason for kidney stone formation. He suggests that dietary causes of kidney stones are easily understood and are also easy to avoid. Excessive consumption of packaged food or a very high protein diet with low fiber should be avoided. If the patient has high levels of uric acid, it is important to avoid food items like spinach, aubergine, tomatoes, etc. While it is now being appreciated that a fixed quantity of fluids should not be advised for every individual it is important not to ignore thirst. Indiscriminate consumption of supplements and ‘protein shakes’ and similar concoctions can lead to the formation of kidney stones. Staying physically active, and consuming a balanced nutritious diet while avoiding junk food can keep the risk of forming kidney stones low.

Genetics, obesity, and underlying health conditions also trigger stone formation
Dr. Kamaal explains genetic links to kidney stone formation. “Genetic links to urolithiasis have been long established in certain heritable disorders, such as primary hyperoxaluria to AGXT gene, and Xanthinuria to XDH gene. Individuals with a family history of stone formation are more susceptible, suggesting a hereditary link to this condition,” he explains. “Conditions such as hypercalciuria, hyperoxaluria, and hyperparathyroidism disrupt the normal balance of minerals in the body, increasing the likelihood of kidney stone development. Chronic urinary tract infections, cystic kidney diseases, and inflammatory bowel diseases can create an environment conducive to the development of kidney stones. Obese (BMI>30) people have RR (relative risk ) of 1.44 as compared to non-obese for stone formation, ” he adds.

What causes recurrent kidney stone formation?

Recurrence of kidney stones occurs in many individuals despite treatment. More than 90% of the individuals who get treated for kidney stones develop another stone within 20-25 years.

Dr. Kamaal explains the reasons behind this. “Inadequate treatment can leave residual crystals, providing a foundation for the recurrence of kidney stones. Failure to make necessary lifestyle changes, such as improving dietary habits, maintaining proper hydration, and addressing metabolic abnormalities can contribute to the reformation of stones. Individuals with a family history of kidney stones may be more prone to recurrence due to inherited factors. Understanding the genetic component can aid in developing personalized preventive strategies,” he explains.

“Adopting a healthy lifestyle plays a key role in preventing recurrent kidney stones. This includes maintaining a balanced diet, staying hydrated, avoiding excess salt and sugars, and engaging in regular physical activity,” he suggests.