Consultancy Corner: ‘Incidence of kidney stones on the rise’

In India, it is estimated that 12 per cent of the population harbour stones in their urinary tract and nowadays more women are being diagnosed with renal stones. In general, men are more likely to have a kidney stone than women, but recent statistics reveal that this gender gap is narrowing.

A combination of various risk factors predisposes a person to develop stones. Endogenous risk factors include Age (40-60), gender (men>women), and heredity. Exogenous risk factors are more important. Climatic conditions where in people living in hot and dry conditions are more likely to develop stones. Low water intake, consumption of high salt and animal protein have been proven to cause urinary stones. Calcium is the commonest constituent of urinary stones with calcium oxalate being the commonest type of stone. Uric acid stones, Infection related stones & Phosphate stones also occur.

Stones inside the kidney are usually discovered during ultrasound scans done for some other purpose or during routine health check-ups.

In certain situations, special tests like 24-hour urine analysis and parathormone level may be done to rule out any potential metabolic abnormality that may be causing the formation of stones.

When a stone residing in the kidney detaches and drops into the tube connecting the kidney to the bladder called as ureter, the person develops sudden and severe pain along the flank that can radiate to the genitalia. The reason for the pain is that the stone blocks the flow of urine on that side. The condition becomes serious when it is associated with infection evidenced by the development of fever with chills. Stones in the bladder usually causes pain, blood in urine and difficulty in passing urine.

The type of management depends on location and size of the stone. As mentioned earlier, stones that are stuck in the ureter are the ones which usually results in renal colic. Stones up to certain size have a good chance of coming out by themselves with the help of medicines and adequate water intake. But as the size of stone increases, the likelihood of the stone coming out by itself decreases in which case the patient may require surgical intervention to remove the stone. Currently, almost all the stones are removed by less-invasive endoscopic techniques with no scar and short recovery time. The choice of the technique again depends on the size and location of the stone.

​Studies have shown that there is a 50 per cent chance of stone recurrence within 5 years of the first episode. Hence follow-up and preventive measures are important. Any patient treated for stone disease should have an ultrasound scan at least once in a year to detect formation of new stones.