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Kidney Stones

What are the risk factors for kidney stones?6

There are certain risk factors for stone formation including, but not limited to:

  • Diet - sudden changes in diet, or a diet comprised of a high intake of animal protein, oxalate, sodium, sucrose, and fructose.
  • Fluids – the risk of developing a kidney stone increases as urine volume decreases.  Also, sugar-sweetened colas may increase the risk of developing a kidney stone.
  • Health conditions –chronic health conditions such as Crohn’s disease, gout, Type 2 diabetes mellitus, chronic kidney disease, and obesity may contribute to the formation of kidney stones.
  • Certain medications, including calcium and Vitamin C supplements.
  • A family history and genetics.

What are the different types of kidney stones?

There are four basic types of kidney stones:

1. Calcium stones

Approximately 90% of kidney stones encountered are comprised of calcium oxalate (75%) or calcium phosphate (15%), making it the most common type of stones.7 Calcium stones are most often caused by, but not limited to, dehydration or sensitivities to nutritional variations in the diet such as consuming too much calcium or foods high in oxalates, such as soda, coffee, beer, spinach, and sweet potatoes.8

2. Uric acid stones

Less common uric acid stones (8%) are caused by a diet high in purines, which are substances found in animal proteins such as meats and meat products, but also fish like anchovies, sardines, herring, mackerel, scallops, as well as certain drinks like beer. Moderate amounts of purines are contained in asparagus, cauliflower, spinach, mushrooms, and green peas.9 If uric acid becomes concentrated in the urine, it can develop into a stone, with or without calcium.

3. Struvite stones

Struvite stones, which result in only a very small percentage of kidney stones.10 (1%), can be associated with chronic or recurrent infections in the urinary tract.


4. Cysteine stones

Kidney stones caused by cysteine (less than 1%), an amino acid produced by the body that is found in most proteins, are the result of a genetic disorder that causes cysteine to leak through the kidneys and into the urine, forming crystals that tend to accumulate into stones.11

What are the causes of kidney stones?12

Doctors do not always know for certain what causes a particular stone to form. It is widely agreed that some people are just more susceptible to developing kidney stones—and those who are may increase their risk by eating certain foods known to cause stones, or by not drinking enough water.

A person with a family history of kidney stones may be at higher risk of developing stones. Urinary tract infections, kidney disorders such as cystic kidney diseases, and metabolic disorders such as hyperparathyroidism, a condition which may result in increased calcium levels in the blood, are also linked to stone formation.

Certain intestinal disorders can increase the risk, as can taking certain medications, like protease inhibitors and anti-seizure medication. Even taking diuretics or calcium-based antacids can increase the risk of forming stones.


References

  1. Monastersky, R. (1993). Kidney Stones: Don't Curb the Calcium. Science News,143(13), 196. doi:10.2307/3977303.
  2. Margaret Sue Pearle, MD, PhD.; David S. Goldfarb, MD, et. al. Medical Management of Kidney Stones: American Urological Association (AUA) Guideline, 2014.
  3. National Kidney and Urologic Diseases Information Clearinghouse.  Kidney stones in adults. NIH Publication No. 13–2495. February 2013. p. 1.
  4. Kasper, D. L., Fauci, A. S., Hauser, S. L., & Longo, D. L. (2015). Harrison's Principles of Internal Medicine (19th ed., Vol. 1, Internal Medicine). Chapter 342: Nephrolithiasis. New York, NY: McGraw Hill.
  5. National Kidney and Urologic Diseases Information Clearinghouse.  Kidney stones in adults. NIH Publication No. 13–2495. February 2013. p. 1.
  6. Kasper, D. L., Fauci, A. S., Hauser, S. L., & Longo, D. L. (2015). Harrison's Principles of Internal Medicine (19th ed., Vol. 1, Internal Medicine). Chapter 342: Nephrolithiasis. New York, NY: McGraw Hill.
  7. Kasper, D. L., Fauci, A. S., Hauser, S. L., & Longo, D. L. (2015). Harrison's Principles of Internal Medicine (19th ed., Vol. 1, Internal Medicine). Chapter 342: Nephrolithiasis. New York, NY: McGraw Hill.
  8. Foods High in Oxalate-Topic Overview. (n.d.). Retrieved October 28, 2016, from http://www.webmd.com/kidney-stones/tc/foods-high-in-oxylate-topic-overview
  9. Vegetables High in Purines. (n.d.). Retrieved October 28, 2016, from http://healthyeating.sfgate.com/vegetables-high-purines-10306.html
  10. Kasper, D. L., Fauci, A. S., Hauser, S. L., & Longo, D. L. (2015). Harrison's Principles of Internal Medicine (19th ed., Vol. 1, Internal Medicine). Chapter 342: Nephrolithiasis. New York, NY: McGraw Hill
  11. Cysteine. (n.d.). Retrieved October 28, 2016, from http://www.newworldencyclopedia.org/entry/Cysteine
  12. National Kidney and Urologic Diseases Information Clearinghouse.  Kidney stones in adults. NIH Publication No. 13–2495. February 2013. p. 2-3.
  13. Kasper, D. L., Fauci, A. S., Hauser, S. L., & Longo, D. L. (2015). Harrison's Principles of Internal Medicine (19th ed., Vol. 1, Internal Medicine). Chapter 342: Nephrolithiasis. New York, NY: McGraw Hill
  14. Portis, A. J., Sundaram, C. P.  Diagnosis and initial management of  kidney stones.  Am Fam Physician 2001;63:1329-38.
  15. Portis, A. J., Sundaram, C. P.  Diagnosis and initial management of  kidney stones.  Am Fam Physician 2001;63:1329-38.
  16. Portis, A. J., Sundaram, C. P.  Diagnosis and initial management of  kidney stones.  Am Fam Physician 2001;63:1329-38.
  17. National Kidney and Urologic Diseases Information Clearinghouse.  Kidney stones in adults. NIH Publication No. 13–2495. February 2013. p. 6-7
  18. Kasper, D. L., Fauci, A. S., Hauser, S. L., & Longo, D. L. (2015). Harrison's Principles of Internal Medicine (19th ed., Vol. 1, Internal Medicine). Chapter 342: Nephrolithiasis. New York, NY: McGraw Hill.