Health Tips

“Drink more water” is a typical Asian mum’s response to any problem under the sun. Be it feeling heaty, having a headache or dealing with acne — drinking water seems like the go-to solution for our parent’s generations, and rightfully so. 

Perhaps you may have heard of one of the consequences of not staying hydrated from your parents: it increases the risk of kidney stone. But is it true?

What are kidney stones and how do they develop?

Kidney stones are just what they sound like: small stones that form inside the kidneys. They form when salts and minerals, such as calcium, oxalate, cystine, or uric acid that are normally in the urine build up and harden. The substances form tiny crystals, which become anchored in the kidney and gradually increase in size, forming a kidney stone.

A color photograph of a kidney stone, 8 millimetres in length. Image credit: Robert R. Wal, Public domain, via Wikimedia Commons

Kidney stones can also form even when the salts and minerals are at normal levels, especially if you are not making a lot of urine (e.g. as a result of not drinking enough water). So, your mom is not wrong when she said that drinking less water can make you more prone to get kidney stones. 

Besides not drinking enough fluids, the following also makes it easier for you to get kidney stones:

• Diets with low level of calcium

• Use of calcium supplements

• Diet with high levels of animal protein

• Diet with high levels of sugars (sucrose, fructose)

• Diet with low levels of phytate (found in wheat, rice, rye, barley, and bean products)

• High sodium diet (such as salty food, processed food)

• Frequent spinach consumption

• Gout

• Diabetes

• Obesity

• Primary hyperparathyroidism

• Crohn's disease

• Gastric or intestinal bypass surgery

• Previous kidney stones

To reduce your risk of developing kidney stones, make sure that you have a balanced diet, stay hydrated and manage your other medical conditions well.

What to expect if you have kidney stones

Kidney stones can go “undercover” for years without causing any discomfort if they remain in the kidneys. They may only be found when imaging tests are done for other reasons. However, when kidney stones do cause symptoms, it is usually when they pass through your urinary tract.

• Pain — Never underestimate the level of pain caused by kidney stones, as it can range from mild ache to intense pain that requires hospitalisation. 

Typically, the pain fluctuates in severity but does not go away completely without treatment. Waves of severe pain, known as renal colic, usually last 20 to 60 minutes. Pain can occur in the flank (the side, between the ribs and the hip) or the lower abdomen, and the pain can move toward the groin.

Diagram showing the typical location of renal colic, below the rib cage to just above the pelvis. Image credit: NIH, Public domain, via Wikimedia Commons

• Blood in the urine — It’s common for people with kidney stones to detect blood in their urine; the medical term for this is "hematuria." The urine may appear pink or reddish, or the blood may not be visible until a urine sample is examined under a microscope. Blood in the urine is, however, not an unique phenomenon limited to kidney stones only, as many medical conditions can lead to similar issues. If you notice any blood in your urine, consult a healthcare professional immediately.

• Gravel — You may pass "gravel" or "sand," which are multiple small stones in your urine.

• Nausea or vomiting

• Pain when urinating

• Urgency to urinate

Kidney stones treatment

Kidney stones are relatively easy to treat, but only before they develop into a bigger, more complicated medical problem. If your stone is big or causes severe symptoms, you might need to stay in the hospital. If your stone is small and causes only mild symptoms, you might be able to stay home and wait for it to pass in the urine. On top of that, you’ll be given a few medicines, such as:

• Painkillers, such as ibuprofen and naproxen to manage the pain caused by kidney stones. Consult a healthcare professional before taking these medicines.

• Urine alkalizer (e.g. Ural®). Although there aren’t many studies on how useful urine alkalizer is in the treatment of kidney stones, by theory they could help dissolving certain kidney stones and pass them out, as well as preventing future kidney stones formation

It’s important that people with kidney stones drink enough fluids to achieve a 24-hour urine volume of at least two liters. Increase in fluid intakes has been shown to effectively prevent recurrent kidney stones. However, if you have other medical problems that limit your water intake, such as heart failure, do consult your doctor the amount of water you should take.

Stones that do not pass on their own can be treated with:

• A machine that uses sound waves to break up stones into smaller pieces. This is called "shock wave lithotripsy." This procedure does not involve surgery, but it can be painful.

• A special kind of surgery that makes very small holes in your skin. During this surgery, the doctor passes tiny tools through the holes and into the kidney. Then they remove the stone. This is called "percutaneous nephrolithotomy."

• A thin tube that goes into your body the same way urine comes out. Doctors use tools at the end of the tube to break up or remove stones. This is called "ureteroscopy."

It’s important to make sure your kidney stones are properly treated. If not, it may develop into complicated health issues such as infection and kidney failure.

Educate yourself if you have kidney stones

It’s not the end of the world if you have kidney stones, although it might bring many nuisance. If you have kidney stones, below are some questions you may want to ask your healthcare provider.

1. How much water and liquids should I drink every day? How do I know if I'm drinking enough? Is it OK to drink coffee, tea, or soft drinks?

2. What foods can I eat? What foods should I avoid?

3. Is it OK to take extra vitamins or minerals? How about herbal remedies?

4. What are the signs that I may have an infection?

5. Could I have a kidney stone and not have any symptoms?

6. Can I take medicines to keep kidney stones from coming back?

7. What surgeries can be done to treat my kidney stones?

8. What tests can be done to find out why I get kidney stones?

9. When should I call the doctor?

A word from Doc2Us

If you have any questions related to kidney stones, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

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Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

1. Medline Plus - Kidney stones - what to ask your doctor

2. UpToDate - Uric acid nephrolithiasis

3. UpToDate - Patient education: Kidney stones in adults (Beyond the Basics)

Cover image credit: Robina Weermeijer on Unsplash

Written by

Ms Joyce Toh