Header image courtesy of Gleneagles Hospital Hong Kong
We’ve all heard it bemoaned by anyone who’s ever had them before: kidney stones can be excruciatingly painful. Some even claim the pain is comparable to childbirth! Most people already have a fairly decent understanding about cardiac and heart health, and are also starting to pay a lot more attention to the gut and digestive system.
But how many of you can safely say you take really good care of your kidneys? We speak to an urologist at Gleneagles Hospital Hong Kong for some facts about kidney stones, as well as advice on how to maintain the health of your kidneys.
Unfortunately, the fact is that kidney stones are a common health issue. It has been estimated that one in ten people will have a kidney stone at some point in their lives. The risk of kidney stones is about 10 percent in men, and about seven percent in women. In men, this issue is likely to first occur after the age of 30, but there is a possibility it could also occur earlier.
If you’ve had one kidney stone before, you’re at a 50 percent risk of developing another within the next five to seven years. This is why it’s so important to get advice from medical professionals on healthy aftercare, and actually follow through on the tips!
There are four major types of kidney stones: calcium stones, struvite stones, uric acid stones, and cystine stones.
These are the most commonly occurring type, accounting for approximately 80 percent of all kidney stones. Often, this is in combination with oxalate, though sometimes also with phosphate or other substances.
Also known as infective stones, these sometimes develop following repeated urinary tract infections. They are generally a mixture of magnesium, ammonium, phosphate, and calcium carbonate phosphate crystals. Though softer in nature, struvite stones can grow very large—even filling the contours of the kidney and taking up the entire space where urine collects—and are nicknamed ‘staghorn stones’ because of their bull horn-like shape.
Uric acid is something that is naturally produced when the body breaks down protein. Urine will be more saturated with uric acid when it becomes acidic. This is why people who consume high animal protein diets are more likely to form uric acid stones. Having gout, chemotherapy, or disorders involving a high cell turnover are also risk factors. Uric acid stones can be particularly tricky to diagnose: they don’t show up on X-rays, CT scans are usually required to make the diagnosis.
Accounting for only one percent of all kidney stones, this is the rarest type, and forms due to a genetic disorder that creates high levels of cystine in the urine. Because it’s an inherited condition, these stones can occur even in childhood.
You wouldn’t be alone in assuming that because kidney stones are made mostly of calcium, their formation can be affected by calcium intake. But the truth is that unless you are consuming much, much more than the recommended daily amount, the amount of calcium in your diet does not usually affect kidney stone formation—on the contrary, it is a lack of dietary calcium that can increase your risk!
And the foods that do lead to kidney stones? In general, high salt content and non-dairy animal proteins—essentially all types of meat, beef, chicken, fish, and pork—are associated with increased stone formation. Also, foods that are rich in oxalate, such as chocolate, nuts, spinach, and tea, may also cause increased stone formation.
Specialists apparently refer to summer as kidney stone season. Hot weather can easily lead to dehydration, which increases the chances of kidney stones forming. The best way of combating this is to stay well-hydrated. If you like doing activities like tanning on the beach or hot yoga—anything that causes you to sweat a lot—then make sure you’re really chugging down that H2O!
Nobody pays much attention to the waste fluid that is urine, but it’s actually a complex liquid that contains hundreds of chemicals and minerals. If there is too high a concentration of these minerals, they can precipitate into crystals, which will eventually form kidney stones.
There is also a range of other conditions that are linked to kidney stones. Obesity is one of them, a health issue on the rise that has also seen a correlated increase in kidney stones. Diabetes, metabolic disturbances, recurrent urinary tract infections, parathyroid disease, and certain congenital urinary tract abnormalities are also associated with kidney stones.
Kidney stones don’t appear overnight! They form slowly and cause no symptoms. It is only until they “drop” out of the kidney and into the ureter—the thin muscular tube draining from the kidney to the bladder—that the following symptoms will appear.
Referred to as renal colic, this intense pain is caused by the flow of urine being obstructed and pressure building up in the kidney. The pain often radiates along the urinary tract, beginning high in the back over the kidney, then moving down to the lower abdomen, groin, and even the genitals.
This discomfort strikes suddenly and quickly becomes unbearable, accompanied by nausea and vomiting. When a stone moves into the lower urinary tract closer to the bladder, it could cause an increase in urination and urgency as well as pain while urinating called dysuria.
Known as haematuria, the amount of blood found in urine could be enough that it’s visible to the naked eye. Alternatively, large numbers of red blood cells could be found present under a microscope, fittingly called microscopic haematuria.
A kidney stone in the ureter will block the flow of urine. Pressure building up in the kidney will cause swelling, and permanent damage may occur if the obstruction is prolonged, possibly even leading to loss of kidney function.
Methods for treating kidney stones can range from non-invasive shock wave therapy to break up kidney stones into small pieces—called extracorporeal shock wave lithotripsy—to an inpatient procedure where a small puncture is made in the back to remove stones directly from the kidney.
An initial diagnosis is made using radiological imaging that could be an ultrasound, an X-ray, or a non-contrast CT scan. The choice of treatment will vary from case to case, depending on the size of the kidney stones in question, what they’re made of, and whether they are obstructing the urinary tract.
Obviously as with most health conditions, prevention is much better than cure. In general, around 50 percent of the risk of kidney stones has to do with personal genetic background—there’s not much one can do to alter this. The other 50 percent of the risk is due to environmental factors such as diet, fluid intake, and obesity.
Health practitioners generally recommend a well-balanced, high-fibre diet to reduce this risk. This means eating more fresh fruits, vegetables, dairy products, and whole-grain products, and limiting the consumption of meat and salt.
Another major prevention is to drink plenty of water—you’d be surprised at how many people are actually going through life dehydrated! A good rule of thumb is to aim for two to three litres of water a day, and for urine to be colourless rather than dark yellow or orange.
Lastly, medical studies have shown that people with increased body mass index have a higher risk of kidney stones. Obesity also makes stones harder to treat because it would be more difficult to target stones with lithotripsy, and there are heightened risks in undergoing anaesthesia.
Luckily here in Hong Kong, we are blessed to have so many top-notch medical practitioners to look after our health. In response to the increase in patients suffering from kidney stones, Gleneagles Hospital Hong Kong has launched their Kidney Stone Centre, so Hongkongers with this health issue can have a single point of care to refer to.
Led by a multidisciplinary team using the latest, minimally invasive equipment, Gleneagles’ Kidney Stone Centre creates individualised surgical treatments to remove stones, as well as provides metabolic evaluation to prevent stone recurrence. Such services are perfect for patients who have recurrent kidney or ureteric stones.
From now until 31 December 2020, Gleneagles are offering public hospital patients a 20 percent discount for their all-inclusive ExtraCorporeal Shock Wave Lithotripsy (ESWL) package. This two-days-one-night package is designed to ensure patients can be discharged in one to two days and be able to resume daily activities. The original price of the ESWL package was $38,100, but for patients who present a valid follow-up appointment slip issued by the Hospital Authority specialist outpatient clinics, this will be reduced to a special rate of $30,500.
Let Gleneagles Hospital Hong Kong take care of your kidney stone-related troubles, and contact them at (+852) 2122 1333 to make an advanced booking now.