Kidney Stone: Symptom Cause And Prevention

Arvind K. Singh Chandel, CSIR -CSMCRI Bhavnagar

2018-02-14 12:36:37



Kidney stones are a result of precipitation of water-soluble salts, minerals, and others organic, an inorganic substance in any part of the kidney which cannot flush out from body during the urination. In normal physiological condition, the precipitation does not take place but when the equilibrium pH of body fluid disturbed the chance of precipitation increase and many other factors also involved in this process.


Sometimes kidney stones do not show symptoms. However, if a stone becomes trapped in the ureter (the thin tube between the bladder and kidney), symptoms can be very intense and severe. Often, symptoms vary depending on the stone's location, progression and their types

The kidney stone attacks come mostly at late night or in the early morning time, maybe due to low urine output during this period while kidney stone attacks less common during the late afternoon time.

The pain usually begins sharply on the single side and stays to be sharp and consistent. (In some cases it lasts for some minutes, disappears, and then returns after about 10-20 minutes.)

The patient cannot get a comfortable position and usually sits, stands, paces, or reclines in a failed search for a position that will provide relief. If the stone is present in the kidney or upper urinary tract, the pain ordinarily starts in one haunch area (to the side of the back near to the waist). It typically radiates to the groin area. If the kidney stone is too big to pass quickly, the pain follows the muscle contractions in the wall of the ureter as they try to squeeze the stone along into the bladder.

•   Nausea and vomiting may occur.

•   Blood may be present in the urine.

•   As the stone passes down the ureter, closer to the bladder, the person may feel the compulsion to urinate more often or a burning sensation during urination.

•    A fever suggests that the person may also have a urinary tract infection.

The size of the stone does not essentially predict the severity of the pain. A very tiny crystal with sharp edges can cause intense pain, while a larger round stone may not be as distressing. Struvite stones can often occur without symptoms.

Cause and solution of kidney stone

The principle causes of the kidney stones formations are following:

1. High TDS water

Generally around the sea coastal area and others places where ground water contains very high TDS (total dissolve solid) such water mainly contains calcium, magnesium, potassium, sodium, bicarbonates, chlorides, and sulfates) are makes the TDS of water more than 600-1800 PPM or more that may cause the problem like kidney stone.Typical suggested dietary intakes are about 1000 mg of calcium per day and 200– 400 mg of magnesium every day. For calcium and magnesium, the typical contribution from water is 5–20% (WHO, 1973; National Research Council, 1977; Neri& Johansen, 1978). Because of dietary habits in most countries, many people fail to get the recommended intakes of these salts from their diets and therefore their supply depends on drinking water is important. The hard water is not bad for health, In fact, the National Research Council (National Academy of Sciences) states that hard drinking water usually contributes a small amount to total calcium and magnesium human dietary needs. They further state that in some instances, whereas dissolved calcium and magnesium are very high, water could be a significant contributor of calcium and magnesium to the diet. Very high hardness (above 300 PPM) which is not typical of drinking water originating from surface water and may be associated with higher risk of kidney stones and others cardiovascular complication such as blood pressure atherosclerosis etc. In most cases of kidney stones. Hardness testing of water

  • By taste
  • Simple titration with EDTA (ethylenediaminetetra-acetic acid)Concentration (ppm) Hardness Rating < 61 Soft, 61 – 120 Moderately hard,121-180 Hard,> 180 Very hard
  • Commercial hardness testing strips: Insta-Test 6-Way Drinking Water Test Strips
  • Hardness testing kits:Calcium Hardness in Fresh or Salt Water Test Kit, total hardness kit.
  • Hardness testing instruments:ColorQ Pool 4, ColorQ PRO 7, ColorQ PRO 7 Plus,SMART 3 Colorimeter

How to lower the TDS of water

The TDS of water can lower by following techniques: Distillation, Deionisation (DI), Potash alum (fitakari) treatment, Reverse Osmosis (R.O.) Reverse Osmosis removes TDS by forcing the water, through pressure, through a synthetic membrane. The membrane contains microscopic pores which will allow only molecules smaller than 0.1 nanometres to pass through. As the molecules of dissolved metals, bacteria, virus and salts are large compared to the water molecules; water squeezes through the membrane separating the metals and salts from others site. This technique is the best and effective techniques for the water purification nowadays.


Removal of exes of water from the body or not drinking enough water each day can increase your risk of kidney stones. People who live in hot climates and those who sweat a lot may be at higher risk than others. Due to dehydration the concentration of salts in the body fluid increases and get precipitated. In such condition take plenty of water with the essential salts because in sweating the salts get lost from the body fluid and create the chance of low blood pressure condition. 

3. Certain diets. 

Taking high calcium, protein and acid containing diets such as s Eating a diet that's high in protein, sodium (salt) and sugar may increase your risk of many types of kidney stones problems. This is remarkably true with a high-sodium containing diet. High content salt in the diet increases the amount of calcium your kidneys must filter and significantly increases your risk of kidney stones.

Avoid stone-forming foods:chocolate, tomato, carry, Beets, tea, spinach, rhubarb, and most nuts are rich in oxalate, and colas are rich in phosphate, pulses, both of which can contribute to kidney stones.

Reduce sodium: A high-sodium congaing diet can trigger kidney stones because it increases the amount of calcium in your urine. So a low-sodium diet is suggested for the stone prone. Current guidelines recommend limiting total daily sodium intake to 2,300 mg. try to reduce your daily intake to 1,500 mg. This will also be good for your blood pressure and heart

Limit animal protein:takinghigh animal protein, such as eggs, red meat, poultry, and seafood, boosts the level of uric acid and could provoke to kidney stones. A high-protein diet also reduces levels of citrate, which in urine that helps prevent stones from forming.

Take calcium in your diet: Receiving too little calcium in your diet can cause oxalate levels to rise and cause kidney stones. To avoid this, make sure to take in an amount of calcium appropriate to your age. Ideally, obtain calcium from foods, since some studies have linked taking calcium supplements to kidney stones. For men 50 and older should get 1,000 milligrams of calcium per day, along with 800 to 1,000 international units (IU) of vitamin D to help the body absorb the calcium.

Drink plenty of water: Intake extra water which dilutes the substances in urine that lead to stones. Strive to drink enough fluids to pass 1.5-2 litters of urine a day, it may help to include some citrus beverages, like lemonade and orange juice. The citrate in these beverages helps block stone formation. The urine should not having any coloration.

4. Digestive diseases and surgery

Some conditions such as inflammatory bowel disease,gastric bypass surgery, or chronic diarrhoea can cause changes in the digestive process that may affect your absorption of calcium and water, increasing the levels of stone-forming substances in your urine.

5. Obesity. 

High body mass index (BMI), large waist size and weight gain have been linked to an increased risk of kidney stones

6. Medical conditions. Diseases and conditions that may increase your risk of kidney stones include hyperparathyroidism, cystinuria, renal tubular acidosis, certain medications and some urinary tract infections.

7.Family history. If in your family someone has kidney stones, you have high chance to develop kidney stones. And if anyone has already kidney stones that may increase risk of developing another kidney stone.

8. Medicines that increases the risk of kidney stone

Calcium stones- Antacids,furosemide and acetazolamide, theophylline,Glucocorticoids, such as dexamethasone and Vitamins C and D

Uric acid stones-probenecid,salicylates,hydrochlorothiazide.

Others- Acyclovir, indinavir,triamterene.

Types of kidney stones

Calcium Stones. Approximately 80% of all kidney stones contain calcium, generally formed with oxalate or oxalic acid. Many simple vegetables, fruits, and grains contain oxalate that also forms. A little percentage of calcium stones made of calcium phosphate. Hypercalciuria (too much calcium in the urine) leads to its formation. Conditions that lead to hypercalciuria and calcium stones:

•    Too much calcium absorbed by the intestines.

•    Excessive chloride intake. Because of chloride has a negative charge, and calcium has a positive charge, so they balance each other in the body.

•    Renal calcium leakage promotes causing an increase in calcium outflow in the urine.

•    Excessive sodium intake. Due to that high urinary levels of sodium resultant in enhanced levels of calcium. Several defects in the kidney tubules transport system can cause imbalances in sodium and phosphate, which can promote high calcium levels in the urine. A high-salt diet can also produce this effect.

Uric Acid StonesUric acid is responsible for nearly 10% of kidney stones. It is the metabolic by-product of nitrogen, purines, compounds found in the body and several foods. Uric acid accesses the bloodstream and then passes mainly into the kidneys. From the kidneys, uric acid drops the body in the urine. Frequently, uric acid stones occur with calcium kidney stones.


Struvite Stones. Magnesium ammonium phosphate forms struvite stones. They always associated with some urinary tract infections. Worldwide, they estimate for up to 30% of all kidney stones. In the United States, however, fewer than 15% of all types of stones are struvite. Most struvite stones happen in women. Better control of urinary tract infection can prevent such conditions


Cystine Stones. Such types of stones develop by cystine amino acid which is a building the block of protein, generally causes 1% of total kidney stones in adults and up to 8% of kidney stones in kids. The tendency to form these type of kidney stones is genetically inherited. Cystine stones proliferate and tend to recur. If not treated promptly, they can eventually lead to kidney failure.

Xanthine Stones. Other types of kidney stones are composed of xanthine, a nitrogen compound. These stones are extremely uncommon and usually occur as a result of a rare genetic disorder.


Physician can diagnose the kidney stone on the basis of symptoms and prescribed the following diagnosis tests:

Imaging Techniques

Ultrasound, X-rays CT scan,Intravenous Pyelogram (IVP), MRI,

Urine Tests

Urine samples are needed to evaluate features of the urine, including its acidity and the presence of: Red or white blood cells, Infection, Crystals, High or low levels of chemicals that inhibit or promote stone formation.

Blood tests

Blood Tests for Stone Factors:Parathyroid Tests,Tests for Infection,Tests for Metabolic Problems


When detects the positive kidney stone physician prescribes the medicine according to types and severity of the stone and suggest the peccoustions also  

Extracorporeal Shock Wave Lithotripsy


Percutaneous Nephrolithotomy

Open Surgery (Nephrolithotomy)

Effective prevention

The prevention is better than cure, so few preventive steps should adopt that may keep away from such type of severe disorders:

  • Increase fluid intake,
  • Restrict sodium intake
  • Reduce protein intake
  • Take more potassium
  • Maintains acid alkaline balance
  • Take low salt diet
  • Use low TDS water

Despite all of these if feel few problem regarding these should not ignore and must visit to your physician and take prescription.