Kidney Stones and Crystal Formation
Kidney stones are common in the urology practice. 5-10% of you will make stone within his or her lifetime with a peak incidence of onset during the prime of life in the 20-50, Men tend to make more kidney stones. If you have had your first kidney stone the recurrence rate is about 50% within 5-10 years.
Kidney stones can be big or small, can be very painful or asymptomatic, can pass on their own or need surgical intervention. Kidney stones can sit quietly in a kidney for years and years, or become acutely problematic causing pain, infection, and at their worst, kidney damage or kidney failure.
There are really 5 basic types of stones.
Calcium based stones, Ca oxalate and Ca phosphate account for 80% or so of kidney stones. Calcium readily combines with oxalate and phosphate in urine that is concentrated or lacking other stone inhibitors. Uric acid stone make up about 10-15% of stones. Uric acid stones form in acidic urine and in urine high in uric acid, a byproduct of protein breakdown. Struvite or infection stones occur in patients with chronic bacteria or infections. Lastly, Cystine stones come from a specific disorder of kidney filtering which increase cystine levels within the urine precipitating many stones for those patients.
Other types of stones exist but are much less common.
OK now let’s get our nerd on and talk a little science. Don’t worry I won’t go too far into the woods here.
Kidney stones form by a process called crystallization. A crystal is a solid consisting of a symmetrical, ordered, three-dimensional aggregate of atoms or molecules.
Here in Minnesota it is just about winter. Ice and snow are on their way. Ice and snow are crystals.
Each type of kidney stones is a crystals unique to each mineral. Each has its own shape allowing layering of crystal to create a stone. Kidney stone crystals form out of a solution, minerals present in urine.
The goal of stone prevention is to decrease the saturation of minerals that will make a stone, to increase stone inhibitors (other minerals that get in the way), and to minimize stasis of urine.
How do we do this?
Increasing fluids and drink more water. Limit salt, protein, and oxalate in the diet. Increase citrate by drinking lemonade or orange juice.
Do not limit calcium in your diet to try to decrease your risk of forming calcium stones. It doesn’t work that way.
That’s the episode. Be well and do good.
