Renal considerations: When stones strike

The age bracket in which kidney stones typically occur is 18 to 30 years

Are you at risk for kidney stones? Find out how to steer clear of this common ailment. DESIGN BY HIRA FAREED

Are you at risk for kidney stones? Find out how to steer clear of this common ailment.


Appearance of blood in urine

Pain in the abdomen, flank, or groin. The pain is usually sudden, very severe and intermittent. The pain radiates from the back, down the flank, and into the groin.


A majority of stones pass spontaneously from the body within 48 hours. Factors that influence this passage include:


Prior stone passage

Prostate enlargement


The size of the stone

If a stone does not pass, a urology specialist may be needed. Routine treatment includes pain relief measures, hydration, and a course of antibiotics in case of an infection.

Eight to 10 glasses of water a day

“The correct way to see if you’re meeting your body’s fluid requirement is by the urine output. You may be drinking eight to 10 glasses of water, but you may be sweating most of it out,” explains Dr Sohail Tanvir, Senior Registrar at Pakistan Institute of Medical Sciences. Dr Tanvir explains that the ‘eight to 10 glasses’ rule applies to people who spend most of their day indoors. For people who work outside, even 15 to 18 glasses may not be enough during hot summer days.

Kidney stones are small, hard mineral deposits that form inside your kidneys. The age bracket in which kidney stones typically occur is 18 to 30 years but they may occur outside of this bracket depending on the patient’s lifestyle and family history. Factors that commonly cause kidney stones include reduction in fluid intake, increased exercise with dehydration, medications that cause high uric acid, and a history of gout.


Patients with a history of kidney stones are advised to pass at least 2.5 litres of urine in a day. A diet low in protein and rich in oxalates (spinach, beets, potato chips, French fries, nuts and nut butters) can lead to the recurring formation of kidney stones.

Kidney stones in infants

Kidney stones may occur in infants due to Renal Tribunal Acidosis. A deficiency of inhibitors magnesium and citrate causes the process of acid absorption from the blood stream to slow down, leading to the formation of stones. If this deficiency is left untreated, it could cause kidney failure.

Types of kidney stones

Two common types of kidney stones:

Calcium Oxalates

Calcium oxalates occur when there is a high level of oxalates, found in chocolate milk, hot cocoa, tea, nuts, sesame and so on, present in the diet. The most common preventive measure is to introduce citrate into the patient’s blood stream. Citrate is the strongest inhibitors of calcium, and its supplementation will help decrease the potential to form stones in the future.

Uric Acid Stones

Uric Acid stones most commonly occur in patients with a family history of kidney stones. These stones are made of uric acid, a waste product normally passed out in the urine. They are caused by low urine output, high protein diet (especially animal protein) and inflammatory bowel disease. Uric acid stones do not show up in an ultrasound, which makes them all the more dangerous. This is why doctors need to be thorough with their testing and run an abdominal CT scan and Intravenous Pyelogram if the patient persistently complains of pain in the abdominal region.

Patients are advised to increase fluid intake, decrease protein and increase the intake of citrates in the form of citrus-rich fruits. Treatments include stone diluting tablets and surgical removal of stones.

Hurmat Majid is a subeditor at The Express Tribune. She tweets @bhandprogramme 

Published in The Express Tribune, Sunday Magazine, August 23rd, 2015.


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