Statistics say that one in 10 Americans will have a kidney stone at some time in their lives. Aside from already having had a kidney stone attack, what can increase the odds that a person will have the misfortune to develop stones? Here are a few factors.
Studies show that up to one-third of all children are born with a possible genetic defect that can change the flow of urine, putting them at risk for kidney stones. If these individuals drink too little water or too many sugary juices, caffeinated beverages, or soft drinks, they can develop kidney stones.
Approximately 40 percent of people who form kidney stones have a family history of kidney stones. Other hereditary conditions can also increase the risk of developing kidney stones, including hypercalciuria (too much calcium in the urine), distal renal tubular acidosis, Bartter Syndrome types III and IV; and several others. Another condition, cystinuria, causes the kidneys to excrete excess cystine into the urine, which may lead to the formation of cystine stones.
The female factor
As I’ve mentioned in a previous blog post, although kidney stones used to be much more common in men, women are rapidly catching up. Why? For two apparently contradictory reasons: the first of these is the obesity epidemic, and the second is that women are taking too good care of themselves by getting lots of exercise. Unfortunately, many women who exercise a lot don’t drink enough water and therefore get dehydrated—a key risk factor for kidney stones.
Pregnant women are also at a higher risk for kidney stones, although the pregnancy itself is not what causes them. The stones may form either because a pregnant woman has a genetic predisposition to stones or because she is not drinking enough water during the gestation. Physiological changes during pregnancy—including an increase in the kidneys’ filtration rate, a heart and cardiovascular system that is taking care of both the woman and the developing fetus, and the increasing absorption of calcium by the intestines—can all increase the risk of kidney stones.
Combine that with the increasing pressure the growing baby puts on the kidneys and ureters (and the resulting increased risk of UTIs), and you’ve got a potential breeding ground—no pun intended—for kidney stone risks.
Patients who are paralyzed or immobile because of an accident or illness—including long-term residents of nursing homes—are at an increased risk for kidney stones. Even office workers who spend a long time sitting at their desks can raise their risk.
There is not yet a complete understanding of the long-term effects of bariatric surgery, but urologists have taken note of significant short-term effects of the gastric bypass. Within six months of the surgery, a patient’s risk of developing kidney stones nearly doubles. That’s because the whole digestive process changes for people who have had the Roux-en-Y gastric bypass surgery. The planned malabsorption caused by this procedure—which significantly affects the composition of urine—drives most of the risk of kidney stones. Bariatric surgery can create the perfect storm for stone disease, especially in patients who experience diarrhea, which results in fluid loss.
That said, bariatric surgery is a life-changing procedure that can stop many other diseases associated with morbid obesity. People whose doctors recommend gastric bypass surgery shouldn’t necessarily be afraid have it done—often, the health benefits far outweigh the risks. However, the decision should be an informed one consensually agreed upon by both the patient and doctor.
Certain medical conditions, including, but not limited to, urinary tract infections, gout, primary hyperparathyroidism, some types of cancer (and the chemotherapy drugs used to treat cancer), inflammatory bowel disease, sarcoidosis (enlarged lymph nodes in many parts of the body), and urine reflux can increase the risk of developing kidney stones.
With all of these risk factors, you might be asking, who’s not going to get kidney stones? People who drink enough water and who know their medical and genetic history are far more likely to be able to mitigate some of the risk factors. Those who don’t have rare diseases like medullary sponge kidney, primary hyperoxaluria, or cystinuria are also much less likely to develop kidney stones. Ultimately, the single best way to prevent kidney stones is to drink enough water!
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