Thursday, September 29

Kidney stones? How to prevent painful renal colic

Kidney stones, also popularly known as kidney stones, are the third most common disease of the urinary tract, behind urinary tract infections and prostate pathology. Approximately 5% to 12% of the population of developed and industrialized countries suffer from some symptomatic episode before the age of 70, according to current data from the Spanish Society of Nephrology.

It is also estimated that the number of people with this pathology increases by 40% due to rising temperatures during the hot months. This is admitted by Dr. Carmen González Enguita, head of the Urology Service at the Fundación Jiménez Díaz University Hospital, Madrid, according to whom “summer is one of the most dangerous times due to high temperatures”, which causes our body to lose more water due to to sweating and, therefore, there is a greater risk of dehydration. Although, as she points out, these pathologies are also frequent throughout the year.

What are kidney stones and why do they form?

A stone is a mineral element that develops from deposited substances that drag the urine, and that come to form crystals. The accumulation, the aggregation of these crystals and their growth is what gives rise to their formation in the renal cavities. Once the stone has formed in the kidney, they can be identified in the ureter —the tube that allows urine to pass from the kidney to the bladder— or in the bladder.

Calculi are formed when the mineral elements or salts contained in the urine —as a final product of the different metabolisms— crystallize. Some grow until, randomly and capriciously, they are released from the site where they were formed and the elimination process begins along the urinary tract. And, when passing through certain areas, they can stop abruptly and cause an obstruction in the course of urine, causing colic. Sometimes, this accumulated urine due to the obstruction can be accompanied by bacteria causing an infection that can become severe.

Regardless of the size of the stone, renal colic is a very intense and sharp pain that begins in the corresponding renal fossa and radiates to the genital area. It is usually a unilateral pain, that is, it appears on the side of the affected renal unit. It is not associated with certain movements or postures, so it is not relieved with changes that the patient can adopt. “It is, without a doubt, one of the most terrible and intense pains that a human being can suffer,” says Dr. González Enguita.

This pain, which can radiate to the groin area, moves forward as the stone tries to come out, is usually accompanied by nausea, vomiting, malaise, anxiety and anguish. Due to its nature of “colic” pain, that is, it comes and goes, the patient anxiously awaits another episode that is to come, which generates terror of its occurrence and great anguish.

“The colic ends when the stone is expelled. This action can come right away, that is, the expulsion can be immediate as soon as the colic begins or be delayed in time: it can take many hours”, warns the doctor.

What are the risk factors for renal colic?

Men are two to three times more likely than women to form stones and to have renal colic. Although the lifestyle, certain habits and diet, very similar in the population of developed countries between men and women, is gradually equating this possibility of forming stones and presenting renal colic. Age also has an influence —between 40 and 60 years old they tend to be more common—, a sedentary lifestyle —it is believed that regular exercise can prevent crystalline aggregation— and a diet rich in saturated and unsaturated fats and sugars favor the formation of calculations.

“An association between high temperatures and urolithiasis has also been shown, a relationship that is due to a greater risk of dehydration, which leads to urinary supersaturation and which would explain why more cases are seen during the summer,” explains the doctor from the Jimenez Diaz Foundation.

When the kidneys have a constant flow of urine, and it is not supersaturated with lithogenic elements, the calcium fragments and other materials remain stable, do not increase in size and may not cause symptoms. But when little water is drunk it gives these little fragments a chance to come together and grow.

Drinking more water is the first line of defense against stone formation.

The most important way to prevent kidney stone formation and renal colic, especially during the summer, is to increase your water intake to a liter and a half or two liters of water a day. According to a review published in Cochrane —the organization specialized in evidence-based health care—, focused on the role of fluid intake in prevention of recurrence of renal colicthose patients who have already had renal colic at some point in their lives and who increase their water intake by more than two liters a day, regardless of the type of stone, reduce the recurrence of colic in a period of five years.

“With proper hydration, calcium and other crystal-forming substances are adequately eliminated in the urine. And, although genetics, family history and some medical conditions can increase the chances of developing kidney stones, working on changes in lifestyle, certain habits and diet will help prevent and even avoid them”, explains Dr. González Enguita.

It is important to avoid the consumption of sugary drinks, alcohol or industrial juices. The intake of animal proteins and salt should be minimized —it is not recommended to exceed the daily intake of two or three grams of salt—. Foods rich in fiber should be prioritized; limit the consumption of foods rich in oxalate, such as nuts, spinach or chocolate, and avoid a sedentary lifestyle since obesity is a factor associated with stone formation.

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