Dumaguing: How harmful are kidney stones

Victor Dumaguing

OUR previous article on kidney stones has generated many responses - questions, comments, feedbacks - name it, in the form of text messages, and calls from our readers, patients and friends. Understandably, most of the fear and anxiety generated by the article is the fact that indeed, our diet - Ilocanos, Pangasinenses and Cordillerans - are dripping with purine foods which contribute the uric acid that would eventually lead to formation of the pesky bothersome kidneys stones- again our delicious dishes like igado, dinakdakan, pinapaitan, bopis, beans of all colors, our veggies and fruit like strawberries, tomatoes.

At this juncture, it is good to remind our readers that stones do not just form in the kidneys; ureterolithiasis in the ureters, cystolithiasis in the urinary bladder. However, most of the queries focused on kidney stones and we are more than happy to oblige our readers and friends.

Kidney stones are small, hard deposits of mineral and acid salts on the inner surface of the kidneys. Normally, these stone are diluted and dissolved in the urine. When urine is too concentrated- thus the advice to have 8-10 glasses of water per day- these minerals may crystallize , stick together and solidify resulting to kidney stones. Most of these stones contain calcium- thus again a "kulit" reminder for those taking calcium with vitamin D like Calciumade, always take them with lots of water and preferably during the day.

Until a kidney stone moves into the ureter- the tube that connects the kidneys to the urinary bladder- you may not know that you have it. Signs and symptoms may occur which include pain at the side and back, below the ribs, pain radiating to the lower abdomen and groin, bloody, cloudy or foul-smelling urine, dysuria or painful urination, nausea and vomiting, persistent urge to urinate and worse, fever and chills if infection has set in which can be explained by the fact that stones would have reached a size that obstructs or blocks urine flow, thus creating a conducive environment for microbes like E. coli and Proteus vulgaris to multiply and proliferate.

Complications of a long standing kidney stone that has become obstructive include hydronephrosis- enlargement of the kidneys due to swelling by excess fluid resulting from the back pressure build up secondary to the blockage. Sad to say, this would lead to an eventual deterioration of kidney functions as evidenced by abnormal or elevated blood levels of BUN- blood urea nitrogen and creatinine. By now, the public is aware of the role of the kidneys in blood pressure control, thus a kidney malfunction contributes to hypertension, which now becomes a vicious cycle- hypertension damages the kidneys, damaged kidneys further raises blood pressure.

Kidneys stones are diagnosed with routine urinalysis- hematuria or red blood cells, crystals of either urates, oxalates, phosphates and sometimes pyuria or pus in the urine when there's a UTI- urinary tract infection. X-rays like plain abdomen or KUB-kidney urinary bladder, ultra sound and CT scan.