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Urology

Urological Conditions

Kidney Stones

Kidney Stones–Causes, Risk Factors and Prevention

For unknown reasons, the number of people in the United States with kidney stones has been increasing over the past 20 years. Each type of kidney stone has its own set of causes, described below:

  • Calcium stones
    One cause of calcium stones is a disorder called absorptive hypercalciuria. It causes the body to absorb too much calcium from food. The extra calcium can be emptied into the urine, causing crystals of calcium oxalate or calcium phosphate to form in the kidneys or urinary tract. Another condition that can cause high levels of calcium is hyperparathyroidism, or overactive parathyroid glands. The parathyroid glands regulate calcium. A third cause is a rare metabolic disorder called hyperoxaluria that makes the body produce too much oxalate, a salt. When there is more oxalate than can be dissolved in the urine, the crystals settle out and form calcium oxalate stones.
  • Struvite (infection) stones
    This type of stone is caused by urinary tract infections and is usually found more often in women. For more information about urinary tract infections, click here. [Note: could put link to urinary tract infections page here]
  • Uric acid stones
    Uric acid is a by-product of protein metabolism. Therefore an overabundance of certain foods, such as meat, in one’s diet may cause excess amounts of uric acid in the urine. Certain chemotherapy drugs can also cause high levels of uric acid in the blood and urine.
  • Cystine stones
    Cystinuria is a rare, inherited metabolic disorder that causes too much of the amino acid cystine to be excreted into the urine. Because cystine does not dissolve in urine, cystinuria can lead to the forming of cystine stones.

Other risk factors include:

  • Certain diseases
    Besides the conditions mentioned above, some common disorders such as gout, chronic urinary tract infections, cystic kidney disease, as well as rare, inherited diseases, such as renal tubular acidosis, can increase the risk of kidney stones. Calcium oxalate stones may also form in people who have a chronic bowel inflammation or who have had an intestinal bypass operation, or ostomy surgery.
  • Certain drug treatments
    Certain diuretics (water pills) or calcium-based antacids may increase the risk of forming kidney stones by increasing the amount of calcium in the urine. People who take the protease inhibitor indinavir, a drug used to treat HIV infection and AIDS, are at risk of developing kidney stones.
  • Age
    Kidney stones strike most typically between the ages of 20 and 40.
  • Race
    Asians have the lowest rates of the disease. White Americans are more prone to develop kidney stones than African Americans.
  • Gender
    Stones occur more frequently in men.
  • Family history
    A person with a family history of kidney stones may be more likely to develop stones.
  • Personal history
    A person who has already had a kidney stone may be more likely to develop others. The recurrence rate is about 3 percent after the first stone and 6 percent after the second.
  • Diet and lifestyle
    A high protein (meat, chicken and fish) and low fiber (fruits, vegetables and whole grains) diet may increase the risk of some types of kidney stones. A diet that doesn’t include enough fluids can do the same, because it may leave higher concentrations of stone forming substances in the urine. Similarly, not drinking enough water while living in a hot, dry climate, working in a hot environment, or exercising heavily can also lead to stones. Finally, people who are bedridden or don’t get enough exercise may develop stones because their bones release more calcium.

Remember that having one or more risk factors may increase your chance of developing kidney stones, but it does not mean that you will get them.

The best preventative measures, especially to prevent recurrence, may be diet and lifestyle changes. For example, eating more fiber and less protein, especially meat protein, and drinking more water may help prevent stone formation. You should talk to your doctor about this. Your doctor may also prescribe certain medications to prevent recurrence, depending on the type of stone.