Kidney Stones

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Causes and Risk Factors

Several factors increase the risk for developing kidney stones, including inadequate fluid intake and dehydration, reduced urinary volume, certain chemical levels in the urine that are too high (e.g., calcium, oxalate, uric acid) or too low (magnesium, citrate), and several medical conditions such as reflux, medullary sponge kidney, renal tubular acidosis and urinary tract infections (UTIs). Anything that blocks or reduces the flow of urine (e.g., urinary obstruction, genetic abnormalities) also increases the risk.

Chemical risk factors include high levels of the following in the urine:

• Calcium (hypercalciuria)
• Cystine (cystinuria; caused by a genetic disorder)
• Oxalate (hyperoxaluria)
• Uric acid (hyperuricosuria)
• Sodium (hypernaturesis)

A low level of citrate (called hypocitraturia) is a risk factor for stones.

The following medical conditions are also risk factors for kidney stone disease:

• Arthritis (ainful joint inflammation)
• Colitis (inflammation of the colon that causes chronic diarrhea, dehydration, and chemical imbalances)
• Gout (caused by excessive uric acid in the blood) which leads to high urinary uric acid levels
• High blood pressure (hypertension)
• Hyperparathyroidism (excessive parathyroid hormone, which causes calcium loss from bone)
• Medullary sponge kidney (MSK; a congenital kidney defect associated with urinary tract infections, low urinary citrate levels, and increased urinary calcium loss)
• Renal tubular acidosis (inherited condition in which the kidneys are unable to excrete acid)
• Urinary tract infections (UTIs; affect kidney function and chemistry)

• Inherited condition in which the kidneys are unable to excrete acid (renal tubular acidosis)
• Intestinal disorder that causes chronic diarrhea, dehydration, and low citrate (Crohn's disease)
• Painful joint inflammation (arthritis)
• Urinary tract infections (affect kidney function)

Diet plays an important role in the development of kidney stones, especially in patients who are predisposed to the condition. A diet high in sodium, fats, meat, and sugar, and low in fiber, vegetable protein, and unrefined carbohydrates increases the risk for renal stone disease. Recurrent kidney stones may form in patients who are sensitive to the chemical byproducts of animal protein and who consume large amounts of meat.

High doses of vitamin C (i.e., more than 500 mg per day) can result in high levels of oxalate in the urine (hyperoxaluria) and increase the risk for kidney stones. Oxalate is found in berries, vegetables (e.g., green beans, beets, spinach, squash, tomatoes), nuts, chocolate, and strong tea. Stone formers should limit their intake of cranberries, which contain a moderate amount of oxalate.

Kidney Stones, Causes reprinted with permission from urologychannel.com
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