The stone saga

Kidney stones have been troubling mankind since time immemorial. The earliest kidney stones were found in Egyptian mummies and the ancien...

Kidney stones have been troubling mankind since time immemorial. The earliest kidney stones were found in Egyptian mummies and the ancient Indian treatise on surgery 8212; Susruta Samhita 8212; also contains vivid descriptions of kidney stone removal.

Simply speaking, a kidney stone is a solid concretion of various chemicals. Normally, the kidneys flush out unwanted chemicals but sometimes due to certain reasons, the kidneys are unable to flush out the waste and the chemicals precipitate to form crystals that aggregate to form stones.

Stones are commonly formed of oxalate, phosphate and uric acid and calcium is the most common element that binds with them. Mostly affecting North Indians, which is also referred to as the 8220;stone belt8221; by doctors, stones are formed due to a milieu of reasons a metabolic breakdown, heredity, infection, dietetic factors, low intake of water, a sedentary life style, absence of stone inhibitors and hyper activity of the para-thyroid gland.

Though there are many methods for stone removal, the real problem for both the doctor and patient is how to tackle the recurrence of a kidney stone. Since kidney stones are most often a lifetime condition, prevention is the most important challenge.

Renowned nephrologist Dr K.S. Chugh says the first step towards prevention is to get a chemical analysis of the stone done to determine the exact nature of the stone. Also, complete blood and urine investigations will indicate any metabolic disorder. Once the doctor knows why the stone is being formed, recurrence can be easily controlled, says Dr Chugh. High fluid intake is the single most important factor in the prevention of a kidney stone and its importance cannot be undermined. Doctors advise about three to four litres of fluid intake daily or enough to produce 2 to 2.5 litres of urine. The urine must be kept dilute so that crystal formation is not encouraged. Water intake also has to be spaced out. The patient must take water in small quantities throughout the day to prevent concentration of the urine. A simple indicator of whether you are having enough fluid is the colour of urine. Tap water colour urine is fine.

After fluid therapy, a preventive diet programme, depending on the chemical composition of the stone, can keep a patient absolutely stone free. Usually, a patient is advised a low calcium, low oxalate and low protein diet. If the water in any region contains excessive amount of minerals, especially calcium, as is the state in north India, water should be boiled and cooled to lower calcium levels.

A preventive diet becomes all the more important because kidney stones, with the exception of uric acid stones, cannot be dissolved with any medicine. 8220;There is no medication in any system of medicine, anywhere in the world, to dissolve oxalate and phosphate stones,8221; says Dr Chugh. 8220;Only the ignorant people go for it.quot;

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It8217;s vital to remove all the stones during a removal procedure as any residue acts as a nuclei for recurrence. Kidney stones can easily be stopped cold. All it takes is to make certain changes in lifestyle and diet.