Preventing Kidney Stones

IT is that time of the year again where we will enjoy the festivity and delicious food. With Hari Raya a few days away, the Muslims will celebrate this joyous occasion with their family and friends, and will host open houses.

Apart from Hari Raya, there is also another treat in July – the ongoing Euro2016. When it comes to food and football, I am often reminded of celebrity chef Gordon Ramsay.

Many may not be aware that the British chef, restaurateur and television personality, who has been awarded 16 Michelin stars in his career, started his life journey as a professional footballer.

He was signed by Rangers at the age of 15, but was dropped after an injury.

Ramsay once said: “I still love football, though, and I think cooking is like football. It’s not a job, it’s a passion. When you become good at it, it’s a dream job and financially you need never to worry. Ever.”

This week we digress from the usual topic of sexual health and address the concerns from a reader about food and recurrent kidney stones. Is there such a thing as food indulgence and “need never to worry?”

Dear Dr G,

I am Abdullah and hope you can help me. I noticed you usually address the issues of sexual and reproductive health, but I am hoping you can also deal with the pain of my life, kidney stones.

I was recently admitted to hospital, two weeks after the start of Ramadan with a kidney stone attack.

The pain was so intense that the urologist decided to do an endoscopic operation and laser the stone.

I was told the stone in the urethra that caused obstruction had been removed, but there were more stones in the kidney scheduled for removal after Raya.

This is the third attack of renal colic. I am only 38 years old and worry the stones will recur.

Can you tell me the measures to avoid kidney stones?

Regards
Abdullah

Kidney stones are formed when the excess substances are concentrated and crystalised in the urine. The substances include calcium, oxalate and uric acid that are generally the byproducts of food and tissue repairs.

Diet is one of several factors that can promote or inhibit kidney stone formation.

Certain foods may promote the formation of stones in individuals who are susceptible. The susceptibility is generally influenced by genes, environment, body weight and fluid intake.

There are four main types of kidney stones. The most common types are the calcium oxalate and phosphate stones, which is caused by the combination of high urine calcium and alkaline urine.

The second most prevalent stones are the uric acid stones. A diet rich in purine, such as animal protein, meat and shellfish will increase the uric acid concentration in the urine resulting in the formation of stones by itself or along with calcium.

Other types of stones such as genetic disorder cysteine stones or infective struvite stones are less common.

The first step in stone prevention is understanding and knowing which type of stones the sufferer is having.

This can be determined by analysing the stones that is passed or extracted. Alternatively, the lab examination of the urine and blood may also determine the concentration of calcium, oxalate and uric acid.

The simplest way to reduce the risk of urinary stones is making changes in fluid intake. The amount of fluid recommendation obviously depends on the weather and the level of exercise for the individual.

Drinking between two and three litres of fluid per day is the best way to dilute the urine and prevent concentration and crystallisation of stones.

As calcium stone causes the vast majority of stone formers, avoiding excessive calcium, reducing sodium and animal protein will help to reduce the risks of future stone formation.

In addition, avoiding food high in oxalate contents such as rhubarb, nuts, beams and wheat bran is also important.

Sodium, often from salt, causes the kidneys to excrete more calcium into the urine. Learning the sodium content of food can help sufferers to control their sodium intake.

Avoiding certain food with high level of sodium such as processed frozen food and fast food generally will reduce the overall sodium consumption.

Meat and other animal proteins such as eggs and fish contain purines, which break down into uric acid in the urine.

Animal protein may also raise the risk of calcium stones by enhancing the calcium excretion and reducing the citrate concentrations in the urine. This will in turn increase the overall risk of kidney stones formation.

In the world of abundance food, it is too easy for us to indulge and not think of the consequences. Although some may get away with no harm, but for many, the over consumption will come and haunt us one way or another.

Of course, I have no intention of dampening the spirit of festivity.

Just an advice from a wise member of The Beatles George Harrison: “All the world is birthday cake, so take a piece, but not too much.”

On that note, I wish fellow Malaysians Selamat Hari Raya!