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Stay away from stone!

DRINK WATER to avoid stones. Photo : N.Rajesh   | Photo Credit: N_RAJESH;N_RAJESH - N_RAJESH

Every day of your life, your kidneys are hard at work, cleansing your system, removing the toxic build-up of chemicals (that are the natural by-product of digestion) and keeping you fresh. Unfortunately, sometimes due to the kinds of food we eat and the nature of our own bodies, a hardened mass can form in our kidneys from the crystals that are naturally present in urine. These pebble-like 'stones' can hinder kidney function. They can also travel to the ureter (the tube that links the kidney with the bladder) and lodge themselves there. Eliminating this can be excruciatingly painful. "Kidney stone formation can happen to anyone and usually, 5-10% of our Indian population (over 50-100 million people) are affected by this condition," says Dr MG Rajamanickam, member of the Urological Society of India, Professor of Urology (Academic head), Sri Ramachandra Medical College Hospital, Porur, and Consultant urologist at St Isabel's Hospital, Chennai. "Men tend to be more vulnerable than women. Women are protected by the hormone estrogen which plays a vital role in preventing stone formation." But they too are at risk after menopause and sometimes, a family history can make you prone to the condition, regardless. Lifestyle factors too are to blame. For instance, lack of sufficient fluid intake, obesity, eating deep fried foods--all this can aggravate stone formation, especially if you have a tendency for it. Here's how you can fight the condition.

Fluid intake

"Dehydration remains a major cause," explains Dr Rajamanickam. "Chronic dehydration causes a super-saturated urine output, which can put you at risk. Everyone should drink at least 8-10 glasses of water and fluids (2-2.5 litres) a day. If you've suffered from stones before or have a family history, you require a daily fluid intake of 3 litres. Fluids can include fresh fruit juices, buttermilk and tender coconut." "It's best to keep a record of what you are drinking and use a small cup or glass," says Dr Nupur Krishnan, clinical nutritionist and Director of Bio-logics Nutrition Clinics, based in Mumbai. "Most of your fluid intake should be from water. Remember, the less concentrated the urine is, the better."

Food myths and misconceptions

Kidney stones are formed from the deposits of many different kinds of chemicals, but the most common one, making up nearly 80% of all stones, is calcium oxalate. For this reason, many people tend to think that cutting down on your calcium intake can help you prevent the formation of this kind of stone. "This is very widespread misconception and is just not true," says Dr Rajamanickam. "Cutting back on calcium can actually be harmful because inadequate calcium in your system (apart from causing other deficiencies) can have the opposite effect and even hasten stone formation. For this reason, be sure to make calcium (from natural sources) an important part of your daily diet, especially if you are over 50. Buttermilk (with minimal salt) is highly recommended. You can even have curd without the cream. Avoid animal proteins (from non-vegetarian food sources), junk foods, chat items, pickles, processed and packaged items, deep fried foods and salty fare." Vegetables and fresh fruit juices are ideal, but even here there are some restrictions. "I ask my patients to avoid the chickoo fruit and grapes that have seeds (the seedless kinds are alright). In all, home-made fresh foods are the best."

Another popular dietary recommendation for those with stones (and one that you may have heard of all too often) is the juice from the plantain stem (vazhathandu in Tamil). "Too much of this juice can actually cause the formation of oxalate, so the raw juice is best avoided," says Dr Rajamanickam. You can however, enjoy the lightly sautéed form of the vegetable.

Avoiding other ‘Oxalate’ foods

Some research suggests that limiting high oxalate foods may help reduce the risk of your forming oxalate stones. "Foods that are high in oxalate include: peanuts, tea, instant coffee (more than 8 ounces a day), rhubarb, beets, beans, beets, berries (blackberries, raspberries, strawberries, gooseberries), chocolate, Concord grapes, dark leafy greens, oranges, tofu, sweet potatoes and draft beer," says Dr Nupur Krishnan.

Risks from metabolic factors

If you have parathyroid disease, this will change the way your body metabolizes calcium. With such a condition, regardless of your diet or lifestyle, you will be at risk to developing calcium oxalate kidney stones. Nearly 15 per cent of kidney stones are the result of uric acid deposits. If you're affected by gout (an arthritic condition that affects the small joints of the body) you would be more prone to such uric acid stones. Obesity and diabetes can leave one vulnerable as well. "Treating these metabolic conditions and going in for regular screening for stones by taking an ultrasound of the abdomen and the kidneys every year is important," says Dr Rajamanickam.

Help at hand

Most smaller stones pass by themselves, but today, help is at hand for chronic sufferers and invasive treatment is kept to a minimum. "Open surgery for stone removal is now redundant," says Dr Rajamanickam. "The most preferred method of stone removal is called extracorporeal shock wave lithotripsy (ESWL). In this technique, small stones (less than one cm) are broken down into fragments by high energy shock waves from a device outside the body. For larger stones, treatment options include Percutaneous nephrolithotomy, (PNL) which involves making a small perforation or hole, inserting a tube to endoscopically disperse the stone, without affecting kidney tissue. But even as technology advances, prevention remains the best medicine!

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Printable version | Oct 24, 2020 9:45:54 AM | https://www.thehindu.com/features/metroplus/stay-away-from-stone/article3840023.ece

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