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Kidney Stone Formation

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)
  • Urine normally contains chemicals-citrate, magnesium, pyrophosphate-that help prevent the formation of crystals and stones. Low levels of these inhibitors can contribute to the formation of kidney stones. Of these, citrate is the most important

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

  • The following medical conditions are also risk factors for kidney stone disease:
  • Gout (caused by excessive uric acid in the blood) which leads to high urinary uric acid levels
  • Hyperparathyroidism (excessive parathyroid hormone, which causes calcium loss from bone)
  • Mdullary 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)

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 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 by products of animal protein and who consume large amounts of meat.

Oxalate is found in, Red meat (beef, pork, mutton), vegetables (e.g., greens, spinach,), nuts, chocolate, coffee and strong tea. Stone formers should limit their intake of these items, which contain a moderate amount of oxalate.

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