What are the first symptoms of kidney stones and how to prevent them?

Writing.- Pain comes without warning. Sometimes it starts in the back, spreads to the abdomen or goes down to the groin. In many cases, it is kidney stones, known colloquially as kidney stones: small solid accumulations that can generate intense discomfort and, if not treated in time, cause infections or damage to the urinary system. In 2017 alone, the Mexican Social Security Institute (IMSS) performed more than 25,000 procedures to remove kidney stones, highlighting the magnitude of the problem in Mexico.

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Knowing the symptoms of kidney stones is the first step to acting in time. According to Dr. Walter P. Mutter, nephrologist at Mass General Brigham and chief of nephrology at Newton-Wellesley Hospital, identifying early signs and receiving timely treatment can prevent serious complications. In addition, the specialist shares practical recommendations to reduce the risk of forming new stones in the future.

What are kidney stones?

Kidney stones are solid masses formed by minerals and salts that clump together inside the kidney or, in some cases, in the bladder. They are generated when these substances, which are normally eliminated with urine, concentrate and crystallize over time.

“Kidney stones form in the urinary system,” explains Dr. Mutter. “They will typically develop within the kidney and sometimes in the bladder. They are composed of substances that are naturally present in our urine, which crystallize and accumulate layer upon layer over several months and years.”

Their size can range from a grain of salt to a golf ball. The larger they are, the greater the likelihood that they will obstruct the flow of urine and cause discomfort.

Symptoms of kidney stones

Generally, the calculations do not cause discomfort while they remain still. But if they move or block the urinary tract, the symptoms can be intense and sudden.

Some of the most common are:

• Experiencing intense pain in the back, side, lower abdomen, or groin • Nausea and vomiting • Blood in the urine • Pain or burning sensation when urinating • Difficulty urinating or doing so in small amounts • Cloudy or foul-smelling urine • Fever and chills These early signs of kidney stones in adults should not be ignored. If you experience any of these symptoms, consult a doctor immediately. Timely diagnosis can prevent major complications.

How are kidney stones diagnosed? To confirm the presence of kidney stones, the doctor may request:

• Urinalysis, to detect blood or infection • Imaging studies, such as X-rays, ultrasound, or computed tomography
These tools allow determining the size, location, and type of stone, as well as choosing the most appropriate treatment.

Causes of Kidney Stones

"Ultimately, in most cases we don't know exactly what causes kidney stones," says Dr. Mutter. "In some cases, it will be possible to identify a specific medical condition that could increase the risk of kidney stone formation in the patient. In those cases, it is key to conduct a detailed metabolic study to try to identify the risk factors that that specific patient presents that are the cause of the kidney stones." In this more exhaustive checkup, the patient's history, medication review, and laboratory analysis are usually considered. It may also include a 24-hour urine collection, in which the doctor examines it to detect anything in the urine that could increase the risk of developing kidney stones.

What are the risk factors for kidney stones?

Despite not knowing for sure what causes kidney stones, there are multiple factors that can increase the possibility of developing them.

These include:

• Race and sex: white men are more likely to develop kidney stones • Having an obstructed urinary tract, having a personal history of urinary diseases or infections, having endocrine and/or calcium disorders, or having certain bowel conditions • Family history of kidney stones • Dehydration • Eating protein-rich foods or consuming foods rich in oxalates such as spinach, almonds, and rhubarb • Obesity • Use of certain medications and supplements

Kidney Stone Treatments

The treatment will depend on the size of the stone, its location, the symptoms it causes, and the patient's condition. Some small stones can be expelled on their own with sufficient hydration. Others, however, require medical intervention. The most frequent options are: • Ureteroscopy: a thin probe is inserted to remove or fragment the stone • Shock wave lithotripsy: a non-invasive procedure that breaks up stones so they can be eliminated through urine Your doctor and urologist will evaluate the risks and benefits of each option before deciding.

How to prevent them?

Although not all calculations can be avoided, there are measures that reduce the risk of forming them:

1. Stay properly hydrated

Dr. Mutter recommends drinking between 3 and 4 liters of fluids a day. Maintaining a constant flow of urine helps dilute the substances that form the stones. Including fruits and vegetables rich in water — such as melon, strawberries, cucumber, or broccoli — can also be helpful.

2. Improve nutrition

"Reducing salt or sodium intake is especially useful for calcium calculations, in addition to providing cardiovascular benefits," explains Dr. Mutter. "Kidney stones share some of the same metabolic abnormalities that are associated with hypertension and diabetes, so any measures people take to improve their cardiovascular health can reduce the risk of developing kidney stones." In addition, the specialist recommends avoiding sugar-sweetened beverages, foods containing high-fructose corn syrup, and animal proteins. Instead, they suggest incorporating foods rich in natural calcium, magnesium, potassium, and fiber (such as legumes, fruits, vegetables, and whole grains) to strengthen kidney health.

3. Maintain a healthy weight and exercise

The exercise is an important tool that not only serves to reduce your risk of developing kidney stones, but also to help you expel the stones you already have. However, it is important that you consult your doctor before starting or changing your exercise routine.

What should I do if I have kidney stones?

The worst thing you can do is ignore the symptoms. Although many stones are eliminated without complications, others can generate infections or damage the kidneys if left untreated. According to Dr. Mutter, working together with a urologist and a nephrologist is essential to resolve the current problem and prevent new episodes. "Unfortunately, kidney stones have no cure, but they can be treated," says the specialist. "And the sooner they are detected, the easier it will be to avoid complications," he concludes.