Why are cases of Kidney stone on a rise in Urban cities of India?
Kidney stone disease is also known as Urolithiasis occurs in the urinary tract. It typically forms in the kidney and leaves the body in the urine stream. If the size of stone formed is small it can pass without causing symptoms. If it is greater than 5mm it will cause blockage of the ureter resulting in severe pain in the lower back or abdomen. It may also result in presence of blood in urine, vomiting or painful urination.
Implications of global warming have a greater role in the formation of kidney stone. The heat and climate are the significant risk factors for this disease. Therefore, urbanisation has a greater role. The factors like sunlight exposure and regional variations in the diet share some contribution. Notably, the role of heat is much greater in men than in women. The role of significant human migration from the rural to warmer areas may have a greater impact than global warming on the observed worldwide increasing prevalence rate of this disease. Excessive loss of fluids leads to an increase in serum osmolality that in turn causes an increased secretion of vasopressin by the posterior pituitary leading to increase in urine concentration and reduced urinary volume. As urinary concentration increases, the concentration of relatively insoluble salts such as Calcium Oxalate increases. When the concentration of these salt increases such that their activities exceeds the upper limit of solubility the salt precipitate out of solution and form salt crystal that develops into stone. The mechanism for humidity contributing to the stone formation is similar when humidity is low and the air is dry. More water is lost through the skin and again the urinary volume falls and urinary concentration increases.
More stones are formed due to combinations of genetic and environmental factors. Risk factors also include high urine calcium level, obesity, certain food, some medications, calcium supplements, hyperparathyroidism, gout, and not taking enough fluids. Stones are formed in the kidney when minerals in the urine are at high concentration.
SIGNS AND SYMPTOMS
Renal Colic caused by kidney accompanied by urinary urgency, restlessness, hematuria, sweating, nausea, vomiting are common symptoms. It typically lasts for 20-60 minutes as it attempts to expel the stone. Drinking fluoridated tap water may increase the risk of the formation. High dietary intake of potassium appears to reduce the risk of kidney stone formation. Kidney stones are more likely to develop and become larger if a person has low dietary magnesium. Diets in Western nation typically consists of a large proportion of animal protein. Consumption of animal protein leads to increase of mineral salts. Also, excess intake of vitamin C leads to increase of Calcium. It is also found that frequent intake of alcohol can lead to dehydration which in turn lead to the development of kidney stone. Low urinary citrate excretion can cause kidney stones.
Diagnosis of kidney stone is made on the basis of information obtained from the history of physical examination, urine analysis, and radiographic studies. Clinical diagnosis is usually made on the basis of location and severity of pain. Pain in the back occurs when Calcium produces an obstruction in the kidney. Physical examination may reveal fever, and tenderness at the costovertebral ankle of the affected side.
- It depends on the type of stones. In those with Calcium stone drinking lots of fluids, thiazide diuretics and citrate are effective.
- Preventive strategies include some combination of dietary modified and medication with a goal of reducing the excretory load of calculogenic compounds on the kidney.
- Increase in the total fluid intake more than two litres per day for urine output.
- Increase in the citric acid intake, lemon or lime juice.
- Moderate Calcium intake.
- Limiting Sodium intake.
- Avoiding large doses of supplemental Vitamin C.
- Limiting consumption of cola soft drinks.