Dr. Gary Faerber explains how dehydration, diet and genetics can increase your chance of kidney stones and shares some tips to lessen your risk of forming a stone.">

Oct 5, 2016 — In the past few years, doctors have seen a 30 percent increase to kidney stone cases in the United States. In fact, for some urologists, treating kidney stones makes up over half of their practice. So what’s causing this increase in the extremely painful condition? Urologist Dr. Gary Faerber explains how dehydration, diet and genetics can increase your chance of kidney stones and shares some tips to lessen your risk of forming a stone.

Interview

Interviewer: Kidney stones, could they happen to you? And what can you do to prevent them? We'll examine that next on the scope.

Announcer: Health tips, medical news, research and more, for a happier, healthier life. From University of Utah Health Sciences, this is the scope.

Interviewer: Dr. Gary Faerber is a urologist at the University of Utah Health Care. Dr. Ferber, do you get a lot of patients with kidney stones? I hear it's on the rise like 30% in the last 30 years.

Dr. Faerber: Yes, it is. Absolutely, there's no question about it. And people with kidney stones probably make up a good . . . almost half of my practice.

Interviewer: Wow, you deal with them a lot.

Dr. Faerber: Absolutely. And if you look at urologists across the country, about 20 to 30% of their practice is managing patients with kidney stones. So it's a big, big job for all of us.

Interviewer: So why the increase in the past 30 years? Thirty percent in 30 years, that's quite a bit.

Dr. Faerber: It is. And there probably . . . it's multi-factorial, to be honest with you. I think obviously, one of the reasons why is because Americans tend to be dehydrated. They don't drink enough water.

Interviewer: You're kidding me. You can't go outside without seeing somebody with a water bottle.

Dr. Faerber: I know, and it's crazy. About one in 10 patients are people that are in the United States drink the right amount of water.

Interviewer: Just one in 10?

Dr. Faerber: One in 10.

Interviewer: Okay.

Dr. Faerber: A full quarter percent or a 25% don't drink any water at all in the day.

Interviewer: They're just getting their water from sodas, and juices, and stuff like that?

Dr. Faerber: Right. Which is not a good thing, to honest with you.

Interviewer: So it's . . . dehydration is a big part of it. So just by drinking more water, it helps your system flush that stuff out and prevents it from kind of building up into those stones?

Dr. Faerber: That's absolutely right. If you can recall back to your grade school experiments where you would put the string in a bowl of sugar water and then you'd see the sugar precipitate out on the string. Well, the same thing sort of happens in a kidney. When the water or the urine isn't concentrated, then those crystals can't form. But when urine is concentrated, that's when you get the crystals forming, and then those crystals grow into stones.

Interviewer: Okay. So . . .

Dr. Faerber: Same thing happens.

Interviewer: If I want to prevent kidney stones, drink water. Be sure that I'm getting the right amount. What is the right amount, by the way? We were having a debate about this other day. Is it eight glasses a day?

Dr. Faerber: I tell people six to eight glasses of water a day.

Interviewer: And if that's just a normal person. If you're doing outside stuff sweating a lot, exercising a lot, even more?

Dr. Faerber: You obviously need to drink more. And I think probably a good rule of thumb is that if the urine looks yellow, you're probably not drinking enough. If it's nice and clear, then you're probably just fine.

Interviewer: All right. So what else could cause kidney stones? Like if I'm drinking the right amount of water, am I immune now?

Dr. Faerber: No.

Interviewer: Okay. I've got a better chance, but . . .

Dr. Faerber: You have a better chance. The other thing is that what diet you eat certainly affects your chances of forming kidney stones. The American diet is really conducive to forming kidney stones. We eat way too much salt. We have a lot of animal protein in our diet, and we have a relatively high amount of fats.

Of all those things, probably the most worrisome is the amount of salt that we ingest. The kidneys, when they see all that salt, excrete calcium in the urine, and that calcium in the urine forms kidney stones. Calcium oxalate are the most common kidney stones that we see in the US. So by limiting salt, we can certainly reduce the amount of calcium that you see in the urine.

Interviewer: If I have a relative that had kidney stones, am I my more likely?

Dr. Faerber: Yes. You can't run away from your genes, unfortunately. So . . .

Interviewer: So that's just the way my body works is . . .

Dr. Faerber: It's . . . clearly, there's a significant familial component to the risk of forming kidney stones.

Interviewer: So if you have a family history, then it's really important to watch your diet, drink water.

Dr. Faerber: Yes, absolutely. There is no question about it.

Interviewer: And when you finally find out if you have them, there's no real lead up, is there? You don't . . . there aren't any symptoms that present till the excruciating pain comes along?

Dr. Faerber: Typically, what you describe is the most common thing is that people are perfectly fine, and then they suddenly develop this quite severe flank pain that is really debilitating. If you speak to women who've undergone childbirth and who have also had the unfortunate episode of having a kidney stone, they would say that having a child is much, much easier than trying to pass a kidney stone. So yeah, on a scale of one to 10, with 10 being the worst pain, most people say it's around a 12.

Interviewer: Wow. Other than the pain, and you have to go to the ER to have them removed, can there be long-term damage caused by kidney stones? Because there might be somebody that says, " You know, I really like my energy drinks. I can deal with every few years having a stone, even though they're excruciatingly painful."

Dr. Faerber: Fortunately, the chances of having a permanent injury secondary to the stone are relatively small. Most people, when they're in a significant amount of pain, would like to have the stone removed. Fortunately, most patients who have the typical kidney stone will pass the stone on their own.

It may take some help, but certainly, they can pass it on their own. Those who can't, we have very minimally invasive ways of taking care of those stones. If patients pass them on their own or they're treated effectively, the long-term damage to the kidney is really quite small, which is fortunate.

Interviewer: Is there evidence that supports the correlation with sugary drinks, salt, diet, that sort of thing? Do have like a number that if I have that kind of lifestyle, I've got three X or four X times more chance to get kidney stones?

Dr. Faerber: There are some . . . there are some numbers. The relative risks of those who drink sugary drinks, for example, their risk might be more than . . . more than double. It's really true of those who have a high salt rate intake. Their risk is three to four times that of someone who has a normal intake of sodium. So there are studies that have shown the significant risks of kidney stone formation in patients who eat too much sodium and drink too much soft drinks.

Interviewer: And the more of those things you do, it just keeps building upon that multiplying and multiplying

Dr. Faerber: Right.

Interviewer: So if you drink sugary stuff but, boy, I'm in the sodium and sugary stuff, that just means I have even more of a chance.

Dr. Faerber: That's exactly right. Which factor is the most important is unclear at this point, but certainly, if you have a family history, you're overweight, you drink sugary drinks, high sodium, you're at significant risk of forming a kidney stone.

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