Nov 8, 2018

Interview Transcript

Dr. Jones: Passing a kidney stone has been called the worst pain in the world. Of course it would be second to active labor and childbirth. Kidney stones are on the rise, and on the rise in women. This is Dr. Kirtly Jones from the Department of Obstetrics and Gynecology at the University of Utah Health Care and this is the scope of Kidney Stones in women on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to the Scope.

What Are Kidney Stones?

Dr. Jones: Kidney stones are small, hard bits of crystals that have grown in the kidney, minerals like calcium that are filtered by the kidney. Kind of like hard water that develops hard bits in your tea kettle. They can be small, much smaller than a pea, but they don't feel small. They're usually without symptoms when they're growing in the kidney but when they pass down the very small tube called the ureter, they can get stuck and cause severe pain called renal colic. Renal colic is an intermittent severe pain in your back or side that might move into your pelvis as the stone is passing down to the bladder. It's often associated with nausea and vomiting and frequent urination. There may be blood in the urine. There's really nothing quite like it except childbirth.

Who Is Most Affected by Kidney Stones?

Kidney stones aren't new. Evidence of bladder stones was found in a seven thousand year old Egyptian mummy. Bladder stones were well-known in Hippocrates' time in Ancient Greece. But kidney stones are becoming more common in the United States and more common in women. We used to think that kidney stones were a problem for middle aged men but now, they're becoming more common in middle aged women and can also be a problem in pregnancy.

Once someone's had one kidney stone, they have about a 50/50 chance of getting another. Ow! Kidney stones now affect about one in ten men in their lifetime and one in twelve women. There are different kinds of minerals in kidney stones but the most common are calcium containing stones. There are some diseases that are associated with kidney stones like gout or overactive parathyroid gland and others but the most common stones just happen.

What Factors Increase Women's Risk of Kidney Stones?

Why is the incidence of kidney stones increasing in women? Well, the risk for stones include obesity, high-salt diet, increased sugar in the diet, and diabetes. All these risks have increased for women over the past 30 years. Some recent studies looked at the risks for kidney stones in women. 82,000 post-menopausal women were followed in the women's health initiative study. Women who didn't get stones had the highest intake of fiber, fruits and vegetables and lower sugar intake.

Unfortunately, women who've already had stones didn't seem to lower their risk of getting them by having a diet high in fiber, fruits and vegetables. So once you're a stone former you're kind of stuck, or the stone is stuck. Another study of many thousands of women showed that a diet high in calcium was a little bit of a risk but taking calcium supplements wasn't.

5 Ways Your Diet Can Help Prevent Kidney Stones

So you want to avoid being the one in 12 women who will get kidney stones in their lifetime, what should you do?

  1. Avoid a high-salt diet, processed foods, canned foods, cheeses, bottled salad dressings, high-salt snack foods and baked goods. Avoiding these are all part of a healthy diet anyway and the rise of these foods in our diet has been associated with the obesity epidemic. Pizza is the poster food for kidney stones, salty crust, salty pepperoni, salty cheese, salty processed pizza sauce, but you can make your own with limited salt. (Okay, maybe you can have pizza once in a while.)
  2. Eat your fiber, eat your fruits and veggies without salt.
  3. Make sure you drink enough water. Getting dehydrated or lower fluid intake is a risk for stone formation.
  4. The calcium story is mixed. Some studies suggest that increased calcium increases the risk, some show that it doesn't. Don't restrict your calcium but don't get too much because some sources of calcium like cheese are high in sodium.
  5. Maintain a healthy weight. Obesity is a risk but maybe it's the foods that are associated with obesity that we already mentioned.
  6.  

    If you've had a stone, talk to your doctor about what kind of stone you made. What minerals were the crystals made of and what should you do to decrease your risk of recurrence. In the interest of full disclosure and as I am disclosing it, isn't a HIPAA violation. I'm a middle-aged, chubby, pizza-loving woman who is one of the one in 12. And having a kidney stone certainly got my attention, I was very impressed.

    So if you want to avoid the worst pain ever except child birth—and there you get a baby out of it, which is much better than delivering a little kidney stone—eat your fruits and veggies, keep your gut happy with a high-fiber diet, and stay hydrated. Limit your salt and sugar intake, maybe pizza only twice a month. And stay tuned to Scope Radio.

    Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.


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