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Painful Kidney Stones Are Becoming More Common

A Mayo Clinic study showed an increase in the incidence of painful kidney stones. Changing dietary patterns and medications may be contributing.
Painful Kidney Stones Are Becoming More Common
Green smoothie with spirulina. Young barley and chlorella spirulina. Detox superfood.Glass Jar of Healthy Green Smoothie Detox Drink wirh Green Apple Celery and Raw Spinach Diet Beverage Above Close Up

Kidney stones can cause excruciating pain. For some patients, a kidney stone becomes a medical emergency. What causes painful kidney stones?

How Often Do People Suffer from Painful Kidney Stones?

A study from the Mayo Clinic Proceedings showed that the rate of painful kidney stones increased dramatically over the last 30 years (Kittanamongkolchai et al, Mayo Clinic Proceedings, online, Feb. 6, 2018). The scientists looked at medical records for residents of Olmsted County, Minnesota, where the Mayo Clinic is located. They analyzed data for people treated for kidney stones between 1984 and 2012. They found more than 10,000 adults with symptomatic or asymptomatic kidney stones.

Young women under 40 were four times more likely to develop kidney stones in 2012 than they had been in 1984. The rate doubled in men. Because men started with a higher incidence than women, the absolute incidence ended up being similar. It was 154/100,000 person-years in men. For women, the rate was 166/100,000 person-years. Most of the increase was due to asymptomatic kidney stones detected on imaging.

Painful Kidney Stones in Kids:

Even children are being diagnosed more frequently with painful kidney stones. Adolescent girls are at particular risk. Most of these cases were symptomatic.

Why Would the Incidence of Kidney Stones Be Increasing?

High levels of calcium in the urine are suspected as the cause of many kidney stones. A diet high in salt, animal protein and sugar can increase this problem. Insulin resistance is also linked to high absorption and urinary excretion of calcium. This increases the probability of kidney stone formation.

Although the Mayo Clinic scientists do not mention it, certain popular medicines such as acid-suppressing drugs also increase the risk of kidney stones. One reader was distressed to learn that a popular antacid could contribute to this problem.

What to Do for Heartburn Without Tums?

Q. I have suffered from nighttime reflux for as long as I can remember. I relied on Tums before bed until I developed kidney stones. The doctor said the extra calcium was a contributing factor.

I switched to omeprazole, but the label said to take it for only two weeks. When I stop, my heartburn comes back. What else can I do?

A. Too much calcium from antacids containing calcium carbonate could increase the risk for kidney stones (Annals of Internal Medicine, April 1, 1997).  Calcium-rich food does not seem to pose this problem, however.

You should not rely too heavily on a PPI like omeprazole. Steady use could increase the chance of kidney damage. However, cutting back on carbs, especially in the evening, could be helpful (Digestive Diseases and Sciences, Aug. 2006).

If you like home remedies, this reader has an approach you might like:

“My husband finely chews and then swallows about six almonds before bed each night. Before he started this practice, he had terrible heartburn. Since then, he hasn’t had any heartburn unless he forgets his almonds.”

Foods high in oxalates, such as beets and Swiss chard, kale and parsley, or even chocolate or turmeric, may also raise the danger of urinary stones.

Could Green Smoothies Boost the Risk of Painful Kidney Stones?

Although foods like beets, spinach and Swiss chard are healthful, you can get too much of them, especially if you make a habit of drinking them. Here is a reader’s dilemma:

Q. Can you settle a dispute? One friend insists that you need to juice vegetables to get enough nutrients and I have started doing that for my husband. I myself eat salad for lunch almost every day, as I appreciate the fiber.

Then my husband said something about the juice was irritating his throat and he wants to stop. Another friend said that drinking your greens could lead to kidney stones.

I have already had a stone in my only kidney. Passing it was a horror I do not wish to repeat, nor do I wish it on him. Does juicing really increase the amount of oxalates you are getting?

Too Many Oxalates:

A. Juicing dark green leafy vegetables could lead to an overdose of oxalates. These natural compounds are excreted by the kidneys. When the diet is especially high in oxalate-containing foods, crystals can accumulate in the kidneys and form stones.

Several cases of kidney stones or injury have been reported in the medical literature linked to juicing. One 65-year-old woman had been drinking a green smoothie juice cleanse rich in oxalates. Her kidney function was normal before the cleanse, but she developed acute kidney injury afterwards (American Journal of Kidney Disease, Feb. 2018).

In another case, a man who had been juicing oxalate-rich fruits and vegetables developed kidney damage as a result (American Journal of Medicine, Sept. 2013). Because calcium can grab onto oxalate and prevent its absorption, people with normal to high calcium intakes from food are less likely to suffer painful kidney stones based on eating spinach or beet greens (Nutrients, Sep. 2, 2020). On the other hand, the balance of intestinal microbes can also influence oxalate absorption and excretion.

Troubles With Juice and Star Fruit:

Juice is an easy way to consume concentrated greens. While it can provide a lot of nutrients, most people should be wary of a regimen that calls for juicing on a regular basis. In addition, they should also be careful not to overindulge in star fruit. This exotic fruit is delicious, but those who consume large quantities may develop painful kidney stones or even kidney damage (BMC Nephrology, Oct. 22, 2018).

Learn More:

If you would like to learn more about kidney stones and how to minimize your risk, you may wish to listen to our Show 1148: What Can You Do About Kidney Stones?

You can learn more about options for managing heartburn in our eGuide to Overcoming Digestive Disorders.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Citations
  • Kittanamongkolchai W et al, "The changing incidence and presentation of urinary stones over 3 decades." Mayo Clinic Proceedings, online, Feb. 6, 2018. DOI:https://doi.org/10.1016/j.mayocp.2017.11.018
  • Curhan GC et al, "Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women." Annals of Internal Medicine, April 1, 1997. DOI: 10.7326/0003-4819-126-7-199704010-00001
  • Austin GL et al, "A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms." Digestive Diseases and Sciences, Aug. 2006. DOI: 10.1007/s10620-005-9027-7
  • Makkapati S et al, ""Green smoothie cleanse" causing acute oxalate nephropathy." American Journal of Kidney Disease, Feb. 2018. DOI: 10.1053/j.ajkd.2017.08.002
  • Getting JE et al, "Oxalate nephropathy due to 'juicing': case report and review." American Journal of Medicine, Sept. 2013. DOI: 10.1016/j.amjmed.2013.03.019
  • Bargagli M et al, "Dietary oxalate intake and kidney outcomes." Nutrients, Sep. 2, 2020. DOI: 10.3390/nu12092673
  • Wijayaratne DR et al, "Star fruit nephrotoxicity: a case series and literature review." BMC Nephrology, Oct. 22, 2018. doi: 10.1186/s12882-018-1084-1
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