What Causes Kidney Stones

What Causes Kidney Stones? It's Not Just About Drinking Less Water

Introduction

Kidney stones are one of the most prevalent and agonizing urological conditions that plague millions of individuals globally. If you've ever had the torturous experience of passing a kidney stone, you're not alone. For decades, dehydration has been theorized to be the primary culprit—but what if that's only half the picture? While a lack of water is a contributing factor, kidney stones have numerous unsuspecting causes that extend far beyond hydration.

In this blog, we’ll dive deep into the true causes of kidney stones, exploring everything from diet, lifestyle, genetics, medications, to underlying medical conditions. Whether you’re looking to prevent kidney stones or understand why they keep coming back, this article covers it all in detail.

Section 1: Understanding Kidney Stones

What Are Kidney Stones?

Kidney stones are hard, mineral and salt deposits that develop within your kidneys. They can be as small as a grain of sand or as large as a golf ball and can remain within the kidney or pass down the urinary tract.

Types of Kidney Stones

There are a number of different types of kidney stones, each with various causes:

Calcium Oxalate Stones – Most common.

Uric Acid Stones – Usually due to diets rich in purines (in red meat, shellfish).

Struvite Stones – Usually due to urinary tract infections (UTIs).

Cystine Stones – Due to a rare congenital disorder known as cystinuria.

All of these are related to specific dietary and metabolic components that we will discuss in the following sections.

Section 2: The Myth of Dehydration — Only Part of the Story

Yes, inadequate water intake can lead to kidney stones—but it's only half of a complicated equation.

Why Hydration is Important

Water serves to dilute the chemicals in urine that cause stone formation. If fluid intake is lacking, the urine will become concentrated, and minerals will crystallize and cling to each other.

But some individuals drink loads of water and still develop stones. That's because hydration itself is not sufficient if other risk factors exist.

image credit: FREEPIK

Section 3: Diet and Kidney Stones — You Are What You Eat

1. High-Oxalate Foods

Oxalate is a natural substance in many foods. When there's too much oxalate, particularly with calcium, it can cause calcium oxalate stones.

Some typical high-oxalate foods are:

-Spinach

-Beets

-Rhubarb

-Almonds

-Sweet potatoes

-Chocolate

➡️ Tip: Combining high-oxalate foods with calcium-containing foods (such as yogurt or cheese) during meals can bind oxalate in the bowel and inhibit its absorption.

2. Too Much Animal Protein

Too much consumption of red meat, poultry, eggs, and seafood raises uric acid levels in the body, increasing the likelihood of uric acid stones.

Animal protein also reduces citrate in the urine—a substance that inhibits stone formation.

3. High Sodium Intake

Salt leads to the kidneys passing more calcium into the urine, which aids in stone formation. The majority of our sodium intake comes from processed and packaged foods—not the salt shaker.

4. Sugary Drinks and Soda

Cola and other sweetened beverages, particularly those containing high fructose corn syrup, may boost the risk of kidney stones.

➡️ Did you know? Phosphoric acid in colas can lead to changes in urine that favor calcium stone growth.

5. Low Calcium Diet

Ironically, a deficiency of calcium actually puts you at greater risk for calcium stones. Calcium binds with oxalate in the intestine, keeping it from being absorbed into the bloodstream.

Section 4: Genetic and Medical Risk Factors

1. Family History

If a member of your family has had kidney stones, then your risk of developing them is higher. Genes may affect the way your body handles calcium, oxalate, and uric acid.

2. Obesity and Metabolic Syndrome

Obesity changes the acid-base status of urine, promoting uric acid and calcium stone formation. Insulin resistance, an important component of metabolic syndrome, is also linked to decreased urinary citrate and increased urinary calcium.

3. Digestive Diseases

The following conditions:

-Inflammatory Bowel Disease (IBD)

-Crohn's Disease

-Gastric bypass surgery

.may enhance oxalate absorption in the small intestine, resulting in increased concentrations in the urine (a condition known as enteric hyperoxaluria).

4. Some Medications

Some medications that may lead to stone development are:

-Diuretics (loop diuretics such as furosemide)

-Calcium antacids

-Topiramate (for migraines and seizures)

-Protease inhibitors (for HIV treatment)

Always talk to your doctor if you are on long-term meds and are at risk of stones.

Section 5: Lifestyle and Behavioral Factors

1. Lack of Physical Activity

A sedentary lifestyle may result in loss of calcium from bones and therefore increase the concentration of calcium in the urine. Regular exercise also aids a normal metabolism, which helps minimize risk factors such as obesity and insulin resistance.

2. Poor Sleeping Habits

Disturbed sleep and night work have been shown to lead to hormonal changes that could influence kidney function and urinary content.

3. Overuse of Supplements

Numerous individuals consume supplements without knowledge of their possible side effects. Overuse of:

-Vitamin D

-Vitamin C

-Calcium

.can result in a heightened risk of stone development, particularly in susceptible individuals.

Section 6: Environmental and Seasonal Factors

1. Hot Climates

Individuals residing in hot or tropical environments are at greater risk for dehydration, augmenting stone risk. Sweating lowers urine production, which concentrates stone-causing substances.

2. Occupational Hazards

Occupations requiring long periods in hot settings (e.g., construction, mining) or restricted bathroom use may deter fluid consumption, augmenting stone risk.

Section 7: The Gut Microbiome's Role

There is some evidence to suggest a connection between the gut microbiome and the development of kidney stones.

Oxalobacter formigenes is a key bacterium that digests oxalate in the gut. Individuals without this microbe might absorb more oxalate, putting them at risk for calcium oxalate stones.

➡️ Current and future treatments could involve probiotics that decrease the absorption of oxalate.

Section 8: Prevention Strategies Beyond Water

If you’re prone to kidney stones, don’t rely on water alone. Here are evidence-based prevention tips:

1. Eat a Balanced, Plant-Forward Diet

-Include fruits and vegetables high in citrate (lemons, oranges).

-Limit red meat and processed foods.

-Include low-fat dairy for calcium.

2. Limit Salt and Sugar

Cut back on salty snacks, canned soups, processed meats, and sugary sodas.

3. Moderate Oxalate Intake

Don't avoid oxalates completely, but pair them with calcium during meals.

4. Be at a Healthy Weight

Weight loss (if necessary) can correct metabolic imbalances that cause stones to form.

5. Discuss Medications with Your Doctor

There are medications that will prevent specific types of stones, including:

-Thiazide diuretics (lower calcium in urine)

-Allopurinol (for uric acid stones)

-Potassium citrate (increases urine pH and citrate)

Section 9: When to See a Doctor

Seek a healthcare provider if you have:

-Severe pain in the back or side

-Blood in the urine

-Nausea or vomiting

-Fever and chills (can be a sign of infection)

-Recurring kidney stones

Your physician might prescribe blood work, urinalysis, imaging (such as CT scans), or even a 24-hour urine test to identify the reason for your stones.

Conclusion: What Causes Kidney Stones

Yes, it's crucial to be hydrated—but kidney stones are usually not due to just one single factor. They're a multifaceted development of diet, lifestyle, genetics, environment, and medical conditions. Knowing the whole picture enables you to make more intelligent, more specific changes to avoid future stones.

So the next time you hear someone tell you "Just drink more water," you'll understand that sure, that's a good point, but there's more to it.