A Stone's Throw Away

Kidney Stones and Their Role in Chronic Kidney Disease

- Dr Nor Azhari Bin Mohd Zam

Kidney stones are solid masses formed in the kidney due to crystallization and aggregation of stone-forming products within the urine. It is a common condition which is estimated to affect one in 10 adults worldwide. Chronic kidney disease (CKD) is a long-term condition where the kidneys are not functioning as well as they should. It is a progressive condition that can lead to end-stage kidney disease, which is a lethal condition without dialysis treatment or kidney transplant. While the main causes of CKD such as diabetes, hypertension and glomerulonephritis (inflammation of the kidney tissue) are well known, kidney stones are a significant but often overlooked contributor.

As a urologist with a subspecialty focus on kidney stones, I often treat patients with not only large or complex stones, but also preexisting CKD from chronic illnesses, and with anatomical or structural abnormalities. This article aims to increase awareness about complications arising from kidney stones that can adversely affect kidney function. It highlights the importance of early detection and management in order to preserve long-term kidney function.

TYPES OF KIDNEY STONES

In Singapore, the most common type of kidney stone is calcium oxalate stone, which is estimated to comprise about 70% of all cases. Other types of stones include calcium phosphate, uric acid, struvite (infection) and cysteine stones. Roughly 50% of patients will suffer from kidney stones again within the next 10 years of their life.

CAUSES

The causes of kidney stones are multifactorial. For some individuals, certain factors are more important than others. One of the main causes is having low volume of (concentrated) urine due to inadequate intake of fluids or excessive loss of fluids (e.g. through sweating or diarrhoea).