Kidney Stones: Why They Recur, and How to Prevent the Next One

Anyone who has passed a stone knows the pain. Half will form another within a decade — but prevention is genuinely effective.

Renal colic is a pain patients rarely forget: sudden, severe, gripping the flank and radiating to the groin, often with vomiting and an inability to sit still. What many do not realise is that passing one stone marks them as likely to form another. Roughly half of patients do so within ten years — unless something changes.

Why our climate raises the risk

Stones form when urine becomes concentrated enough for minerals to crystallise. In a hot, humid climate, a great deal of fluid is lost through sweat, particularly by those working outdoors — construction workers, farmers, fishermen, drivers. Less fluid leaves the body as urine, so what remains is more concentrated. This is why stone disease is common here and why fluid intake is the foundation of prevention.

The single most effective measure

Drink enough that your urine stays pale. Aim for two and a half to three litres a day, more if you work in the heat or sweat heavily. The practical guide is the colour: pale straw is right, dark yellow means you are behind. Drink through the day rather than large amounts at once, and include a glass at bedtime, since urine concentrates most overnight.

Diet: the advice that is often given wrongly

• Do not cut calcium. It sounds logical for calcium stones and it is wrong — low calcium intake increases stone risk, because dietary calcium binds oxalate in the gut. Keep normal amounts of milk and curd.
• Reduce salt. High salt raises calcium in the urine. Pickles, dried fish, papad and packaged snacks are the usual sources.
• Moderate very high-oxalate foods if you form oxalate stones: spinach, beetroot, nuts, excessive tea.
• Reduce red meat and organ meats if you form uric acid stones.
• Citrus helps. Lime or lemon in water adds citrate, which inhibits stone formation.

When pain needs emergency care

Most stones pass with fluids and pain relief. Come in immediately if there is:

• Fever with the pain — infection behind an obstructing stone is an emergency
• Pain not controlled by prescribed medication, or persistent vomiting
• Not passing urine, or passing very little
• Visible blood with clots
• Only one functioning kidney, or known kidney disease

Have the stone analysed

If you pass a stone, collect it and bring it in. Stones differ in composition, and prevention differs accordingly — advice for a uric acid stone is not the advice for a calcium oxalate stone. Along with a blood and urine assessment, analysis turns general advice into a plan specific to you.

Our urology consultant sees patients weekly, with ultrasound and laboratory support on site.

This article is general health information and is not a substitute for medical advice. Symptoms vary between individuals — please consult a doctor about your own situation. In an emergency, our casualty at Chettipadi is open 24×7.