Q&A-1 "Delayed treatment for urinary stones can damage the kidneys... Seek immediate medical attention if you have a fever"

There are many causes. Kidney stones include various types such as calcium oxalate, calcium phosphate, uric acid, cystine, and infection stones, each with different causes depending on the type. Multiple factors can also influence their formation in combination. Commonly cited causes include dehydration, environmental factors, excessive intake of supplements, genetic disorders, anatomical abnormalities of the urinary tract, side effects of medications, and urinary tract infections.

Could it be that the living environment is a cause?

Urinary stones are a condition influenced by weather. The higher the temperature, the greater the risk of occurrence. This is because, when it gets hot, the body loses more water and there is increased exposure to sunlight. In fact, looking at the monthly incidence rates, July and August have about a 30% higher occurrence rate compared to winter. People living in hot regions like the Middle East experience urinary stones in about one out of three individuals, and in Korea, the number of patients has increased compared to the past, with approximately one in seven people affected by urinary stones.

What is the relationship with dietary supplements?

Recently, people of all ages and genders are taking health supplements that are good for the body. When receiving or purchasing multiple supplements, they often take more than necessary, which can also lead to kidney stones. For example, women over the age of 50 often take calcium supplements for bone health along with multivitamins. Many multivitamins taken by women in their 50s contain calcium. Additionally, women diagnosed with osteoporosis also take calcium prescribed by their doctors. As a result, they may consume an unnecessarily large amount of calcium, which can lead to the formation of kidney stones.

Can it be inherited?

It's not a genetic disease, but there is a family history. Statistically, if a parent has urinary stones, the risk of their child developing urinary stones is reported to be about 1.5 to 9 times higher. This is presumed to be because family members live in the same area and share similar eating and lifestyle habits.

You said there are various types of stones?

70-80% of kidney stones are calcium oxalate stones. Most urinary stones that develop in healthy adults are calcium oxalate stones. Gout patients, among others, tend to develop uric acid stones due to uric acid excretion problems, but these are not visible on X-ray examinations unlike calcium oxalate stones. Patients with metabolic disorders mainly develop calcium phosphate stones, and in cases of cystinuria, the substance cystine is continuously excreted, leading to cystine stones forming once every 1-2 years. Additionally, there are infection stones that commonly develop in patients with infectious diseases.

Are there high-risk groups for urinary stones?

As is well known, male patients are nearly twice as many as female patients, and the risk of occurrence is also higher in cases with genetic factors or anatomical abnormalities in the ureter or urethra. Bladder stones and urethral stones are associated with urinary disorders. Additionally, as previously explained, people living in hot regions also have a higher risk of developing the condition. In fact, statistics from Daegu, which is considered the hottest region in Korea, show a higher number of stone patients per population and a relatively high rate of surgeries.

Why has the number of domestic patients increased?

According to statistics from the Health Insurance Review and Assessment Service, the number of patients who received treatment due to absences over a year was 250,000 in 2009, increased to 280,000 in 2013, and surged to 400,000 in 2022. Factors such as rising temperatures, changes in dietary habits, and an aging population have contributed. In the past, a large proportion of patients were under 40, but now there are more patients in their 50s. This is because the population in their 50s has increased along with aging. It is also characteristic that the proportion of female patients increases with age. For those over 80, the number of female patients exceeds that of males. This is because water intake decreases and the risk of urinary tract infections is higher in men compared to women.

What kind of pain does it cause?

The most severe pain humans feel among abdominal pains is the pain caused by urinary stones. It is often described as being more painful than cancer pain. Mothers who have experienced urinary stones also say it is more painful than giving birth. In fact, patients with urinary stones can be easily identified in the emergency room because they are so obviously suffering. Usually, no patient walks in properly; they often roll around in agony due to the intense pain. Typically, one side of the abdomen hurts. People often think that the pain occurs where the stone is located, for example, if it is in the kidney, the kidney will hurt, or if it is in the upper or lower ureter, that area will hurt. However, this is not the case. The pain occurs because the stone blocks the ureter and causes the kidney to swell, so the pain can be felt in the flank or back near the kidney, regardless of the stone's location. When a stone forms in the kidney, severe pain can also occur in the testicles, which share blood vessels and nerves. In women, the pain may present as discomfort around the genital area.

Does the pain sometimes subside on its own?

Initially, the pain can be severe, but once urine bypasses the ureter, the pain may lessen slightly. Then, it can become painful again. The level of pain experienced varies from person to person. People who have experienced urinary stones multiple times, especially elderly patients, may be insensitive to pain or endure the pain and only seek medical help later. Patients with kidney stones also often have no symptoms until the stones grow to a certain size. There have been cases where patients were unaware that their stones had grown to 7-8 cm.

Is it possible to suspect a urinary stone before the pain occurs?

Before the stone completely blocks the lower ureter, symptoms such as urinary retention and hematuria may appear as warning signs. Aside from these cases, it is quite difficult to predict when pain will occur. Even if symptoms improve, pain can recur during the process of the stone moving.

Are there any symptoms other than pain?

You may experience nausea, vomiting, and indigestion along with flank pain. If a stone remains blocked for a long time, causing urine to back up and inflammation to develop, fever symptoms may occur. Additionally, blood in the urine or urinary difficulties can result from the stone.