Kidney stones, according to some patients, can rival the pain of childbirth. And for those individuals who have both given birth and had a kidney stone, some will tell you that the kidney stone was worse.

So, what causes kidney stones and how might having diabetes, specifically type 2 diabetes, put individuals at risk for developing these bothersome stones?

To start, kidney stones are, according to the Cleveland Clinic, “hard mass[es] of crystallized minerals that form in the kidneys or urinary tract.”

When one of the half a million people who present themselves annually at emergency rooms across the nation, those individuals are often exhibiting the telltale signs of kidney stones, according to the Mayo Clinic:

• Severe pain in the side and back, below the ribs
• Pain that radiates to the lower abdomen and groin
• Pain that comes in waves and fluctuates in intensity
• Pain on urination
• Pink, red, or brown urine
• Cloudy or foul-smelling urine
• Nausea and vomiting
• Persistent need to urinate
• Fever and chills if an infection is present
• Urinating small amounts

It is important to note that if you or a loved one are experiencing one of the following signs or symptoms, you should seek medical attention immediately:

• Pain so severe that you can’t sit still or find a comfortable position
• Pain accompanied by nausea and vomiting
• Pain accompanied by fever and chills
• Blood in your urine
• Difficulty passing urine

How Are Kidney Stones and Type 2 Diabetes Related?

The presence of kidney stones, however, can also be especially vexing for people with type 2 diabetes, whose urine can be more acidic, especially if individuals have consistently high blood sugars. While kidney stones often do not have one easily discernible cause, it is important to understand how those with type 2 diabetes can reduce their risk for kidney stones through hydration, diet, and achieving or maintaining a healthy weight.

Uric acid makes up one type of kidney stone. The substance can be created in the urine when blood sugar is too high, and may lead to these painful stones. In addition to uric acid stones, there are three other types of kidney stones: calcium stones (calcium oxalate or calcium phosphate), struvite stones, and cystine stones.

While it is true that one out of 10 people will have a kidney stone at some point in their lifetime, most notably after the age of 30 years, there are proactive steps individuals can take to reduce their risk of developing a kidney stone. Reducing risk is especially important because once an individual develops a kidney stone, the likelihood of future stones occurring increases.

Who’s at Risk for Developing Kidney Stones?

To understand how to reduce one’s risk for kidney stones, let us first explore some of the basic risk factors for developing one. According to the American Kidney Fund, some behaviors, medical conditions, and genetics may influence the formation of these dreaded stones:

• Having kidney stones previously and/or having a family history of kidney stones
• Not drinking enough water on a consistent basis
• Following a diet high in protein (Hello, keto and low-carb lifestyles!), sodium, and/or sugar
• Being classified as overweight or obese
• Having had gastric bypass or another intestinal surgery
• Having polycystic kidney disease or a related cystic kidney disease
• Having any condition that causes your urine to contain high levels of calcium, cystine, oxalate, or uric acid (such as type 2 diabetes)
• Having a condition that causes swelling or irritation in your bowel and joints
• Taking certain medications or pills, such as water pills (diuretics), calcium-based antacids, or high doses of calcium — such as pre- or post-natal vitamins

Important to note, men are often much more likely to develop kidney stones during their lifetime — 19 percent —  than women, who are about half as likely. White, non-Hispanic men, per the American Kidney Fund, are much more likely to develop kidney stones than people of other ethnicities.

The sobering news for why prevention is paramount? The National Kidney Foundation reports, “Those who have developed one stone are at approximately 50% risk for developing another within 5 to 7 years.”

How Do I Reduce My Risk for Kidney Stones?

There are many lifestyle changes that may delay or even prevent kidney stones and the resulting pain. Some of those changes may even help prevent the development of kidney disease, a common and very dangerous complication of diabetes.

The Mayo Clinic recommends some of the following guidelines for anyone at risk of developing kidney stones:

1. Stay hydrated throughout the day by drinking plenty of water. For people with a history of kidney stones, doctors recommend passing 2.5 liters of urine a day. If you live in a hot and humid climate and/or exercise a lot, drink even more water.
2. Choose a diet low in salt and animal protein. This can be tricky for those observing a ketogenic or low-carb diet, especially if you depend on meat to curb cravings. But consider balancing your sodium and red meat intake with lower-carb vegetables whenever possible.
3. Continue to eat low-fat, calcium-rich foods, but skip the calcium supplement.
4. As the National Institute of Diabetes and Digestive and Kidney Diseases points out: “Studies have shown that the Dietary Approaches to Stop Hypertension (DASH) diet can reduce the risk of kidney stones.” To learn more about the DASH diet, click here.

Conclusions

While having type 2 diabetes may put certain people at greater risk of developing kidney stones, especially as they age, there are many potential steps one can take to diminish the risk of hurting one’s kidneys further. Diet and water intake can help moderate your risk, as well as maintaining a healthy weight and blood sugar.

References

“6 Easy Ways to Prevent Kidney Stones.” (2019). National Kidney Foundation.

Carbone, A., Al Salhi, Y., Tasca A3, Palleschi, G.., Fuschi, A., De Nunzio, C., Bozzini, G., Mazzaferro, S., & Pastore, AL. (2018). “Obesity and Kidney Stone Disease: A Systematic Review.” Minerva Urol Nefrol. 70(4): 393-400. doi: 10.23736/S0393-2249.18.03113-2.

“Eating, Diet, and Nutrition for Kidney Stones.” (2017). National Institute of Diabetes and Digestive and Kidney Diseases.

“Is there a Connection between Diabetes and Kidney Stones?” (2019). Next Generation of Clinical Research.

“Kidney Stones.” (2019). Mayo Clinic.

“Kidney Stone Risk Factors.” (2019). American Kidney Fund.

Sorensen, M.D. (2014). “Calcium intake and urinary stone disease.” Translational Andrology and Urology, 3(3): 235–240. doi: 10.3978/j.issn.2223-4683.2014.06.05.