Kidney Stone Health: Everything You Need to Know

Early signs of kidney stones you should never ignore

Kidney stones — medically known as nephrolithiasis — affect nearly one in ten people at some point in their lives. The condition is particularly prevalent in urban populations like Mumbai, where dietary habits and dehydration contribute significantly to stone formation. Recognising the early warning signs can prevent complications and allow for timely treatment.

• Sudden, severe flank pain — A hallmark symptom. Pain typically radiates from the lower back to the groin and may come in waves, known as renal colic. This is often described as one of the most intense pains a person can experience.
• Blood in urine (haematuria) — Urine may appear pink, red, or brown due to stone irritation of the urinary tract lining. Even microscopic haematuria without visible colour change warrants investigation.
• Burning sensation while urinating — Dysuria occurs when a stone moves into the ureter, close to the bladder, and mimics a urinary tract infection.
• Frequent urge to urinate — Increased urgency, even when the bladder is not full, is a common indicator that a stone is near the ureterovesical junction.
• Nausea and vomiting — The kidneys share nerve connections with the gastrointestinal tract. Renal colic frequently triggers nausea, reducing oral intake and worsening dehydration.
• Fever and chills — If present alongside pain, these may indicate a urinary infection secondary to obstruction — a urological emergency requiring immediate attention.
• Cloudy or foul-smelling urine — Indicates possible infection or the presence of struvite stones, which form in response to bacterial activity.

What causes kidney stones? Risk factors explained

Kidney stones form when minerals and salts in the urine crystallise and clump together. There is no single cause — rather, a combination of genetic, dietary, and environmental factors contributes to their formation. Understanding your personal risk profile is the first step toward prevention.

In Dr. Utture's clinical experience treating patients across Mumbai, a sedentary lifestyle combined with inadequate hydration and a diet rich in refined carbohydrates and animal protein is the most common profile seen in stone formers under the age of 45.

Best foods to prevent kidney stones naturally

Dietary modification remains one of the most effective and evidence-based strategies for preventing kidney stones. The right foods reduce urinary saturation of stone-forming minerals, while certain foods accelerate their formation. Here is what the evidence — and Dr. Anand Utture, one of Mumbai's most trusted urologists — recommends.

RIRS vs PCNL: which kidney stone treatment is right for you?

When a kidney stone cannot be managed conservatively or with shock-wave lithotripsy (ESWL), two surgical procedures are most commonly considered: Retrograde Intrarenal Surgery (RIRS) and Percutaneous Nephrolithotomy (PCNL). Choosing the right procedure depends on stone size, location, composition, and patient factors — and requires the expertise of a skilled urologist.

Dr. Anand Utture is highly experienced in both RIRS and PCNL, and has performed hundreds of these procedures for patients across Mumbai and Maharashtra. His patient-centred approach involves a detailed pre-operative evaluation — including CT urogram, renal function tests, and urine culture — to select the procedure that maximises stone clearance while minimising operative risk.

The advent of flexible ureteroscopes with laser lithotripsy has made RIRS the preferred choice for most stones under 2 cm, offering day-care surgery with negligible scarring. For complex staghorn calculi or large upper-pole stones, Mini-PCNL (mPCNL) — a refined, less invasive version of the standard technique — is increasingly preferred by leading urologists in Mumbai.

How to prevent recurring kidney stones

Without targeted prevention, the recurrence rate for kidney stones is approximately 50% within five years and up to 80% over a lifetime. The good news: with the right interventions, recurrence can be reduced dramatically. Dr. Anand Utture recommends a personalised metabolic evaluation for every patient following their first stone episode.

1. Get a 24-hour urine metabolic workup

   This test measures urinary levels of calcium, oxalate, citrate, uric acid, and creatinine. It is the most informative test for identifying why stones form, and must be done in a stable, non-acute state. Based on results, Dr. Utture tailors a specific prevention plan for each patient.

2. Hydrate to a target urine output

   The goal is to produce at least 2 litres of urine per day, not just drink 2 litres of water. In Mumbai's climate, this requires 3–3.5 litres of total fluid intake. Monitor urine colour — it should be pale yellow.

3. Stone analysis after every episode

   Stone composition (calcium oxalate, uric acid, struvite, cystine) determines specific dietary and medication strategies. Always strain urine after a stone event and bring the stone for laboratory analysis.

4. Consider pharmacological prevention

   Depending on metabolic findings, medications such as potassium citrate (for low urine citrate), thiazide diuretics (for hypercalciuria), or allopurinol (for uric acid stones) can reduce recurrence significantly. These must be prescribed after metabolic evaluation.

5. Annual imaging surveillance

   Even in the absence of symptoms, small residual stone fragments can grow silently. A yearly ultrasound KUB or low-dose CT scan helps detect early recurrence before stones become symptomatic or cause renal damage.

6. Address underlying systemic conditions

   Conditions like primary hyperparathyroidism, renal tubular acidosis, and Crohn's disease predispose to recurrent stones. A comprehensive urology evaluation, as offered by Dr. Utture at his Mumbai clinic, screens for these underlying causes as standard practice.