Medical science have advanced considerably particularly in the last decade. These advances have greatly improved our understanding of course of the stone disease and the management of this ailment has undergone revolutionary changes. This knowledge has further been helpful in the prevention and treatment of stone disease.
Various factors play a role in the formation of kidney stone in a susceptible individual. These factors are diet, water intake, urinary output, climate, occupation, and heredity, radical and family background.
1. Diet- Ingestion of excessive amount of calcium, oxalates, purines (uric acid), phosphates and other elements often results in excessive excretion of these components in the urine. The stone formation can be precipitated by high intake of calcium in the form of milk, ice creams, cheese, chocolates, cocoa, calcium containing drugs or vitamin D.
2.Water Intake and Urinary Output- It has been well established that increased water intake and increased urinary output decrease the incidence of urinary stone in patients predisposed to the disease.
3.Climate- High environmental temperature increases sweating, which may result in increased concentration of urine. This hyper concentration may contribute to stone formation.
4.Occupation- Stone disease is more likely to be found in individuals with sedentary occupation like professionals and managerial class rather than unskilled and partly skilled labourers.
5.Genetic Disorders- Like Gout, Cystinuria, primary Oxaluria, metabolic disorders like bowl, endocrine and kidney problems that increase blood and urine calcium and oxalates can promote the tendency for stone formation. Other rarer conditions like rickets, hyperparathyroidism and demineralization of bone may lead to stone formation.
6.Obstruction and Infection- Due to stricture or enlarged prostate may cause stagnation of urine leading to stone formation. Chronic infection in the kidney may also allow stone formation around the debris in the urine.
In stone belts, where the disease is endemic, it is the hot dry climate and the high content of calcium in the hard water and in the food grown in the soil that leads to stone formation. In areas where this disease is not endemic, in most cases no cause can be detected and it may be the tendency of the kidneys in the individual to form urine of high calcium or urate content. In some it may be due to a period of negligence in intake of adequate fluids worsened by excessive sweating.