Kidney stones are one of the most painful conditions a person can experience — often described as worse than childbirth. They are also one of the most preventable. In North India, where temperatures are high, diets are rich in salt and oxalate, and water intake is often inadequate, kidney stones are surprisingly common. Dr. Anirudh Kaushik explains who is at risk and what actually works to prevent recurrence.

What Are Kidney Stones and How Do They Form?

Kidney stones are hard mineral and salt deposits that form inside the kidneys when urine becomes concentrated. When the urine contains more crystal-forming substances — calcium, oxalate, uric acid — than the fluid can dilute, crystals begin to form. Over time these crystals aggregate into stones, which range in size from a grain of sand to a golf ball.

The most common type in India is calcium oxalate stones, accounting for roughly 80 percent of cases. Uric acid stones (associated with high-protein diets and gout) and struvite stones (linked to recurring UTIs) are less common but clinically significant.

Recognising a Kidney Stone

Small stones may pass without any symptoms. Larger ones cause the characteristic renal colic: severe, cramping pain in the flank (the side of the lower back) that radiates down towards the groin and inner thigh. The pain comes in waves, is often accompanied by nausea and vomiting, and is typically unlike any pain the patient has experienced before. Blood in the urine, painful urination and an urgent need to urinate frequently are also common.

If you experience these symptoms, seek medical attention promptly. Imaging (ultrasound or CT) will confirm the diagnosis and identify the stone's size and location, which determines the appropriate treatment.

"A stone that passes once will almost certainly come back — unless we understand why it formed and change what's driving it."

Who Is Most at Risk?

  • Men are affected roughly twice as often as women, though the gap narrows after menopause.
  • Family history significantly increases risk — if a parent had kidney stones, your lifetime risk nearly doubles.
  • Recurrent UTIs, especially in women, increase the risk of struvite stones.
  • Certain metabolic conditions — hyperparathyroidism, renal tubular acidosis, gout — predispose to stones.
  • Chronic dehydration is the most common contributing factor and the most easily corrected.
  • High dietary oxalate (from spinach, nuts, chocolate and tea) combined with low calcium intake paradoxically increases stone risk.

Prevention: What the Evidence Shows

The single most effective intervention for preventing kidney stones is increasing fluid intake. Aim for at least 2.5 to 3 litres of water per day — enough to produce pale, almost colourless urine. In Gurgaon's summer heat, this target needs to increase further. Lemon water is a particularly good choice: the citrate in lemon juice inhibits stone formation.

Dietary changes are the second pillar. Reduce sodium (salt) intake significantly — a high-sodium diet increases urinary calcium excretion. Moderate animal protein, as high intake raises uric acid and reduces citrate. Counterintuitively, do not eliminate calcium from your diet — adequate dietary calcium (from food, not supplements) binds oxalate in the gut and actually reduces stone risk.

For recurrent stone-formers, a 24-hour urine collection and metabolic blood tests can identify the specific abnormality driving stone formation. Treatment can then be targeted: potassium citrate, thiazide diuretics or allopurinol depending on the stone type.

If you have passed a kidney stone or had one removed, a follow-up consultation is essential. We will analyse the stone composition if available, run the appropriate metabolic tests, and give you a prevention plan that significantly reduces your chance of recurrence.