Can Stress Cause Kidney Stones?
Between a pandemic stricken world and upcoming post-pandemic environment, as well as the general events of life, we have probably all experienced stress at some point of our lives. Stress in moderate levels is a normal experience for most, however, excess stress is a key contributor to kidney damage. Stress when combined with chronic dehydration in particular, can trigger kidney stone formation. This is because stress causes high blood pressure and high blood glucose. This imbalance affects the homeostatic equilibrium within the body. This can lead to the narrowing of the blood vessels and subsequent damage in the renal blood vessels.
What are kidney stones?
Kidney stones or renal calculi are hard solid masses made of crystals that originate in the kidneys and develop along the urinary tract comprising the ureters, bladder and the urethra. A small kidney stone may pass easily through the urinary tract, however, larger stone may obstruct the urinary tract, leading to pain, discomfort and other complications. The types of kidney stones are identified primarily on the basis of the materials that constitute them. These include:
- Calcium Stones: Most common type of kidney stones, made up of calcium deposits, including calcium oxalate and calcium phosphate deposits.
- Uric Acid Stones: Caused in cases of highly acidic urine environments, usually affecting individuals with a protein-rich diet.
- Struvite Stones: Comprise magnesium ammonium phosphate, associated with urinary tract infections.
- Cystine Stones: Caused due to cystinuria, marked with high values of amino acid cystine in the urine, leading to dysregulation of urinary function.
- Kidney stones left untreated can lead to haematuria (bloody-urine), severe pain, discomfort, urinary tract infections, kidney infections, loss of kidney function and potential kidney damage.
What is Stress?
Stress is a normal bodily reaction to changes in physical, physiological, intellectual and emotional stimuli. It assists the body in adjusting to the new situation.
The autonomic nervous system regulates the ‘fight-or-flight response’. It leads to the manifestations of physical symptoms including aches, pains, chest pain, fatigue, headaches, dizziness, muscles tension, digestive problems, urinary issues, weak immune system and more.
It has three primary forms namely:
- Major life event: Involve stressors that require for sharp behavioural changes over a comparatively shorter period of time, for example, stress induced by: death of a loved one, divorce, loss of a job.
- Chronic strains: Involve stress inducers that are continuously present over an elongated period of time , for example: chronic disabilities, poverty.
- Daily hassles: Comprise stressors regarded generally as a minor nuisance can potentially cause physiological i.e. bodily, psychological and behavioural responses, over the course of a day. These might seem insignificant, however have an impact due to alterations in the regulatory processes of the body, for example: interactions with people, traffic.
What is the association between stress and kidney stones?
The simplest answer is that stress can indirectly cause kidney stones.
Kidney stones are predominantly caused by dehydration and subsequent concentration of the urine. This is a potential consequence of a series of problems where stress causes poor nutrition, increase in a sedentary lifestyle, alteration in quality and quantity of sleep, increased caffeine intake and possible weight gain. So in short, stress initiates a series of consequences to unhealthy behavioural habits culminating in the development of kidney stones.
Studies assessing the association between stress and physiological function indicate that the heart rate and subsequent blood pressure increase in stress. This alters the sympathetic and autonomic nervous system activity, employing the hypothalamus, pituitary and adrenal glands. This affects regulatory functions and mechanisms that regulate sodium and water retention. This contributes to the deterioration of kidney function. This is linked to a hypothesised development of chemical component build up. These build ups are markers of disease activity and impaired kidney function and are referred to as kidney stones.
What causes kidney stones?
1. Diet
Kidney stones are build-up of chemical components. These can predominantly be formed from our dietary intake in the form a variety of foods, mainly including:
- Oxalate-rich foods: Oxalate is found in healthy amounts in many food groups such as fruits and vegetables, nuts, seeds, legumes, tea and chocolate. However some foods have high levels of oxalate in particular including peanut, rhubarb, spinach, beetroots, and sweet potatoes. This food should be limited by individuals who form calcium oxalate stones.
- Purine-rich foods: These include red meats, organ meats and shellfish. They contain a high level of amino acid purine. High purine content can potentially lead to increased uric acid production, inducing kidney stone formation.
- Alcohol: It can cause blood sugar imbalances, affecting homeostatic function and increasing the pressure on the kidneys for excretion. Alcohol can also increase uric acid levels.
2. Gut problems
Chronic inflammatory diseases such as Irritable bowel disease, Crohn’s disease and Ulcerative colitis have the potential to contribute to impaired renal function and health, as well as inducing kidney stone formation cascades. This can be attributed to the common axis shared by the gut, kidney and liver. The small intestine may manifest dysfunction in the form of malabsorption of nutrients. As a result the small intestine can potentially bind to calcium components thereby creating oxalates that can accumulate in the kidneys in the form of kidney stones.
3. Obesity
Obesity can be associated with the formation of uric acid stones and calcium oxalate stones. This is linked to a low urine volume, low pH values in the urine and hyperuricosuria (high uric acid excretion).
4. Other medical conditions
Medical conditions such as gout, type 2 diabetes, renal tubular acidosis and hyperparathyroidism can increase the risk of kidney stone formation.
How to prevent kidney stones?
It is vital to avoid dehydration, as chronic dehydration is a primary cofactor in the pathogenesis of kidney stone formation. Additionally, limiting protein intake from beef, chicken, eggs, dairy products and sodium-rich foods, can be beneficial in preventing kidney stones. Replacing animal protein with vegetable protein sources can also help. To summarise, increasing fluid intake, ingesting the right amount of calcium, reducing sodium intakes, limiting animal protein sources and avoiding food increasing the risk of stone formation can help prevent kidney stones.
Stress and health management
Stress is a regular part of life. It can be caused by a variety of reasons. If you continue to feel stress for a long period of time, it is advisable to discuss this with your GP or a counsellor in order to understand the underlying cause and develop treatment plans and therapies such as cognitive behavioural therapy and biofeedback techniques, in order to reduce stress and promote general well being.
FAQs
Can stress cause urine crystals
Stress can indirectly, through a cascade of regulatory actions, cause kidney stones. Urine crystals are caused by a build-up of excessive minerals in the urine.
What is the major cause of kidney stones
Kidney stones are caused by a variety of reasons including lack of hydration, excess or lack of exercise, alterations in dietary intake of minerals and chemical components, infections, family history and other diseases such as gout, obesity, chronic kidney disease and more.