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Another Painful Outcome of Obesity, Diet and Lifestyle?

By Ginny Greene, Editor
10/3/2012 11:18:03 AM

"American Idol" winner Phillip Phillips' recent kidney stone news put the spotlight on a fast-growing affliction.

Kidney stones are appearing at almost twice the rate in American adults than in the past, a new study shows. Phillips (pictured) was born with a condition that caused the stones, according to media reports. The singer, 21, had complained of intense abdominal pain while on the "Idol" set. He described that pain to interviewers as crippling. The pain at times made it hard for him to stand up while he performed.

Photo courtesy of George Doyle

The cause of Phillips' kidney stones is unusual. The latest study blames something altogether different - obesity, diet and lifestyle - for the rising number of cases. The study was published in the July issue of European Urology.

Researchers at the University of California, Los Angeles and the Rand Corp. conducted the study. They found the incidence of kidney stones in one in 11 Americans. That compares with one in 20 in 1994. That was the last year that data were widely measured. More than 12,000 people took part in the survey.

"We found that obesity, diabetes and gout were all linked with a history of kidney stones," says lead researcher Dr. Charles D. Scales Jr., a clinical scholar at UCLA. "Given the epidemic of obesity in the United State's over the past two decades, I believe that much of the increase in prevalence of kidney stones is related to obesity, diet and lifestyle."

With the change in epidemiology, he says, kidney stones are now as prevalent as diabetes. They are more prevalent than heart disease or stroke.

"Kidney stones are an important health issue because they cause extreme pain and temporary disability in a working age population," Scales says. "Up to half of people who have their first stone will form another kidney stone within five years."

The pain can be debilitating when they pass or cause blockage of the kidney, Scales says.

"Some of my female patients, who have both passed kidney stones and delivered babies without pain medicine, say that passing a kidney stone was worse than childbirth," he says.

Stones occur in all population groups. There is a higher occurrence among whites and men. But the obesity epidemic seems to be leveling the playing field.

"For reasons that are not entirely clear, the prevalence of kidney stones has always been higher among whites than Hispanics or African-Americans," Scales says. "However, the increase in prevalence has been much higher in Hispanic and African-American groups, which is probably related to the higher rate of obesity in these groups."

More than half a million people seek emergency treatment for kidney stones each year, according to the National Kidney Foundation. Their experts estimate one in 10 people will have a kidney stone.

The peak age for stones is between 20 and 50. High blood pressure, diabetes, obesity, osteoporosis, chronic diarrhea or kidney cysts can raise the risk of stones, the foundation says.

National Institutes of Health experts estimate that in 2000, more than $2 billion was spent to evaluate and treat kidney stones. There is no solid estimate of today's costs.

A kidney stone is a hard object, like a pebble, that is made from waste chemicals in the urine. Crystals form when there is too much waste in too little liquid. They eventually create a solid mass that will keep growing unless it passes out of the body with the urine.

Most kidney stones are about pea-sized or smaller, Scales says.

"However, some kidney stones can grow to be quite large - about the size of a golf ball, or a little larger," he says.

Doctors can be remove kidney stones using a laser and small telescope. Or they can break them up using shock waves transmitted through the body, he says. In rare cases, they remove them through a small hole in the back.

"However, our findings suggest that we may need to rethink how we treat kidney stones," Scales says. "Imagine that we only treated heart disease when a person had chest pain or a heart attack, and did nothing to manage risk factors like smoking, high blood pressure and cholesterol. This is how we treat people with kidney stones today."

Instead, "We know that having a diet that is high in sodium, high in animal protein and high in calories increases your risk of kidney stones regardless of whether you are obese or normal weight," he says. "Doctors and patients need to know that kidney stones are preventable with simple diet and lifestyle measures, like eating a balanced diet that is low in animal protein and salt, and has a moderate amount of calcium, and staying well hydrated."

"The good news is that a diet that will prevent kidney stones is also a diet that is good for your heart as well," he says. "People with kidney failure need special diets that they can learn about from their doctors."

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