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Stones in the Time of COVID-19

Your body has survived a lot during the pandemic: stress, uncertainty at work and at home, and, for some of us, even COVID-19.

So many things about living through a pandemic — isolation from friends and extended family, fewer places to go, fewer ways to get in the workout, more comfort eating — can take a real toll on your physical health. And one of the consequences of your pandemic lifestyle might be unexpected: kidney stones.

What’s in a Stone?

Kidney stones are clusters of crystals that develop when the levels of calcium, oxalate and phosphorus in the urine get too high. Each of these minerals is normally found in urine and doesn’t cause problems at normal levels; stones can form if your urine contains more of these crystal-forming minerals than the fluid in your urine can dilute.

After it is formed, a stone might stay in the kidney or travel down the urinary tract. Sometimes tiny stones just flow out of the body in the urine without causing much pain. But stones that don’t move can cause a back-up of urine in the kidney, ureter, bladder, or urethra. This back-up is what causes the pain — and what could cause serious illness if left untreated.

The Perfect Stone Storm

Kidney stones often have no obvious, single cause, but several factors increase your risk — and many of these factors are harder to manage during the pandemic:

  • Drinking too little water: It can be harder to remember to drink water regularly when you’re masked up.

According to Parul Kharod, a WakeMed nutrition consultant for the Kidney Stone Center,  “The recommendation for water intake is at least 2 liters (about 67 ounces) per day.”

  • Vitamin D and C supplementation: Both vitamins have been recommended at times to help prevent serious COVID-19 complications, and both can increase stone forming in some people.
  • Exercise: The problem with exercise and kidney stones is often the extremes — too much (cue dehydration) or too little — but most of us are struggling with the latter right now.
  • Food with too much salt or sugar: Comfort food is soothing because it’s “too much” of something we don’t need, and indulging in these kinds of foods is a go-to coping mechanism.

Parul Kharod says, “Sugar does not cause stones but may add to weight gain which increases stone risks. However, salt or excess sodium is definitely a big risk factor.”

  • Weight gain: What’s a common outcome when exercise goes down and comfort eating goes up? You guessed it. Researchers aren’t sure why, but people who are at higher weights have higher rates of kidney stones.
  • Animal protein: Parul Kharod says, “One other risk factor is excess animal protein – so high protein low carb diets are not recommended.”

These aren’t the only risk factors for kidney stones, but during the pandemic — especially for those of us with a history of stones — some or all of these factors might be combining to tip the mineral balance in our urine in the wrong direction.

Dr. Shams Zia, a WakeMed hospitalist and nephrology consultant for the Kidney Stone Center, says, “Most of the stones are preventable, and many are treatable especially uric acid or mixed stones. Putting off the stone prevention for long can increase the number and frequency of stones which in turn can lead to urine infections, blood infections as well as emergent need for surgical intervention.”

The Problem with Putting It Off

What’s worse is that for stone-formers, when a visit to a medical center feels risky given the threat of COVID-19, the temptation may be to delay medical care and try to pass the stone at home. But people with kidney stones who put off seeking care face an increased risk of complications and severe illness.

According to Dr. Zia, during the pandemic, many people with kidney stones were waiting longer to seek medical care than they did in pre-pandemic times. The average size of kidney stones treated at medical facilities during the pandemic was about twice as large as the average size before the pandemic.

While home treatment may be fine in some situations, delaying do medical appointments definitely increases the likelihood that a kidney stone could create obstructions, increase complications during treatment and even cause permanent kidney damage.

So if you think you have a stone — or you know you have a history of stones — see a doctor as soon as possible. Pay attention if you begin to experience pain “down yonder,” a sharp pain under the rib cage or any other symptoms of kidney stones. At WakeMed, we are taking every precaution needed to keep you safe and healthy, both during the pandemic and for all your years to come.

Kidney Stone Center

The Kidney Stone Center at WakeMed is a 24-hour service available for those who think they might be passing a stone. We are the only hospital in the Triangle to offer IMMEDIATE help for kidney stones.

If you think you are passing a stone, you can contact our stone center at 919-350-ROCK. Our goal is to help you navigate your medical condition and try to have you avoid an Emergency Department visit. We can answer questions for you, offer advice, and typically get you into the office quite quickly.

Reach the Kidney Stone Center by calling: 919-350-ROCK (7625).