Health Answers

Kidney stones: genetics vs. lifestyle

By Courtney Humphries
September 13, 2010

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Q. I’ve had kidney stones three times, and my father has also had them. How much is it a genetic problem and how much is it influenced by diet or lifestyle?

A. It’s estimated that 10 percent of men and 5 percent of women will have a kidney stone at some point in their lives. These hard masses are formed by crystals in the urinary tract. They often pass out on their own, but their journey can be painful.

“We do know that your risk of becoming a stone-former is 2.5 times more likely if you have a family member with stones,’’ says Heidi Rayala, a urologist with Cambridge Health Alliance. But among identical twins, one twin can form stones regularly while the other remains stone-free. “So clearly, genetics is not the entire answer,’’ she says.

Kidney stones are more common among people living in hotter climates or who work in the heat, because they’re more prone to dehydration. People with certain other medical conditions, like inflammatory bowel disease, gout, or urinary tract infections, are more likely to develop kidney stones, as are people who have had gastric bypass surgery.

Even if you’re at a higher risk of developing stones, lifestyle changes “can certainly minimize or reduce the risk and incidence of stone formation,’’ says Tony Luongo, a urologist at Tufts Medical Center. These changes include staying hydrated, lowering salt intake, and avoiding high-protein foods and large amounts of caffeine. For those with the most common kinds of stones, formed by calcium oxalate, cutting back on oxalate-rich foods can help, including leafy green vegetables, cheese, nuts, and chocolate. Citrus fruits and foods high in potassium can help prevent crystals from forming.

Luongo says that anyone with recurrent stones should receive a medical evaluation to determine the type of stones they have and whether there’s an identifiable cause.

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