Nephrology focuses on diagnosing and treating kidney diseases. The kidneys filter waste, balance fluids, regulate blood pressure, and manage acute and chronic conditions.
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Nephrolithiasis, commonly known as kidney stones, is a prevalent and often painful medical condition characterized by the formation of solid, crystalline mineral deposits within the kidneys or urinary tract. These stones develop when the urine becomes concentrated, allowing minerals like calcium, oxalate, and uric acid to crystallize and stick together. While the kidneys are designed to filter waste and produce liquid urine, a disruption in the chemical balance can turn this liquid environment into a breeding ground for solid stones. For millions of people, a kidney stone is a one-time, agonizing event, but for many others, it is a chronic, recurring condition that requires lifelong management and vigilance.
The medical term “nephrolithiasis” specifically refers to the presence of stones in the kidneys themselves, while “urolithiasis” refers to stones anywhere in the urinary tract, including the ureters and bladder. Regardless of the name, the experience is universally described as one of the most intense pains a human can endure. The condition affects people of all ages, though it is most common in working-age adults. It is a disease of modern lifestyle, diet, and genetics. Understanding the mechanics of how stones form is the first step in demystifying the condition and empowering patients to prevent future episodes.
Kidney stones do not form overnight. They are the result of a chemical process that takes weeks, months, or even years. Urine is not just water; it is a complex chemical solution containing waste products. Under normal circumstances, the body produces natural inhibitors—chemical substances that prevent crystals from forming.
However, when there is too much waste and not enough liquid, the urine becomes supersaturated. Imagine adding salt to a glass of water. At first, it dissolves. But if you keep adding salt, or if you let the water evaporate, the salt eventually turns back into solid crystals at the bottom of the glass. This process is precisely what happens in the kidney. Microscopic crystals form and anchor themselves to the inner lining of the kidney. Over time, more layers of minerals deposit on this anchor, growing from a grain of sand into a pebble and sometimes into a stone the size of a golf ball.
Not all kidney stones are the same. Knowing the specific type of stone is critical because the prevention strategy for one type might be completely wrong for another.
These are the most common type, accounting for about 80 percent of all kidney stones. They are usually made of calcium oxalate. Oxalate is a substance found in many foods, but it is also produced by the liver. Calcium stones can also be made of calcium phosphate. which is more common in people with metabolic conditions or those taking certain medications for migraines or seizures.
Struvite stones are often called “infection stones.” They form in response to a urinary tract infection (UTI). These stones can grow quickly and become huge, sometimes filling the entire kidney (staghorn calculi), often with few warning symptoms. They are more common in women due to the higher susceptibility to UTIs.
Uric acid stones form in people who do not drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Genetic factors and chemotherapy can also increase the risk. These stones are unique because they can sometimes be dissolved with medication, unlike calcium stones.
These are caused by a rare hereditary disorder called cystinuria that causes the kidneys to excrete too much of a specific amino acid (cystine). These stones often start forming in childhood and tend to be larger and harder to treat than other types.
A kidney stone may remain in the kidney for years without causing any symptoms. It is often discovered accidentally during an X-ray for something else. These “silent stones” allow urine to flow and do not cause pain.
The trouble begins when the stone decides to move. If it breaks loose and travels down the ureter—the narrow tube connecting the kidney to the bladder—it acts like a cork. The ureter is a tiny, muscular tube. When a sharp, jagged stone gets stuck, the ureter spasms violently trying to push it out. This spasm, combined with the backup of urine causing the kidney to swell (hydronephrosis), is what causes the excruciating pain known as renal colic.
Kidney stones are often called a “disease of civilization” because they are strongly linked to diet and lifestyle. However, genes play a significant role. If your parents or siblings have had stones, your risk is much higher.
Men are statistically more likely to develop stones than women, although the gap is closing. Dehydration is the single biggest risk factor, universally. People who live in hot climates or who sweat heavily for their jobs are at increased risk because their urine is consistently more concentrated. Additionally, obesity, weight gain, and digestive diseases like inflammatory bowel disease or chronic diarrhea can alter the digestive process and affect the absorption of calcium and water, increasing stone risk.
For someone with recurrent stones, the fear of the next attack can be debilitating. It affects work attendance, travel plans, and daily anxiety levels. The condition’s unpredictability—since a stone can strike at any moment—creates a significant psychological burden.
Preventive nephrology aims to lift this burden. By analyzing the stone composition and the patient’s urine chemistry, doctors can create a personalized prevention plan. This shifts the patient from a state of helplessness to a state of control. While we cannot change genetics, we can change the chemical environment of the kidneys, making it hostile to stone formation.
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Prof. MD. Süleyman Tevfik Ecder
Nephrology
Liv Hospital Bahçeşehir
Asst. Prof. MD. Himmet Bora Uslu
Nephrology
Liv Hospital Bahçeşehir
Prof. MD. Mehmet Taşdemir
Pediatric Nephrology
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Prof. MD. Ozan Özkaya
Pediatric Nephrology
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Prof. MD. Hüsnü Oğuz Söylemezoğlu
Pediatric Nephrology
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MD. FERHAD ŞİRİNOV
Nephrology
Send us all your questions or requests, and our expert team will assist you.
Paradoxically, no. Eating calcium-rich foods actually prevents stones by blocking oxalate absorption in the gut. Taking calcium supplements on an empty stomach can increase the risk of kidney stones.
Indirectly, yes. Stress can lead to poor diet, dehydration, and changes in metabolism that create a favorable environment for stones, although it is not a direct cause.
It varies widely. A small stone might pass in a few days, while a larger one could take weeks. Generally, if it hasn’t passed in 4-6 weeks, intervention is needed to prevent kidney damage.
Yes, dark colas contain phosphoric acid, and tea contains oxalate. Both can increase the risk of stone formation if consumed in large quantities instead of water.
Many patients who have experienced both consider kidney stone pain to be equal to or worse than childbirth because it is a relentless, sharp pain that does not come in waves of relief.
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