Why do more people in the South get kidney stones?

Freeman Brown, FNP

Urology

It’s true: People in the South are more likely to get kidney stones. However, living in the South doesn’t mean kidney stones are inevitable. You can significantly reduce your risk by understanding the connection between environment, dehydration and diet to kidney stone formation.  

Urology advanced practice provider Freeman Brown, FNP, explained why people in the South are more likely to get kidney stones and how you can prevent them.  

“Kidney stones affect about 9% of the US population and are more common in the southeastern states, known to the urology community as the ‘stone belt,'” said Brown. “The hot climate makes your body lose water from increased sweating. This means there is less water for the kidneys to make urine, which becomes more concentrated. When urine is concentrated, chemicals like calcium and oxalate stick together and more easily form stones.”

What causes kidney stones?

The kidneys are a part of the body’s filtration system for what we eat and drink. Waste products get dumped into the urine to be released from the body when you urinate. There are certain foods and beverages that can contribute to accumulation of stone-forming chemicals.  

Here are the main ways diet can increase your risk of kidney stones:

• Hydration: Inadequate hydration is a leading factor in kidney stone formation. You should drink at least 2.5 to 3 liters per day. Your goal is to produce at least 2 liters of urine per day. Pale yellow or clear urine is a good indicator of adequate hydration. 
  
  “Remember that water is best, but drinks with citrus such as lemonade can help prevent stones as well,” said Brown. “Drink more on hot days when you’re outdoors for work or exercise.”
  
• Sodium: Salt is a flavor enhancer and can make food taste great, but overdoing it can affect kidney stone formation. For optimal stone prevention, salt should be limited to about 2,300 mg per day. That’s about 1 teaspoon of table salt.  

• Protein: A diet high in animal protein can make your urine more acidic, which can increase your risk for certain stone types.  

• Oxalate: Certain foods and drinks, like peanuts, chocolate, spinach, instant coffee and concentrated teas are rich in oxalate.  

Does calcium cause kidney stones?

“A low calcium diet can actually aid in the development of kidney stones,” said Brown. “Avoiding calcium is not a good preventative! Instead, eat a normal amount of calcium daily, roughly 1,000–1,200 mg from food.”

There are situations where calcium supplements can help you meet your body’s needs. Speak to your doctor.

What should you do if you think you have a kidney stone? 

A common symptom of a kidney stone is a sharp pain in the back that may feel like it connects to the groin or scrotum. You can also see blood in the urine. You should seek medical attention for further evaluation.  

“Kidney stones can quickly become serious. If you experience fever, nausea, vomiting or unbearable pain alongside the other symptoms, a visit to the emergency room is crucial for evaluation and potentially to remove any blockage caused by the stone. 

After your first kidney stone, you have about a 1 in 5 chance of getting another stone within 5 years, which is why prevention is so important.  

“If you have recurrent kidney stones, uncommon stones or you’ve experienced one and you’re looking to prevent any future stones from forming, speak to your doctor about getting an appointment with a urology clinician,” said Brown. “They can help you create a treatment and prevention strategy.”