A World Record No One Wants to Break

Imagine trying to pee out a grapefruit.

Canistus Coonghe didn't have to imagine it last year...

The unlucky 62-year-old veteran got a kidney stone removed surgically. Measuring roughly 5 inches by 4 inches, it weighed in at a whopping 1.76 pounds... shattering two Guinness World Records for the largest and heaviest kidney stone ever removed.

Thankfully, most stones are smaller than the width of a pencil-top eraser. So they make it from the kidneys to the bladder to get peed out over a one- to two-week period. About 80% of kidney stones get passed without needing medical treatment. It's typically ones wider than 10 millimeters (or two pencil-top erasers) that need medical treatment.

According to the National Kidney Foundation, about 1 in 10 of us will have a kidney stone at some point in our lives. It's also behind more than half a million emergency-room visits each year.

You're likely to get your first kidney stone between your 30s and 50s. Men are more than twice as likely to get kidney stones as women. Conditions such as diabetes, obesity, and high blood pressure all increase your risk. Family history plays a large role, too – one more reason it's important to know your family's medical history.

Getting older raises your risk of developing kidney stones, too, especially once you've reached your 60s. That's also when muscle loss starts ramping up... which can have devastating consequences if left unchecked. (I discussed this in a recent Retirement Millionaire issue– nonsubscribers can give my flagship newsletter a try right here.)

Kidney stones form when you have a buildup of minerals and not enough liquid in your urine. Minerals like calcium, oxalate, cystine, urate, xanthine, and phosphate become concentrated in your urine, form into crystals, and turn into full-on stones.

There are four different types of kidney stones...

Calcium oxalate and uric acid stones are the most common. The latter comes from eating too many purines, which is a chemical found in shellfish and organ meats. Uric acid stones can be seen in family history.

Cystine stones are another type of stone that can get passed down, but they're uncommon. The fourth type, struvite, is also uncommon and can arise from an infection.

As for stone sizes, it's just as you'd expect... Compared with smaller stones, bigger stones can bring on pain, big time. Some folks describe kidney-stone agony as comparable to childbirth.

Most commonly, the pain comes and worsens in waves and is located in your lower area – your back, side, belly, or even groin. Similar to urinary tract infection symptoms, you might have pain and increased urgency with urination. Your pee might even have blood or look cloudy. And you may have fever, chills, nausea, and vomiting, too.

Without treatment, you could get a swollen kidney due to urine backup in the organ, kidney infection, kidney failure, or chronic kidney disease.

As for treatment, your doctor might prescribe medications to help relax the muscles of your ureters, the tubes connecting your kidneys to your bladder. You might also get painkillers prescribed for the pain as you wait to pass the stones.

Bigger, harder-to-reach offenders may call for minimally invasive surgery (using a few small incisions) or major surgery (the kind Canistus had).

Another method is to push a tiny tube into your urethra, through which even tinier tools get fed through so your doctor can try to remove the stone.

As for an even less invasive treatment, a stone could be zapped with shockwaves or ultrasound. It sounds like something out of a comic book, but all it does is break the stone into fragments for easier passing.

And some good news... A small, randomized controlled study published last month showed that going the blasting route can lower your risk of a recurring stone by 70%. Researchers used an ultrasound wand to break up the stone and guide it closer to the ureters.

Speaking of repeat stones, if you've had a kidney stone needing treatment before, I've got some bad news for you...

Folks who have had one stone are more than 50% more likely to have another within five to seven years, and 80% more likely within 10 years.

So the best thing to do is to minimize your risk factors...

Cut back on or avoid sugar. Too much sugar can increase the amount of calcium in your pee. Not to mention, overindulging in added sugar can lead to weight gain... which is linked to stone-favoring conditions like high blood pressure and diabetes, like I mentioned earlier. A 2023 study of 28,303 adults spanning 11 years found that those who had a sugar-rich diet (or added sugar accounting for more than 25% of daily caloric intake) had an 88% higher risk of getting kidney stones. (That's in comparison with folks who had 5% of their daily calories come from added sugar.)

Try to wean yourself off of sugar – like using fruit instead. Skip the fruit juice and soda – slice up some fresh fruit or add frozen berries into sparkling water. I also love adding frozen or fresh blueberries to my unflavored Greek yogurt. Skip the sweet coffee concoctions – add cinnamon or vanilla extract to your coffee. A tiny bit of salt can even reduce the bitterness if you've been using sugar to mask the taste. Speaking of salt...

Don't overdo the salt and meat either. Too much salt can increase calcium levels and lead to calcium oxalate stones. Too much protein can alter calcium and uric acid levels in your pee, which can bump up your risk of stones. Try changing up your diet by substituting animal protein with plant-based protein like beans and lentils. Speaking of beans...

Watch out for oxalates. If your doctor wants you to limit your intake, you might want to go easy on foods like...

• Navy beans
• Spinach
• Almonds
• Tofu and soy-based foods
• Skin-on potatoes
• Beets

Finally, stay hydrated. Drink enough fluids so that your urine doesn't become dangerously concentrated. And hopefully, you won't find yourself carrying a grapefruit around one day.

What We're Reading...

• Did you miss it? The Pantone color code for your pee.
• Something different: What even is "blue raspberry" anyway?

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
September 26, 2024