What Are Staghorn Kidney Stones? (Symptoms, Causes, and Treatment) : The Hearty Soul

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Staghorn stones are large, branching kidney stones that can wholly or partially fill the renal pelvis and calyces (Healy & Ogan, 2007). They are typically found on one side of the body and are less common in men (Diri & Diri, 2018) (Johnson et al., 1979). Staghorn stones are linked with urinary tract infections (UTIs) caused by urease-producing bacteria, leading to rocks known as struvite infection stones (Torricelli & Monga, 2020a).

There are 4 Kidney Stone Types: Calcium oxalate, Uric acid, Struvite, and Cystine.

1. Calcium Oxalate

   Calcium oxalate crystals are the most prevalent type of crystal found in urine and are a leading cause of kidney stones. When there is an excess of oxalate, it can bind with calcium to create kidney stones and crystals. These formations can inflict harm on the kidneys and impede their function. Approximately 80% of kidney stones are comprised of calcium; of that 80%, about 80% are classified as calcium oxalate stones (Finkielstein, 2006a).

2. Uric Acid

   Hyperuricemia, a high uric acid level in the bloodstream, can be caused by an overproduction of uric acid, reduced excretion, or a combination of both factors. If left unmanaged, this condition can form urate crystals, resulting in the painful condition known as gout. High levels of uric acid have been associated with severe health conditions such as hypertension, atherosclerosis, insulin resistance, and diabetes (Soltani et al., 2013).

3. Cystine

   Excessive levels of cystine in the urine can result in the development of kidney stones, which have the potential to become stuck in the kidneys, bladder, or urinary tract. While the condition can be well-managed, there is currently no known cure for cystinuria (Shen et al., 2017).

4. Struvite Stones

   Struvite urinary stones, also known as “infection stones”, are typically caused by infections in the upper urinary tract. These complex structures form from chemicals in the urine. Once they develop, the kidney can retain or pass the stone along the urinary tract and into the ureter (Griffith, 1978).

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Staghorn Kidney Stone Symptoms and Conventional Treatment

If a staghorn calculus is present in your kidney, you may notice symptoms such as a fever, pain on the side between your ribs and hip, and blood in your urine (hematuria). The treatment typically involves surgical intervention to remove the stone, including any small pieces, to prevent infection or the development of new stones. Percutaneous nephrolithotomy (PCNL) is the gold standard surgical treatment for staghorn renal stones (De et al., 2015) (Torricelli & Monga, 2020b).

Dietary Management and Supplementation Modification

In the 1940s, a low-phosphate and calcium diet was proposed to reduce the risk of developing staghorn stones (Shorr, 1950). Fluid intake, calcium supplementation, limiting oxalate-rich foods, regulating vitamin C intake, and monitoring protein and sodium intake are essential factors in managing kidney stone formation.

1. Fluid Intake

   The foundation of effective management is centred around increasing urine volume. Consuming 2.5 to 3 litres of fluid daily is advised to achieve this goal (Finkielstein, 2006b).

2. Calcium Supplement with Meals

   When taking calcium carbonate supplements with meals, oxalate excretion in the urine is reduced, benefiting individuals at risk of developing stones. It’s preferable to use calcium citrate as a supplement, as it increases urinary citrate excretion.

3. Limit Foods High in Oxalate

   It’s essential to limit the consumption of foods high in oxalate and consume them with extra fluids to lower oxalate absorption.

4. Vitamin C (ascorbic acid)

   Taking vitamin C supplements may increase oxaluria and be linked to a higher risk of stone formation. It’s recommended to limit vitamin C supplements to less than 1000 mg per day.

5. Regulate Your Consumption of Animal-based Protein

   Controlling the intake of animal-based protein can reduce the risk of uric acid stone development.

6. Monitor Your Sodium Intake

   Excess salt in the diet can lead to increased calcium excretion by the kidneys, raising the risk of developing kidney stones.

7. Omega-3 (EPA) Has Some Potential Benefits

   Omega-3 fatty acids found in oily fish can reduce the risk of stone formation. Fish oil is recommended as a supplement to treat patients who form stones.

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Conclusion

Staghorn renal stones, or struvite stones, are large kidney stones associated with recurrent urinary tract infections. Proper dietary management and supplementation can help prevent the formation of kidney stones and reduce the risk of complications.