Daily Times

Sir: Pakistan sits in the middle of the stone belt, with the people of Sindh and the Seraiki belt of Punjab among the worst sufferers. Stones in the kidneys cause pain, sepsis, loss of function, and sometimes death.

Stones constitute 60 percent of the workload of urology. In many cases it is a silent disease and is diagnosed after kidney function is lost. Therefore early diagnosis and treatment are mandatory to avoid complications.

The preferred treatment nowadays is non-invasive “extracorporeal shock wave lithotripsy”. Thus it is important that this treatment be available at every district hospital of the country and be provided free to every citizen. A significant number of patients are unable to get timely treatment because of poverty and subsequently develop complications.

Studies on the geographic variation in the prevalence of kidney stone disease have shown a 50 percent higher prevalence in the south east (the ‘kidney stone belt’ ) than the northwest, possibly associated with a changing state of dehydration related to high summer time temperatures and resulting in low urine volumes.

More people report kidney stones in summer and they develop recurrent colics because of dehydration due to warm weather and less intake of water. The recommendations are to take as much water so as to produce 2.5 liters of urine in 24 hours.

All stone formers should take more water, less animal protein, more vegetables and fruits. If they pass a stone in urine they should get it analysed and take precautions accordingly with the advice of a urologist and a nutritionist.

They should get treatment when the stone is small because it is easy to treat a small stone with shock waves without any incision, anaesthisia or hospitalisation.

Murli Dhar

Karachi