Kidney Stones: Prevention in a Hot Climate
Anantapur's summer produces a predictable surge in kidney stone admissions. Recurrence is common — and largely preventable with changes most people can sustain.
Read article
Kidney function can fall to a quarter of normal without producing a single symptom. Two inexpensive tests find it years earlier — and almost nobody asks for them.
The silence problem
The kidneys have enormous reserve. Function can decline substantially before waste products accumulate enough to cause fatigue, nausea or swelling. By the time symptoms appear, a great deal of irreversible scarring has usually occurred.
This is why kidney disease is so often diagnosed at a stage where dialysis is already being discussed — not because it progressed quickly, but because nobody looked earlier.
Two tests that find it early
- Serum creatinine with eGFR — an estimate of how well the kidneys filter. Below 60 sustained for three months indicates chronic kidney disease
- Urine albumin-to-creatinine ratio — detects small amounts of protein leaking into the urine, often the earliest sign of all, appearing years before creatinine rises
Worth knowing
Ask for a urine albumin test, not just a routine urine examination. Standard urine dipsticks miss the small amounts of albumin that signal early kidney damage.
Who should be screened annually
- Everyone with diabetes
- Everyone with high blood pressure
- Anyone with heart disease
- Family history of kidney disease
- Anyone over 60
- Regular users of painkillers of the NSAID class
- People with recurrent kidney stones or urinary infections
- Anyone with a history of kidney disease in pregnancy
Slowing progression
- Blood pressure control to below 130/80 — the most important single measure
- Blood sugar control in diabetics
- Specific kidney-protective medications (ACE inhibitors, ARBs and SGLT2 inhibitors) where prescribed
- Salt restriction to under 5 g daily
- Stopping NSAID painkillers — ibuprofen, diclofenac and similar drugs are a major and avoidable cause of kidney injury
- Avoiding unverified herbal and ayurvedic preparations, some of which contain nephrotoxic heavy metals
- Adequate hydration, but not excessive fluid if there is already fluid retention
- Treating urinary obstruction and infections promptly
Preparing early if progression continues
If kidney function continues to decline, planning ahead makes an enormous difference to outcomes. Creating dialysis access (an AV fistula) several months before it is needed avoids emergency catheter insertion. Evaluating for transplant early, including identifying a potential donor, considerably shortens the time on dialysis.
Patients who start dialysis in a planned way, with a working fistula and a prepared family, do measurably better than those who begin as an emergency. Ask your nephrologist about planning as soon as stage 4 is reached.
Key takeaways
- Kidney function can halve without any symptom — screening is the only way to detect it early.
- Ask specifically for urine albumin-to-creatinine ratio alongside serum creatinine.
- NSAID painkillers are a major avoidable cause of kidney damage.
- Planned dialysis with a prepared fistula produces far better outcomes than emergency initiation.
A note on medical advice
This article is general health education written and reviewed by the Departments of Nephrology & Urology at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
Kidney diseaseDialysisDiabetesScreening
