Kidney Stones in Pakistan: Symptoms, Causes and Treatment Options

Kidney stones are a genuinely common problem in Pakistan, which sits within what researchers call Asia's "stone belt" — a band of countries with a notably higher regional prevalence of urolithiasis, estimated at 5–19.1% across South Asia, West Asia, Southeast Asia and parts of East Asia ("Risk Factors of Kidney Stones in Khyber Pakhtunkhwa, Pakistan: A Descriptive Cross-Sectional Study," PMC). Within Pakistan specifically, that same study found prevalence rising with age — 12.2% in 20–29 year-olds, 29.6% in 30–39 year-olds, and 31.5% in 40–49 year-olds — and identified low water intake, high tea consumption, and a high-sodium diet as significant, and modifiable, risk factors: 70.5% of the stone patients studied had insufficient water intake, and 56.1% drank more than a cup of tea daily.

At a glance

• Pakistan sits within Asia's "stone belt," with regional prevalence estimated at 5–19.1%
• Prevalence rises sharply with age in Pakistani data — from 12.2% at 20–29 to 31.5% at 40–49
• Low water intake and high tea/sodium consumption are documented, modifiable risk factors
• Calcium oxalate is the most common stone type (75–90% of cases)

What are kidney stones?

Kidney stones are hard deposits that form when minerals and salts in urine crystallise, usually in the kidney, and can then travel down the urinary tract. Most are calcium oxalate stones (75–90% of cases), with smaller proportions being uric acid, calcium phosphate, struvite, or cystine stones — the composition matters because it affects both the underlying cause and the prevention advice.

Symptoms

• Severe pain in the side or back, below the ribs (classically described as one of the most intense pains a person can experience), often coming in waves
• Pain that radiates to the lower abdomen or groin as the stone moves
• Pain or burning during urination
• Pink, red or brown (blood-tinged) urine
• Cloudy or foul-smelling urine
• Nausea and vomiting
• Fever and chills, if infection is also present — this combination needs urgent attention

Small stones can also pass with no symptoms at all, which is why some are found incidentally on imaging done for other reasons.

Causes and risk factors

• Insufficient water intake — the single most consistently documented, and most fixable, risk factor
• High sodium intake
• High tea consumption, per the KP study above
• Family or personal history of kidney stones
• Certain diets high in oxalate-rich foods, in people prone to calcium oxalate stones specifically
• Hot climates, which increase fluid loss through sweat and concentrate urine if intake doesn't compensate
• Some underlying metabolic conditions

How they're diagnosed

A CT scan (non-contrast) is the most sensitive way to detect kidney stones, though ultrasound is also commonly used, especially as a first step or in pregnancy. Urine and blood tests help assess kidney function and identify metabolic contributors. A urologist typically leads both diagnosis and treatment decisions for kidney stones.

Treatment

• Small stones often pass on their own with increased fluid intake and pain management, sometimes helped by medication that relaxes the urinary tract to ease passage
• Larger or stuck stones may need active treatment: ESWL (extracorporeal shock wave lithotripsy, which breaks stones up using shock waves from outside the body), ureteroscopy (removing or breaking up the stone via a scope), or, for larger stones, percutaneous procedures
• Infection alongside a stone is treated as more urgent, since an obstructed, infected kidney can deteriorate quickly
• The right approach depends on stone size, location and composition — a urologist will guide this rather than there being one standard treatment

When to see a doctor

• Sudden, severe flank or back pain, especially if it comes in waves
• Blood in the urine
• Pain combined with fever and chills — this needs urgent, not routine, evaluation
• Inability to pass urine, or persistent vomiting alongside pain
• A known history of kidney stones with new or recurring symptoms

Prevention

• Drinking enough water through the day — the single biggest, most evidence-backed lever, directly relevant given how many stone patients in the Pakistani study had low water intake
• Moderating sodium intake
• Being mindful of tea intake, per the documented association above
• Discussing diet specifics with a doctor if you've had calcium oxalate stones before, since oxalate-rich foods (like certain leafy greens and nuts) may need moderating in some cases — this is individual, not universal, advice
• Follow-up imaging or metabolic testing for people with recurrent stones, to identify a specific underlying cause

Frequently asked questions

How much water actually helps prevent kidney stones?

Enough to keep urine consistently pale rather than concentrated — a doctor can advise a specific target based on climate, activity level and stone history, but "insufficient water intake" is one of the most consistently identified risk factors in the Pakistani data above.

Do all kidney stones need surgery?

No — many smaller stones pass on their own with fluids and pain management. Larger or stuck stones are more likely to need an active procedure, which a urologist determines based on imaging.

Will I definitely get another stone if I've had one before?

Not definitely, but prior stones do raise the risk of recurrence, which is why doctors often recommend follow-up and, in some cases, testing to identify what's driving stone formation for that individual.

Sources

• "Risk Factors of Kidney Stones in Khyber Pakhtunkhwa, Pakistan: A Descriptive Cross-Sectional Study" (PMC)
• "Epidemiology of Stone Disease in Pakistan"

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