At least half of all gout patients will have a kidney stone (ureterolithiasis) problem if their hyperuricemia goes untreated for years. Some people say the weakened kidneys’ inability to filter out excess uric acid causes the elevation of uric acid in the blood. If so, then what causes one’s kidneys to fail to do their job? Before I can answer that question, I must help you recall what is taught about the kidneys in high school biology classes.
Know Your Kidneys
As one of the vital organs of the human body, the kidneys perform several essential tasks, including the excretion of waste products, the maintenance of homeostatic balance in the body, and the release of important hormones. To achieve this, human kidneys have a highly developed, superbly refined anatomy and physiology.
The kidneys are bean-shaped organs, each about the size of a fist (10 centimeters long and 6.5 centimeters wide). Each is identical in structure and function. They are located near the middle of the back, just below the rib cage, one on each side of the spine. The kidneys are sophisticated reprocessing machines. In healthy adults, about 180 liters of fluid is filtered into the kidney tubules each day. Nearly all this fluid and the electrolytes contained in it are reabsorbed by the kidney; only about 2% is excreted as urine. The wastes and extra water become urine, which flows to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. (See figure 5.1.)
Wastes in the blood come from the normal breakdown of active tissues, such as muscles, and from food. The body uses food for energy and self-repairs. After the body has taken what it needs from food, wastes are sent to the blood. If the kidneys do not remove them, these wastes build up in the blood and damage the body. Each kidney comprises an outer cortex and an inner medulla. The kidney is supplied with oxygenated blood via the renal artery and drained of deoxygenated blood by the renal vein. In addition, urine produced by the kidney as part of its excretory function drains out via narrow tubules and the ureter to the bladder. (See Figure 5.2.)
The actual removal of wastes occurs in tiny units inside the kidneys called nephrons. Each kidney has about a million nephrons. In the nephron, a glomerulus—which is a tiny blood vessel, or capillary— intertwines with a tiny urine-collecting tube called a tubule. The glomerulus acts as a filtering unit, or sieve, and keeps normal proteins and cells in the bloodstream, allowing extra fluid and wastes to pass through. A complicated chemical exchange takes place as waste materials and water leave the blood and enter the urinary system.
At first, the tubules receive a combination of waste materials and chemicals the body can still use. The kidneys measure out sodium, phosphorus, and potassium and release them back to the blood to return to the body. In this way, the kidneys regulate the body’s level of these and other substances. The right balance is necessary for life.
It estimated that the total filtration capacity of both kidneys within one minute for a healthy person is between 100 ~ 150 milliliters (125 milliliters). This value is known as the Glomerular Filtration rate. As long as there is blood flowing through the glomerulus, the filtration process will happens automatically.
Up to 60% of the human body is water. The brain is comprised of 70% water, and the lungs are nearly 90% water. Lean muscle tissue contains about 75% water by weight, as is the brain; body fat contains 10% water, and bone has 22% water. About 85% of our blood is water, which helps digest our food, transport waste, and control body temperature. Each day humans must replace at least two and half liters of water, some through drinking and the rest taken by the body from the foods eaten.
Within 24 hours, there will be 144 ~ 216 liters (average, 180 liters) being filtered through those 2 millions tiny glomeruli in the kidneys (Figure 5.5). Imagine if there were no reabsorption mechanism, we would have to either consume 180 liters of water every day or become dried up within hours!
Luckily, 99% of the water is reabsorbed back to the blood as soon as it comes out from the glomerulus. The other 1% of water is used to flush out wastes and toxics from the kidney.
What Will Happen if a Person Does Not Drink Enough Water?
About 85% of our blood is made of water. When there is not enough water in the blood, our body sends out signals to the kidney to reabsorb more water back into the blood to compensate for this water deficit. This results in much lower water content in the urine produced. In another words, urine becomes very thick or saturated.
If you are hyperuricemic, try collecting your urine in a transparent plastic cup and leave it somewhere safe overnight. Look at it the next day, paying close attention to the bottom of the cup. You will notice some fine tiny sediment formed there. If you do not pass urine as often and as much as you should, there will be not enough water to flush away the toxic wastes in the kidney tubules. Accumulation of this uric acid (dried) is how crystallization of kidney stones begins.
About 90% of kidney stone patients do not have the habit of drinking water frequently. (I mean plain drinking water or mineral water). The ironic part is that they often do not realize that their body is crying for more water. They always claim that they drink plenty of water during the day. Well, the water is in fact liquids: soft drinks, beer, tea, coffee, milk, juices, or any other drinkable liquids.
This is a big “no-no.” Those drinks will only make you thirst more for water. Go grab a bottle of beer now and finish it, and I guarantee that you will feel thirstier within 30 minutes. All right, you might say, alcohol is commonly known to be dehydrating. Then trying drinking a bottle of cola or any sweet syrup juice, and you will get the same result.
All these modern drinks are full of excess ingredients, especially sugar or artificial sweeteners and colorings. Consuming these drinks makes your blood become thicker or hypertonic, which will absorb water out from the interstitial fluids or body cells. Gradually, your body cells become dryer and dryer.
Under such condition, the kidneys have to reduce the excretion of water into the urine to keep enough water to maintain the blood concentration. This results in thick and highly saturated urine that flows slowly through the ureter. Hypersaturation is the perfect condition for crystallization to happen. If it continues for a certain period of time, the tiny crystal grows bigger until it blocks the passage of the urine. This blockage causes the pressure to build up in the kidney, so now the kidney is forced to squeeze the urethral muscle to force the urine trough the small passage. This is when the patient starts to feel some pain.
If you feel some odd pain at the lower part of you back, slightly above your hips, go in for a blood test to check your uric acid level.
If the result of a blood test to check your uric acid level is way above healthy range, chances are high that there are already some crystal stones (maybe still too tiny to be seen through an X-ray) in your kidneys. Take action before it is too late because you will not like the way the doctors break those stones. Try to imagine someone sliding a long fine tubing through your private part, and then twisting and poking with it to break down or remove those stubborn stones. Don’t you think cultivating a good water drinking habit is a much better option?
Blood In The Urine
Throughout the years, I’ve came across many cases where the gout patients noticed traces of blood in their urine after drinking Calkaline water for a few days, some even told me that they feel a slight burning sensation when they urinate.
Healing crisis such as this is usually experienced by people who are having kidney stones, with or without them knowing about it. The shape of most of the kidney stones is spiky like a durian. A kidney stone can grow at a certain part of the kidney over time without causing any pain. It’s when the size of the kidney stone grows too big until it blocks the passage of the urine, then the pain will be felt by the patient. This kind of pain is due the pressure build up of the urine stuck in the tubule.
The kidney stones of gout patients are mostly urate crystals that are of acidic nature and can be dissolve by the alkaline minerals of Calkaline. As the size of the acidic kidney stones shrinks, the stone begins to move along the renal tubule. As the spiky stone travel, it scratches on the epithelium of the tubule and that’s what causes the occurrence of traces of blood in the urine and the tingling burning sensation when the patient urinates.
Don’t panic! It’s a good sign that the kidney stones are one its way out. Keep on drinking Calkaline water as your body needs more of it to dissolve and flush the uric acid out from your body. You might experience frequent urination due to increased intake of water.
Increased urination plays a positive role in making sure there is no bacteria stays on the micro wound on the epithelium of the renal tubule and cause urinary tract infection. Thus, hang on and keep on drinking Calkaline water. The traces of blood in the urine will gradually disappear after a few days.