Kidney stones and obesity

1. Running head: KIDNEY STONES IN OBESE PATIENTS 1
Kidney Stones in Obese Patients
Paul Johnson
Walden University

2. KIDNEY STONES IN OBESE PATIENTS 2
Introduction
Opening Statement
The Prevalence of Kidney Stones in obese patients has continually posed a significant
challenge for patients, healthcare practitioners and to a larger extent the healthcare facilities.
Obese refers to a condition whereby an individual has the body weight that is higher when
compared to the normal weight that the individual must have for a given height (Chou et al.,
2011). Actually, the index of weight in relation to height that is commonly applied when
determining whether a person is obese or not is referred to as the Body Mass Index (BMI). On
the other hand, Kidney stones refer to rigid stone-like lumps which are formed when an
individual has a decrease in the volume of urine or when there is an excess formation of stone
substances in the urine (Chou et al., 2011).
From the medical point of view, the disease is also referred to as Nephrolithiasis.
Research has proven that statistically, out of 20 people one of them is suffering from kidney
stones at some point in their lives. As a matter of fact, epidemiological research has proved that
there is a close relation between obese people and kidney stones. The aim of this paper is to
develop a quantitative research plan on the prevalence of kidney stones in obese patients (Chou
et al., 2011).
Background of the study
People with a body mass index that is greater than 30 kg/m2 have been found to be
highly susceptible to kidney stones. According to Meschi ,Nouvenne and Borghi (2011), In
European countries, it is estimated that 10-27 percent of men and approximately 15 percent of
women who are overweight are suffering from kidney stones. Similar research has discovered

3. KIDNEY STONES IN OBESE PATIENTS 3
that at least 5 percent of the American adult population are morbidly obese that is they have a
Body Mass Index (BMI) that is either greater than or equal to 40 kg/m2. Additionally, most of
these people have been found to be suffering from kidney stones. All over the world, it is
estimated that at least 300 million people have been confirmed to be suffering from obesity
(Meschi ,Nouvenne & Borghi ,2011).
Apparently, epidemiological research has indicated that having a greater Body Mass
Index (BMI) than the normal, overweight and larger circumference of the waist are associated
independently with the formation of kidney stones. Okhunov et al (2013) in their research
pinpoints that close to 6000 kidney stone formers who had a body weight that was greater than
120 kilograms had significantly recorded excretion of urine that contained high levels of
calcium, oxalate and uric acid (UA).
All these were highly established symptoms for nephrolithiasis also known as kidney
stones. Moreover, medical practitioners who are specialized in diagnosis of kidney related
complications have established that the urinary pH is inversely proportional to the related Body
Mass Index (BMI). This indicates that the more obese a person is, the lower the pH level of his
or her Urine (Okhunov et al., 2013).
In the United States of America, a similar finding was established after urinary pH was
plotted against the body weight in almost 5000 people who had recovered from kidney stones. It
has been determined that because of the supersaturation of urine of Uric Acid that is present in
urine increases progressively with a decrease in the pH level (Okhunov et al., 2013).

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As a matter of fact, the prevalence of kidney stones among obese people not only in the
United States and Europe but all over the world are primarily caused by an increase in Uric Acid
Nephrolithiasis among the obese people (Okhunov et al., 2013).
Problem Statement
Currently, there are have been increased number of cases relating to obese people who
have been found to be suffering from kidney stones. Even though several research projects have
been carried out with an aim of determining the cause of the problem, many of the findings has
been confined only to a few people with most people becoming victims of this condition without
having the knowledge of how to avoid or prevent themselves from this condition. At an earlier
stage, obesity is a condition that can be avoided or controlled from occurring but surprisingly,
many people become obese at some stage of their lives.
Purpose of the Study
The study aims at developing a qualitative research plan that will establish the prevalence
of kidney stones in obese patients, the major causes, and current statistics and how both
conditions can be controlled or prevented. Moreover, the study focuses on the application of
Evidence Based Practice (EBP) in coming up with a theoretical approach that will help this
information to be dispensed to a relatively high number of individuals so as to equip them with
knowledge and understanding of the relationship between obesity and kidney stones.
Research Question(s) and hypotheses and variables
This study will seek answers to the following questions
1. How does weight impact on the likelihood of developing kidney stones?

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2. Which are the biggest barriers towards prevention of obesity and hence kidney stones?
3. How effective are the strategies currently in place to fight obesity crisis?
4. Which are the best practices that can be put in place in combatting obesity?
Hypothesis
Extrapolating from the current epidemiological data the following can be hypothesized in
relation to this research topic
1. Obesity increases the risk of developing kidney stones.
2. Lack of self-efficacy skills and modern lifestyles are the root causes of obesity and
consequently kidney stones.
3. Educating the general public on lifestyle and dietary modifications can help in reducing
obesity and kidney stones prevalence.
Variables
Independent variables: weight, social status, lifestyle attributes and self-efficacy skills.
Dependent variables: risk of developing obesity and kidney stones.
Theoretical framework
Ecological system theory- Urie Bronfenbrenner

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The theory states that health and wellbeing of an individual or community are shaped by
interactions with immediate components of ecology. Believably, the roots of obesity, as well as
kidney stones, can be attributed to various human ecological factors such as culture, lifestyle,
and diets. As such, this theory is pretty relevant in guiding this study and satisfying the above-
mentioned research questions (Costello et al., 2012).

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References
Chou, Y. H., Su, C. M., Li, C. C., Liu, C. C., Liu, M. E., Wu, W. J., & Juan, Y. S. (2011).
Difference in urinary stone components between obese and non-obese
patients. Urological research, 39(4), 283-287.
Costello, E. K., Stagaman, K., Dethlefsen, L., Bohannan, B. J., & Relman, D. A. (2012). The
application of ecological theory toward an understanding of the human
microbiome. Science, 336(6086), 1255-1262.
Meschi, T., Nouvenne, A., & Borghi, L. (2011). Lifestyle recommendations to reduce the risk of
kidney stones. Urologic Clinics of North America, 38(3), 313-320.
Okhunov, Z., Friedlander, J. I., George, A. K., Duty, B. D., Moreira, D. M., Srinivasan, A.
K., ... & Okeke, Z. (2013). STONE nephrolithometry: novel surgical classification system
for kidney calculi. Urology, 81(6), 1154-1160.