As summer temperatures remain high, RAK Hospital highlights the hidden kidney-stone risks of inadequate hydration, outdoor work, travel and high-protein diets
Dubai, UAE: Dehydration in the UAE summer is usually associated with people working outdoors or spending time in the heat. But residents spending long hours indoors in air-conditioning could also be at risk of inadequate hydration – simply because they may not feel thirsty enough to drink, warns a UAE urologist.
While air-conditioning provides welcome relief from extreme temperatures, spending much of the day indoors can make people less conscious of fluid loss and less likely to drink regularly. For those who then spend time outdoors, exercise, travel frequently or have a previous history of kidney stones, the combination can become particularly problematic.
“People often associate dehydration with sweating in the heat, but in the UAE many people spend most of their day in air-conditioning and simply don’t feel thirsty,” said Dr Vinodh Kumar Manoharan, Consultant Urologist at RAK Hospital. “They may then go outside, exercise or travel without adequately replacing the fluids they have lost. Hydration needs to be a conscious habit, particularly during the summer.”
Adequate fluid intake is one of the most important measures for preventing most kidney stones because it helps dilute urine and reduce the concentration of minerals that can form stones. Fluid requirements increase with heat, physical activity and sweating.
What makes kidney stones particularly easy to overlook is that a stone can sit inside the kidney without causing significant symptoms. Pain often becomes more pronounced when a stone moves into the ureter and begins obstructing the flow of urine.
According to Dr Vinodh, patients should not assume that kidney stones always announce themselves with severe, unmistakable pain.“A stone inside the kidney may not cause the kind of severe pain people associate with kidney stones,” he explained. “Some patients may experience a dull, aching discomfort in the side or flank, or burning during urination. These symptoms can easily be overlooked or attributed to something else.”
Other symptoms can include blood in the urine, pain during urination, nausea and vomiting, while fever or chills alongside suspected stone symptoms can signal an infection and requires prompt medical assessment.
Summer doesn’t create a kidney stone overnight
Kidney stones generally develop over time rather than appearing within a few days. However, summer conditions can expose an existing problem or contribute to the low urine volume and concentrated urine that favour stone formation.
This is particularly relevant in the UAE, where people can move between extreme outdoor heat and heavily air-conditioned indoor environments several times a day.
“Every summer we see more stone-related problems. The stone itself may have been developing for some time, but when people become dehydrated and the stone starts moving, that is when symptoms can suddenly appear,” he said.
Outdoor workers may need significantly more fluids
The risk is especially relevant for people whose work keeps them outdoors.
Construction and other outdoor workers can lose substantial amounts of fluid through sweating, meaning their requirements can be considerably higher than those of someone working in an air-conditioned office.
“For someone who is working outdoors in this heat, simply drinking the same amount as someone sitting in an air-conditioned office may not be enough,” said Dr Vinodh. “They need to replace the fluid they are losing through sweating.”
Dr Vinodh advises generally healthy adults to aim for at least around three litres of fluid a day, with people who have previously suffered from kidney stones and those exposed to significant heat or physical exertion potentially requiring more. Individual requirements should, however, be determined with a healthcare professional, particularly for people with kidney, heart or other medical conditions.
The gym and the high-protein diet: another risk to watch
Hydration is not the only consideration.
With high-protein diets becoming increasingly popular among gym-goers and fitness enthusiasts, Dr Vinodh also cautions against excessive consumption of animal protein, particularly when combined with inadequate fluid intake.
Dietary factors including high sodium intake and excessive animal protein can contribute to the risk of certain types of kidney stones, while being overweight and having certain metabolic conditions can also increase risk.
“The focus on protein has increased considerably, especially among people who are exercising regularly,” said Dr Vinodh. “Protein itself is not something people need to fear, but excessive animal protein combined with poor hydration and an unhealthy diet can increase the risk for some people.”
He recommends focusing on good hydration, a balanced diet with plenty of vegetables, moderation in salt and avoiding excessive animal protein, while recognising that dietary recommendations should ideally be tailored according to the type of stone and individual risk factors.
A previous kidney stone is a warning, not a one-off event
For people who have already experienced a kidney stone, prevention becomes particularly important, as recurrence is common. Adequate fluid intake is a central component of prevention, although the precise amount depends on the individual and their stone history.
Dr Vinodh’s message to previous stone sufferers is straightforward: don’t wait for thirst to remind you to drink.
“Once you have had a stone, you are more prone to developing another one,” he said. “Hydration should become part of your daily routine, not something you remember only when you feel thirsty.”
Don’t wait for excruciating pain
For UAE residents, the most important warning may be not to wait until symptoms become unbearable.
Persistent or worsening pain in the side or back, blood in the urine, painful urination, nausea or vomiting should be medically assessed. Fever or chills in someone with suspected kidney-stone symptoms can be particularly concerning because an obstructed urinary tract with infection can require urgent treatment.
As temperatures remain high across the UAE, Dr Vinodh’s advice is simple: make hydration deliberate, replace fluids lost through sweating and don’t ignore persistent urinary or flank symptoms.