Kidney Stones Prevention and Treatment
?
According to an old fairy tale, a single tiny pea?placed beneath 20 mattresses and 20 featherbeds was enough to keep the true princess awake throughout the night. In real life, a tiny pea-sized stone, lodged in one or the other of your kidneys, is enough to keep you not only awake all night but crying out in pain and gritting your teeth until you can get to a doctor for relief.
Until recently, there were only two unpleasant alternatives for a stone sufferer: waiting to let the stone slowly pass through the urinary tract or undergoing major surgery to remove it. Today, a new treatment called lithotripsy, in which kidney stones are destroyed by shock waves, has brightened the outlook for those unlucky enough to be stone formers.
Scientists really don’t know why kidney stones form. Kidney stones tend to run in families, so individuals with a close relative who has been through a stone episode should be careful. Most first-time victims are between 30 and 40 years old and are otherwise in very good health. Men are four times more likely than women to get kidney stones, the theory being that female hormones may prevent kidney stones from forming.
Despite the improvements in treating kidney stones, it’s definitely preferable to avoid having them in the first place. If you have been through a bout with a stone in the past or think that you might be a candidate for developing a stone, you should do your best to beat the odds, which say that if you get kidney stones once, you run a 10 percent risk of developing more within a year and an 80 percent chance of developing a new stone within 15 years. Here’s how to fight those odds:
Drink more than your fill. Increasing fluid intake should be the first step (and may be the only step needed) to keep free of kidney stones. One hundred ounces?that’s at least 12 eight-ounce glasses a day?is the minimum. “Any fluid qualifies, including water, juice, soda, even tea and?coffee,” says Glenn M. Preminger, M.D., associate professor of urology/internal medicine at The University of Texas Southwestern Medical Center at Dallas. The only restriction, says Preminger, is avoiding tea for persons with high urinary oxalate and avoiding too much milk because of the calcium it contains.
Check it out. Sometimes, it’s not easy to keep track of your daily water intake. That’s why measuring your urine output may be a better indication of fluid intake. “I advise my patients to make sure they are urinating 1,200 to 1,500 cubic centimeters, or 40 to 45 ounces worth,” says Michael Wechsler, M.D., assistant professor of clinical urology at Columbia?Presbyterian Medical Center in New York. Anything below 1,000 cubic centimeters a day is too little, he adds.
Keep the lid on dairy products. By far the most common kidney stones are those formed by calcium: calcium oxalate or calcium phosphate. “Some individuals who are prone to calcium-type stone formation should try to limit their calcium intake,” says Demetrius H. Bagley, M.D., professor of urology and professor of radiology at Jefferson Medical College of Thomas Jefferson University in Philadelphia. If you have been dosing up on calcium supplements in hopes of strengthening your bones, you may actually be increasing your risk of stone formation. Dairy products are the greatest dietary source of calcium. Limit butter?and cheese first; these are also high in the kind of fat that your heart will be better off without.
Don’t oversoothe your tummy. Some over-the- counter antacids are calcium based. Check the label, and if the word “calcium” appears there, select another type of stomach medication.
Eat less meat. Individuals who form uric-acid stones are usually found to eat diets high in animal?protein, which can accelerate formation of uric acid and calcium in the urine. “People who are prone to kidney stones should cut back on animal proteins,” says Wechsler.
Go easy on the oxalates. Eating large quantities of fruits and vegetables gives you lots of vitamins and minerals; however, some of these foods can also give you oxalates, which you may need to go easy on if you have a tendency toward kidney-stone formation. “In people with normal gastrointestinal function, oxalates may not be harmful, but it’s still a good idea to lay off rhubarb and spinach,” says Preminger. Other oxalate-rich foods include: chocolate, tea, cola, parsley, peanuts, and citrus fruit.
Be “A” enriched. Vitamin A is necessary for the overall healthy state of your urinary tract. Foods rich in vitamin A include sweet potatoes, pumpkin, winter squash, broccoli, and carrots. The Recommended Daily Allowance (RDA) of vitamin A for healthy adults is 5,000 international units, which should be easily met through a varied, balanced diet. Don’t rush out for vitamin A supplements; if you get too much, your body won’t excrete the excess, which can be toxic.
“B” fortified. Scientists have found that Vitamin B6 may actually lower the amount of oxalate in the blood, thereby reducing the risk of stone formation. Magnesium, too, has a negative effect on stone formation. Your doctor may suggest a daily supplement of B6 and/or magnesium or a drug that combines the two. If you take vitamin B6, don’t take more than 25 milligrams a day.
“C” less. With news of the positive powers of vitamin C appearing regularly, people may be led to think of it as a wonder vitamin. However, vitamin C in very high doses?more than 3,000 milligrams daily?can be a potential problem for those with kidney-stone tendencies. That’s because vitamin C is converted to oxalate in the body. “People prone to kidney stones should stay away from vitamin C supplements, although foods containing vitamin C aren’t a problem,” says Wechsler.
Move it. One of the many benefits of regular exercise is that it facilitates the passage of calcium out of the bloodstream and into the bones. The result: stronger bones and less risk of stone formation. According to Preminger, it’s “one more excellent reason to exercise regularly.”
Don’t shake it. There’s also a high correlation between kidney stones and salt intake. “Two grams a day is the reasonable intake,” says Bagley.