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b y j a m e s n e w e l l d i l l a r d
(9/8/2010 4:54:53 PM
EDT)
Are There Alternative Methods for Preventing Kidney Stones?
Q: I've had three kidney stone attacks in my 20s and now I'm going for a lithotripsy procedure to break up another two stones before I have my fourth attack. Lithotripsy is a non-invasive shock treatment (sounds great). Are there any alternative methods to stop stones from forming?
A: Yes, there are, but some of the best ways to prevent the formation of kidney stones are not really so alternative. They involve basic lifestyle and dietary habit changes, which maybe makes them a bit alternative. Here's the scoop.
The formation of stones in the urinary tract -- either in the kidneys or in the bladder, that is -- affects 500,000 to 750,000 Americans a year. Men are afflicted with stone formation four times as often as women, and the most common time to get the stones is in your 30s and 40s.
Treating kidney stones requires the skills of a solid nephrologist (a specialist in treating kidney disease) or internal medicine physician, and may involve the use of sound waves to break up the stones, as you mentioned. It is important to try to get all of the tiny stones out of the kidney and bladder, as any small flake can be the seed to form a new stone. Your doctors can best advise you on this.
As for preventing stones, there is nothing that is absolutely foolproof, but here are the important suggestions that many doctors make. It is absolutely critical that you get into the habit of drinking more water and fluids. Kidney stones are much more common in the hot and humid areas of the country, and people are more symptomatic during the hot summer months. We think that this is mainly due to dehydration.
People with recurrent urinary stones should try to roughly double their water intake, particularly after meals and prior to going to bed. You should have to get up during the night to hit the bathroom, and you should drink more water before you sack in again. Many of us don't drink enough water (myself included), and this is a serious risk factor for stone formation and stone recurrence. Of course, if you have significant heart trouble like congestive heart failure, you will need to talk to your doctor before you start drinking a lot of extra water.
We Americans generally eat way too much protein. One common place that this excess shows up is in our kidney stone and kidney disease rates. People on high protein diets make a lot more of a compound called oxalate, which joins with calcium in the urinary tract to form stones. Here's yet another good reason to stay off the high-protein, no-carbohydrate weight loss diets.
High protein diets also seem to directly injure the filtering tissue of the kidney itself. You should limit your protein intake to one gram of protein per kilogram of body weight per day. A kilogram is roughly two pounds, so it's not so tough to figure this out.
Other dietary measures that seem to have good science behind them for reducing kidney stone formation include eating a diet rich in vegetables, low in sugar and sodium, and rich in calcium, magnesium and potassium. This would be a good vegetable and fruit rich diet. You might want to specifically limit oxalate-containing foods, such as spinach, rhubarb, beets, nuts, chocolate, berries, wheat bran and tea. I know there's a lot of good stuff on that list, but they also have oxalate in them.
It is a mistake to limit dietary calcium, as this can actually hasten kidney stone formation. If you're going to supplement calcium, it's a good idea for your doctor to measure urinary calcium and oxalate levels after you start, to be sure you're not causing more problems than you are fixing. To do this, your doctor would have you collect your urine for 24 hours; lab tests would show if the calcium supplements were causing problems. It also seems that excessive consumption of grapefruit juice can contribute to stone formation, so keep this to a minimum. Supplementation with 50 to 100 milligrams of Vitamin B-6 (or this amount in a good B-complex), and 300 to 400 milligrams of magnesium citrate per day has also been shown to help. Drinking beer actually seems to reduce kidney stone risk in a measurable way. (For more information on this, see the American Journal of Epidemiology, July 15, 1999, Volume 150.) Obviously, some moderation on this is advised.
Doctors used to think that high doses of vitamin C could contribute to the formation of kidney and bladder stones. This is not true. Studies seemed to indicate an increase in urinary oxalate in people who were taking a lot of vitamin C. It was naturally assumed that this increased oxalate in the urine would contribute to stone formation. It turned out that vitamin C in the urine interferes with the test for oxalate. Better research has shown that vitamin C does not increase the formation of kidney stones.
As for the ever-popular herbal remedies, I don't think that the evidence is very good for this approach. Several major herbal texts do not list any recommended herbs for kidney stones, including the American Herbal Physicians Desk Reference. The German Commission E monographs of therapeutic herbs list 13 herbs that could possibly help with kidney stones. This tells me that none of the data is very solid, and probably most of this information comes from herbal traditions and folklore. Consultation with an experienced herbal practitioner would be recommended before you try any herbal remedies for kidney stones.
So drink plenty of fluids, not too much beer, watch your diet and stick close to your kidney doctor. Passing a kidney stone is one of the most painful experiences a human can go through, and getting the stones blasted is not really so pleasant; so, as always, an ounce of prevention is worth a pound of cure.
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