How about some Medical Nutrition Therapy? KIDNEY STONES

Just one more reason to drink more water....

Kidney stones are very common and often run in families. There are different types of kidney stones which depend on the cause of the stone. A kidney stone is a solid mass made up of tiny crystals and more than one stone can be in the kidney or ureter at the same time. Kidney stones form when urine contains too much of certain substances which create crystals that become stones. They take weeks to months to form.  I thought since kidney stones are fairly common, this would make a good blog post. 

DIFFERENT TYPES OF STONES:

Calcium stones are the most common, especially those between the ages of 20-30. Calcium combines with oxalate, phosphate, or carbonate to form the stone. Oxalate can be found in foods like spinach or vitamin C supplements. Also small intestinal diseases (celiac, crohn’s, cancer, IBS, obstructions and ulcers) increase your risk of these stones.
People with cystinuria form cystine stones. This disorder runs in families from a faulty gene being passed along that interferes with cystine’s normal ability to dissolve and go back into the blood stream. So it will build up to form crystals/stones.

Struvite stones mostly affect women with urinary tract infections and the stones grow very large.

Uric acid stones are more common in men and occur with gout or chemotherapy.
Other substances that can form stones include the medications acyclovir, indinavir and triamterene.

DIET TIPS WHILE EXPERIENCING KIDNEY STONES:

The biggest risk factor for kidney stones is not drinking enough fluids and are more likely to occur if you make less than 1 liter of urine a day. The best fluid choice, of course is water!! You can also drink ginger ale, lemon-lime sodas and fruit juices. Drink enough to make at least 2 quarts of urine a day or to have light-colored urine. Limit your coffee, tea and dark cola to one to two cups a day. Caffeine may cause you to lose fluid too quickly which results in dehydration.  You might as well drink lemon water for added benefits - learn more from a recent blog post.  Some other things you can do:

• Eat less salt

• Have only 2-3 servings of calcium rich foods (milk, cheese, yogurt, oysters, tofu)

• Eat more lemons, lemonade, and oranges

• Limit protein and choose lean meats

• Follow a low-fat diet

• Do not take calcium or vitamin D supplements or antacids

• Vitamin C supplementation and fish oil could also be harmful (ask your doctor)

• Limit foods high in oxalate: fruits – rhubarb, currants, canned fruit salad, strawberries, concord grapes; vegetables – beets, leeks, summer squash, sweet potatoes, spinach, tomato soup; drinks – tea and instant coffee; other – grits, tofu, nuts, chocolate

• Avoid these if you have uric acid stones: alcohol, anchovies, sardines, oils, herring, organ meat, legumes, gravies, mushrooms, spinach, asparagus, cauliflower, consommé, baking or brewer’s yeast; other suggestions include to not eat more than 3 ounces of meat at each meal, avoid fatty foods and eat enough carbohydrates. Also quick weight loss may cause uric acid stones to form.

SYMPTOMS:

• severe pain that can start suddenly then go away suddenly and could move to groin area.

• Abnormal urine color or blood in the urine

• Chills

• Fever

• Nausea and/or vomiting

TESTING FOR KIDNEY STONES:

• Blood tests to check calcium, phosphorus, uric acid and electrolyte levels

• Kidney function tests

• Urinalysis to look for crystals and red blood cells

• Examination of the actual stone

• Stones/blockages can be seen on abdominal CT scans, MRI, x-ray, intravenous pyelogram, ultrasound, and retrograde pyelogram

TREATMENT:

• Depends on the type of stone

• Small stones can pass on their own – stone should be saved and tested to determine type of stone

• Drink 6-8 glasses of water/day to produce large amounts of urine

• Over the counter pain relievers or if it is severe, may need to stay in the hospital and receive fluids intravenously

• Medications may be prescribed to decrease stone formation or help break it down and remove the material causing the stone

• Surgery may be needed if the stone is too large to pass, the stone is growing or blocking urine flow, or the pain can’t be controlled

• Extracorporeal shock-wave lithotripsy uses waves to break up the stone

• Percutaneous nephrolithotomy is used for larger stones removed by a tube that is inserted into the kidney

• Ureteroscopy can be used for stones in the lower urinary tract

• Rarely, open surgery – nephrolithotomy may be needed if other methods do not work