Friday, May 18, 2012

Stop Kidney Stones

Stop Kidney Stones

You can take many steps to stop kidney stones?

If you know of someone who has had a kidney stone, that's no surprise.
Each year almost half a million people visit emergency rooms because of kidney stones.
What is surprising is how few people do anything to stop kidney stones once they have had one.

There are simple steps to stop kidney stones or reduce kidney stones besides just drinking more water. 

Drinking a minimum of 2 quarts of fluid intake daily is advised. This can be tea, coffee or other beverages like water.

Not all kidney stones are the same.
But most kidney stones are composed of calcium oxalate.
Recently, this type of kidney stone has been shown to be more frequent after surgery for obesity. That fact is often overlooked by bariatric surgeons.

How does a person who has had calcium oxalate stones know what to do to stop kidney stones? This is where analysis of 24 hour urine collections provides crucial information. 
I discussed this in a previous post.

Dietary changes and medication both can be very helpful to stop kidney stones.

Kidney stone prevention is often not addressed by urologists who treat stones.
Prevention is always better than waiting for the next stone to appear and cause more pain and suffering.

Although many endocrinologists are not interested or skilled in kidney stone prevention, in our practice we have knowledge and an interest in kidney stone prevention. 
After all, stones, like osteoporosis, are related to mineral metabolism.
And endocrinologists are specialists in hormones and metabolism.

When we try to help our patients stop kidney stones, we always start with dietary changes and encourage our patients to continue those dietary changes over time.

And what is one dietary change you do not want to make if you have had calcium oxalate stones?
Cutting down on your dairy intake to reduce your calcium intake.
It turns out, that taking in less calcium from the diet may actually increase your chances of more stones.
One reason for this is that with less calcium intake you tend to absorb more oxalate.
A recent study showed that supplementing with vitamin D in stone formers with low vitamin D levels appears to be safe.

Reducing your intake of sodium and oxalate are useful measures to help stop kidney stones. But what foods are high in oxalate? This can be confusing to many.

Nuts and spinach are high in oxalate. Lists of oxalate content of foods are now available from a variety of sources

Rarely, some people have a very high urinary excretion of oxalate and are more likely to get not just calcium oxalate stones but also kidney failure. This disease called primary hyperoxaluria can be missed if the doctor is not aware of it. 
In normal people, urinary oxalate should be below 40 milligrams in 24 hours. 
In those with primary hyperoxaluria urinary oxalate is usually above 100 millgrams in 24 hours.

A recent short term study suggests that fish oil supplements may reduce urinary oxalate. These findings remain preliminary.

In the common cases of calcium oxalate stones, dietary measures are often not enough. Medication is usually necessary to stop kidney stones.
Fortunately, safe, simple, low cost medications are often available.

In our practice, we tailor both diet and medication to the individual.
Our goal is reduce the suffering and expense caused by kidney stones. 

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