Friday, February 14, 2020

How to Avoid and Fight Your Risk of Developing Kidney Stones

Marawan M. El Tayeb, MD
Endourologist
Clinical Assistant Professor, Texas A&M University College of Medicine 
Member, TMA Leadership College

Kidney stones hurt, which is a valid reason why people try – and should – avoid getting them if they can. Kidney stones are crystals made of various minerals that form and grow in your urine. Passing them can lead to severe pain, and obstruction can lead to damage to the urinary tract. Unfortunately, one in every 10 people in the United States will form a stone in their lifetime. Many people who have experienced kidney stones often describe it as worse than giving birth. People get kidney stones from ingesting too many crystal-forming substances, or not drinking enough fluids to dilute the urine and prevent crystals from forming.

If you think you have a stone, it is very important to visit a urologist as soon as possible. Stone symptoms can be very intense in the form of sudden severe back pain, vomiting, nausea, pain during urination, and abnormally-colored urine (pink, red, or brown). If you start developing a fever, you need to visit the emergency room as soon as possible. If kidney stones are treated right away, they are unlikely to cause permanent damage.

People who develop kidney stones can experience severe back
pain and pain during urination, among many other symptoms.
The gold standard of diagnosing a stone is with a computerized tomography (CT) scan, which is a series of x-ray images taken from different angles around your body.  A urine analysis may also be conducted to assess if there is an infection. If you have no infection, the CT scan should determine whether the stone will pass on its own or will require intervention. If the stone is small enough, your doctor may advise you to stay hydrated to help it move. However, if it’s larger, it could block your urinary tract – causing even more pain and requiring further treatment.

Men are more likely to develop kidney stones than women, with the first occurrence often happening after age 30. Someone who has had a stone – or has a family history of kidney stones – might be more susceptible to forming one again.

Fortunately, preventing kidney stones isn’t difficult. Here are the five most important things you can do to decrease your risk of forming a stone:
  1. Drink plenty of fluids - Water is the best, but any fluid will help. Try to avoid black iced tea in general as it has a considerable about of oxalate (a stone-forming chemical the body produces or gets from food) which can increase your risk of stone formation. Drink more than two liters (half-gallon) per day. This amounts to drinking about eight ounces of water every hour, consistently throughout the day. You can squeeze some lemon or lime into your water to make it more palatable.
  2. Eat a low-salt/sodium diet - Salt consists of sodium chloride, and too much of it can lead to kidney stone formation, so try to limit your sodium intake to less than two grams (2000 milligrams) per day. Processed food, in general, has a large amount of sodium, so make a habit of looking at the labels of the food that you are consuming and avoid using the saltshaker.
  3. Limit your animal protein intake to less than 12 ounces a day - Uric acid is a by-product of animal protein such as pork, beef, fish, and poultry. If you consume foods that produce high uric acid, this can make you susceptible to uric acid stones or calcium stones, as the uric acid may act as a place for a stone to form.
  4. Consume adequate calcium - People susceptible to kidney stones might assume that they should avoid calcium since it’s one of the chemicals that forms kidney stones, but calcium is essential for our bone health. Ironically, consuming enough calcium can help prevent kidney stones because it binds to oxalate in our digestive tract. The recommended daily allowance of calcium is 1200 mg per day, which is about two to three servings of dairy products, including milk, cheese, and yogurt.
     
  5. Limit foods high in oxalate - If you tend to get calcium oxalate stones, try to avoid high oxalate-containing food and drinks like iced tea, peanuts, peanut butter, chocolate, and spinach. Soy also contains a large amount of oxalate.
By maintaining a balanced diet and drinking enough fluids, you can keep your kidneys in good health, reduce your chance of developing kidney stones, and avoid a painful episode.

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