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Monday, November 17, 2014

Kidney Stone Lifestyle Changes


1. Drink 2 L of water. Make sure you are measuring this! It is really easy to think you have increased fluid intake with only few glasses of water. I recommend to buy a 1 L bottle of water and measure your water intake. (If you have heart failure, kidney failure or liver disease, discuss this with your doctor first as you can easily accumulate fluid). Drinking water helps you with digestion and prevents constipation. In addition, drinking water helps excreting toxins through your kidney. Try to form a habit of drinking 2 L water per day. This habit will encourage you to live healthy and actually helps with weight loss. Leave the bottle of water at your work and on your table. This way, by seeing the bottle on your table, you slowly form this habit. This is an excellent way of forming healthy habits and avoid kidney stones.


2. The most common cause of kidney stone is calcium oxalate. Even if you have other kind of kidney stones, calcium oxalate usually complicates the picture. As such, it is highly important to avoid the diet that contains the oxalate! Cola beverages, coffee, and tea should be limited to two cups a day because these fluids contain oxalate. Remember, I said avoid oxalate and not the calcium! One of the common mistakes that I hear from my patients and occasionally from physicians is to decrease calcium intake as well. This is a mistake. You should continue to have normal calcium intake. The normal calcium intake in gut will bind to oxalate and prevents it from absorption from the intestine.



3. Drinking lemonade made from fresh lemons or lemon juice may help reduce the risk of kidney stone formation. Lemon juice increases the level of citrate in the urine which in turn prevents the formation of kidney stones. Citrate will increase the solubility of the stones in your urine. It helps with preventing new kidney stone formation AND shrinking the previous kidney stones. Remember this is part of life style modification. Depending to the size and kind of your kidney stone, you may need procedures or medications. Do not forget to follow up with your physician closely. Discuss this different life style modifications with your doctor. As a nephrologist and a kidney doctor, I love it when my patients come to clinic prepared to ask questions about their health. This tells me they are proactive.

4. Decrease salt intake to 2 gram per day. (A tablespoon of salt contains 2,325 mg of salt.) What does salt have to do with kidney stones? The higher salt intake, the more kidney has to excrete the salt. In this process, kidney will also excrete other electrolytes that will make you prone to forming kidney stones. Limiting salt intake has 2 benefits. First, limiting salt intake is important with controlling hypertension. Secondly, by limiting salt intake, you prevent new kidney stone formation or worsening of existing kidney stone. 

5. Eat a healthful amount of calcium. Many people think that if they have kidney stone, they need to decrease their calcium intake. On the contrary, you need healthful amount of calcium. Please read # 2 point above. I explained this in detail. But again, if you have kidney stones, you should not limit calcium intake. Normal calcium intake is highly important. 

6. Moderating consumption of animal protein such as: red meat, poultry, eggs, and seafood. Animal proteins increased uric acid levels in your body. High levels of uric acid will increase your chance of gout and uric acid kidney stones. In addition, a high-protein diet reduces levels of citrate, the chemical in urine that helps prevent stones from forming. Now I don't say do not eat meat. The key is moderation. Limit your daily meat intake to a quantity that is no bigger than a pack of playing cards. This is also a heart-healthy portion.

7. Decrease consumption of oxalate-rich foods. The highest amounts of oxalate are found in dark-green leafy vegetables such as kale, beet greens, okra, spinach, and swiss chard. Other plants that are rich in oxalate include instant coffee, rhubarb, starfruit, soy nuts, tofu, soy yogurt, soy milk, beets, and sweet potatoes. Limiting consumption of these foods may help prevent calcium oxalate stones from forming. 

8. Discuss the over the counter medications that you are using with your doctor. Over the counter medications do not need FDA approval and some of them contain substances that can damage your kidney or worsen your kidney disease.


What kind of kidney stone do you have? Were you ever hospitalized? Do you know if you have any kidney damage from the stone?

Resources:
http://health.usnews.com/health-conditions/urology/kidney-stones/prevention
http://www.health.harvard.edu/blog/5-steps-for-preventing-kidney-stones-201310046721
http://kidney.niddk.nih.gov/KUDiseases/pubs/kidneystonediet/

Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328