Prevention of Kidney Stones
New York Urology Specialists are focused on keeping you stone free. The following advice from our experienced urologist Dr. Alex Shteynshlyuger will help you achieve life without kidney stones. Managing diet, fluid intake, medication use, and nutrient intake can help prevent the formation and recurrence of kidney stones.
“In general more fluid is better than less fluid. “
- Staying hydrated via sufficient fluid intake is key. Drink at least eight 8 ounce glasses of water or lemonade a day. The amount of fluid you drink needs to increase in hot weather, for people spending significant time outdoors in the summer or those who perspire a lot.
- For men and women who have history of kidney stones at least 3 liters (close to a gallon) of fluid intake a day is recommended. The goal is to produce at least 2 liters (> 1/2 gallons) of urine a day to keep urine dilute and to prevent stone formation.
- There is no significant medical reason to avoid various drinks in terms of kidney stones. In general more fluid is better than less fluid. There are reasons to avoid sugary drinks and colas, such as fruit drinks because they add calories and can contribute to obesity, diabetes and other medical problems that increase risk for kidney stones.
- For most kidney stones, urine should be less acidic. Lemonade and orange juice are good sources of citrate.
Treat Kidney Stones without Delay
Smaller stones can be treated easier using lithotripsy (ESWL) or holmium laser. Early treatment can also prevent other stones from forming as stones promote formation of more stones.
Ideally, you should be stone-free to prevent formation of more stones.
Medical Management is Important
Many people have predisposing factors for kidney stones. It is important to identify and treat these. Typically, a 24-hour urine collection along with metabolic evaluation is recommended for men and women who have history of two or more episodes of kidney stones and for all children with kidney stones.
Obese persons are more likely to get kidney stones. A healthy weight is maintained through diet and exercise. Losing weight with laxatives or extreme dieting can increase the risk of kidney stones. Patients who had gastric bypass surgery are at higher risk for kidney stones.
Eating Right for Your Stone Type
In general we do not advise outright diet changes as most men and women with kidney stones do not have dietary risk factors that can be easily modified. The most important dietary advice is high fluid intake.
Decreasing the amount of salt in the diet is also easy to accomplish and should probably be recommended to everyone in the US. Weight loss for those who are overweight benefits your health in many ways including lowering your chances of kidney stone recurrence.
In terms of specific dietary changes, we prefer to address these on case-by-case basis as drastic dietary changes are difficult to implement. Recommending these changes to everyone does not make sense in particular if many do not have risk factors that are diet caused and will not benefit from diet modification. In general a healthy diet recommended for heart disease is recommended.
We recommend a specific kidney stone diet after a full evaluation to those men and women who would benefit from them. Preventing recurrence is largely specific to the type of stone. For prevention of calcium oxalate, cystine, and uric acid stones, urine should be alkalinized by eating a diet high in fruits and vegetables, taking supplemental or prescription citrate. Also, weight loss in obese patients can prevent kidney stones.
Kidney stones present an important and challenging clinical problem. Medical therapy for kidney stones, when used judiciously in conjunction with dietary measures, can help in preventing recurrence and in expulsion of small size (<10 mm) stones. Awareness of the advantages and limitations of different modalities of medical therapy is necessary in order to provide the correct treatment to patients presenting with this common complaint.
Dr. Alex Shteynshlyuger is a board-certified urologist. He treats men and women with kidney and ureteral stones. He is among the most experienced specialists when it comes to treatment of large kidney stones and ureteral stones. Dr. Shteynshlyuger has performed hundreds of ureteroscopy and lithotripsy procedures for large kidney stones, in addition to ESWL procedures. He is among a select number of urologists in the United States who performs PCNL for large kidney stones.