Prevention and dietary guidance for patients with urinary tract stones

  Urinary stones are broadly classified into calcium-containing stones and non-calcium-containing stones according to their chemical composition. Calcium-containing stones account for 80-95% of urinary stones and are mainly composed of calcium oxalate and calcium phosphate. In addition to drinking a lot of water to dilute the urine, it is also necessary to adjust the diet according to the composition of stones to reduce the content of urinary stones.  Drinking water guidance: 1. Adult male patients should drink 2500-3000 ml/day, female patients, elderly patients with normal cardiopulmonary and renal functions should drink 2000-2500 ml/day, and children should be reduced at their discretion. In summer, the amount of water can be increased to maintain the urine volume of 2000-3000 ml / day or more.  2, drinking water method: the amount of water to be distributed throughout the day, the excretion of stone components mostly in the night and early morning peak, so in addition to drinking a lot of water during the day, before bedtime, after getting up during sleep urination must also drink 300-500 ml of water. Generally, drink 300 ml of water at a time, when the activity can slightly increase the amount of water, more water can flush urinary stones, but also dilute the urine, change the PH value, such as long-term acidic urine (urine PH value of 6.6) prone to phosphate stones. Alkaline urine is also prone to the formation of magnesium ammonium phosphate stones (urinary PH > 7.2). For patients with multiple recurrence of urinary stones, in addition to daily uniform drinking water, regular concentration of large amounts of water, regular flushing of the urinary tract, to reduce the clinical type of urinary stones have some benefit, but for those with urinary tract obstruction is used with caution.  3, drinking water should be magnetized water with appropriate temperature, because magnetized water has strong calcium dissolution ability, can reduce the saturation of calcium salts, inhibit the re-formation of calcium stones.  The general principle is: pay attention to animal protein, cereals, vegetables and fiber with food. Low-sugar, low-fat, low-sodium diet is appropriate.  1, calcium oxalate stones should eat less food containing high oxalic acid, such as: radish, spinach, amaranth, celery, lettuce, bamboo shoots, potatoes and soy products; cocoa, chocolate, black tea, lime, cola, beer; vitamin C high food should not eat more such as citrus, lemon, tomatoes, strawberries; oral vitamin B6 and magnesium preparations, conducive to the prevention and treatment of atopic hyperoxalate urolithiasis.  2, calcium phosphate and magnesium ammonium phosphate stones: alkaline urine prone to the formation of magnesium ammonium phosphate stones (urine PH value > 7.2). Low calcium phosphate diet and acidic food is desirable. It is recommended to strengthen the control of infection; all dairy products, lemon juice with phosphate, cola, coffee should be reduced, oral amine chloride can make the urine acidified.  3, calcium-containing stones: an acidic diet is recommended; sugar and its products, beverages, etc. can increase urinary calcium and should be controlled in patients with stones. For absorption of high urinary calcium should limit the amount of calcium in the diet, other patients drinking foods containing high calcium such as milk generally does not affect the body’s calcium metabolism, can drink normally. In the past, it was suggested that calcium intake should be reduced and dairy products should not exceed 300 cc per day, but the new view is that calcium supplementation has little effect on stone formation.  4. Uric acid stones: Limit protein intake and consume more fresh vegetables and fruits. Use low-calorie diet for obese patients. Desirable foods: grains and cereals should be mainly fine grains; vegetables and fruits can be consumed at will; eggs and milk can be consumed appropriately. It is recommended to adopt alkaline diet, and the foods to be avoided are: pork, beef, duck, goose, animal offal, salted or fried food, mackerel, sardine, white scallop, Wu Guo fish, dried meat all kinds of broth, gravy, clam, crab, etc.; vegetables such as spinach, all kinds of beans, cauliflower, lobster and mushroom; wine, strong tea, coffee, cocoa, etc.; strong spices and condiments. It is not advisable to drink alcohol, drinking alcohol can increase the level of uric acid, alcohol is also easy to cause the concentration of urine. Patients with high blood uric acid and hyperuricemia can take allopurinol orally. Oral sodium bicarbonate can alkalize the urine. For more information, see Causes and prevention of uric acid stones.  5. Cystamine stones: low methionine diet.  6, endemic bladder stones: breastfeeding or replacing with cow’s milk for breastfed children and increasing the intake of vitamin A can basically prevent them.  The causes of urinary stones formation are complex and vary from person to person, such as increased excretion of calcium, oxalic acid and uric acid in urine can be divided into absorption, metabolic, renal and other types, and the methods to prevent recurrence of urinary stones vary greatly, and it is best to conduct in-depth examination to achieve the desired results.