The prevention of urinary stones is divided into five types: prevention of stones containing}; prevention of uric acid stones; prevention of infected stones; prevention of cystine stones and prevention of other rare stones, whatever the type of preventive measures, not only need to be clinically effective, but also require it to be simple and easy to implement without side effects, otherwise, it will be difficult for patients to accept.
Prevention of stones containing urinary tract stones
Preventive measures for calcium-containing stones should start with lifestyle changes and dietary modification. Maintaining an appropriate body mass index, appropriate physical activity, maintaining a nutritional balance and increasing the intake of fruits rich in berry acids are important ways to prevent calcium-containing stones. Only when changing lifestyle habits and adjusting dietary structure are ineffective, medication should be considered. Specific measures are as follows.
①Increase the intake of fluids
Increasing fluid intake increases urine output, thereby reducing the supersaturation of urinary stone components and preventing stone recurrence. The recommended daily fluid intake is 2000ml to 2500ml or more. Patients are advised to measure the specific gravity of urine by themselves at home so that the specific gravity of urine is below 1.010 is appropriate in order to maintain a reliable dilution of urine.
②Diet regulation
Maintain a comprehensive balance of dietary nutrition, with emphasis on avoiding excessive intake of one of the nutrients. A low dietary calcium level of 800 mg/day can cause a negative calcium balance in the body. A low calcium diet, although it reduces urinary calcium excretion, can lead to osteoporosis and increased urinary oxalic acid excretion. Drinking water with normal calcium levels and limiting protein and sodium intake has a better effect on preventing stone recurrence than a traditional low-calcium diet. A normal range or moderately high calcium diet has clinical therapeutic value in preventing the recurrence of urinary calcium-containing stones. However, calcium supplementation outside of the diet is detrimental to stone prevention because an uncontrolled high calcium diet can increase urinary supersaturation levels. Physicians recommend a diet rich in dairy products (milk, cheese, yogurt, etc.), tofu and small fish. The daily intake of calcium for adults is 800mg.
Limit the consumption of oxalic acid in the diet.
Although only 10% to 15% of urinary oxalic acid comes from the diet, the excretion of oxalic acid in the urine increases significantly when large amounts of oxalic acid-rich foods are consumed. Patients with calcium oxalate stones, especially those with hyperoxaluria, should avoid foods rich in oxalic acid such as kale, apricot blossoms, peanuts, beets, parsley, spinach, rhubarb, black tea and cocoa powder. Among them, spinach has the highest content of oxalic acid. Patients with calcium oxalate stones should pay more attention to avoid eating spinach.
Limit sodium intake.
A high-sodium diet increases urinary calcium excretion, and sodium intake should be less than 2 grams per day.
Limit excessive intake of high protein.
Because a low-carbohydrate and high-animal protein diet is associated with the formation of calcium-containing stones. Animal protein intake should be limited to 150 grams per day.
Weight loss.
Studies have shown that excess weight is an important factor in the formation of urinary stones.
Increase the intake of fruits and vegetables.
This is because the intake of fruits and vegetables in the diet dilutes the stone formation risk factors in the urine, but does not affect the concentration of urinary potassium and urinary citrate.
Increasing coarse grains and fiber diet.
Because rice bran decreases urinary calcium excretion and reduces the recurrence of urinary stones.
Decrease vitamin C intake.
Because vitamin C is capable of producing oxalic acid after natural conversion.
Limit the intake of high purine diet.
Because high purine diet contains high uric acid, foods rich in high purine include: offal of animals (liver and kidney), poultry skin, herring with skin, sardines, anchovies, etc.
Herbal prevention.
Herbs recognized to have some preventive effect on calcium-containing stones include zedoary, fatty sea, moneywort, cornus, plantain heart, etc.