How to prevent urinary stones in summer

  Urinary stones (urinary stones) are a common disease, with a prevalence rate of 1% to 5% in the general population, but the trend has increased in recent years. The recurrence rate of urinary stones is also very high, more than 50%, which means that if a person has urinary stones, even if they are cured, they will most likely recur in the future. The main components of urinary stones are calcium oxalate, calcium phosphate, uric acid, magnesium ammonium phosphate, cystic chloride and other crystals. These stone components are also found in the normal body, but generally do not form stones. The formation of urinary stones is not only related to systemic factors such as metabolic abnormalities like hypercalciuria and hyperuricuria and local factors such as urinary tract infection and obstruction, but also closely related to climate and diet. In China, summer is the high incidence season of urinary stones, and it is also an important time for prevention and treatment of urinary stones.  Epidemiological surveys show that the incidence of urinary stones has obvious geographical and seasonal distribution characteristics, with a high incidence in tropical and subtropical areas, such as the south of China is more common than the north, and the incidence of stones in summer is significantly higher than other seasons. This is because of the high temperature in summer, the body loses much more water through breathing and sweating, which results in concentrated urine and higher concentration of lithogenic substances in the urine, eventually forming stones. Another reason for the high incidence of urinary stones in summer is the increase in the synthesis of active vitamin D3 (1,25 dihydroxyvitamin D3) due to the long sunshine hours, which promotes the absorption of calcium in the intestine and the excretion of calcium in the urine.  Since concentrated urine is the main reason for the high incidence of urinary stones in summer, drinking large amounts of water is the easiest way to prevent and control urinary stones, and this method is effective for stones of all compositions. Why does drinking a lot of water help prevent and control urinary stones? Drinking a lot of water can shorten the retention time of free crystal particles in the urinary tract, promote the discharge of microscopic stones, reduce the urinary saturation of lithogenic substances to inhibit stone formation, and reduce the chance of urinary tract infection. Drinking large amounts of water may seem simple, but there are also rules. Clinically, the standard for drinking water is not based on how much water is drunk, but on the amount of urine. It is now accepted that the standard for daily water intake is to keep the daily urine volume above 2000 ml, to the point where clear, colorless or slightly yellow urine is appropriate. This requires about 2500~4000 ml of water per day. If engaged in high-temperature work or exercise, sweating, the amount of water to drink should be increased accordingly. The type of water to drink plain water, pure water and mineral water is better, light tea, orange juice and watermelon are good way to ingest water. To take the initiative to drink water, do not wait until you feel thirsty to drink water, and the amount of water to drink throughout the day to try to balance the distribution. Two drinks are popular in summer: beer and tea, both of which can increase urine output, but unfortunately are not the best way to prevent urinary stones. This is because beer is rich in calcium, oxalic acid, uronic acid and purine nucleosides and other acidic substances, their interaction can lead to a significant increase in uric acid, the metabolite of purine substances in the urine, and thus the risk factors for the formation of uric acid stones will increase exponentially, so it is not advisable to drink too much beer in summer, combined with gout patients with urinary stones The drink should be prohibited. As tea is rich in oxalic acid, drinking large amounts of it increases the risk of calcium oxalate stones, so stone patients should try to drink less tea or light tea. Coca-Cola and other carbonated beverages contain more calcium oxalate, which can increase the incidence of calcium oxalate stones, so beverages should not replace drinking water.  In addition to water, diet is another important aspect of preventing urinary stones in summer. There are many components in food that can affect the formation of urinary stones, and the main ones that are more relevant to the season are oxalic acid, uric acid, vitamins, calcium and sodium. Oxalic acid is an important factor in the formation of urinary stones, and calcium oxalate is the most common stone component. High oxalic acid food in addition to the aforementioned tea, foods such as spinach, rhubarb, leeks, garlic scapes, coffee, cocoa, etc. Patients with calcium oxalate stones should try to reduce the consumption of these foods. Another thing to note is to avoid excessive intake of high purine foods. Because the final metabolite of purine in food is uric acid, excessive intake of purine is bound to increase the uric acid content in the body, and the high uric acid content in urine not only promotes the formation of uric acid stones, but also increases the incidence of calcium oxalate stones. At the same time, high purine food often contains a large amount of acid, urine acidification can also promote the formation of uric acid stones. The main high purine foods are beef, seafood and various animal offal. In addition, food should be kept light and not too salty, because excessive salt intake can also promote the development of urinary stones. Studies have shown that high intake of sodium increases the excretion of calcium and cystic chloride in urine, decreases the excretion of citrate (a substance that inhibits stone formation) in urine, and raises the pH of urine, which is one of the risk factors for the formation of calcium-containing stones. It is important to eat more vegetables that are high in fiber, such as celery.  About 90% of urinary stones are calcium stones, but for a long time, both doctors and patients have misconceptions about the relationship between urinary stones and calcium, believing that patients with urinary stones need to strictly limit their calcium intake. It is true that excessive calcium intake can lead to hypercalciuria, which can promote stone formation. However, insufficient calcium intake can also increase the risk of calcium oxalate stones. The principle is that calcium can combine with oxalic acid in food in the intestinal tract to form insoluble calcium oxalate, which is excreted in the feces. Some people in the United States have calculated the relationship between daily calcium intake and urinary stones in more than 40,000 men, and the results showed that the greater the calcium intake, the lower the risk of urinary stone formation. Therefore, from the perspective of urinary stone prevention, high calcium foods such as soy products and milk do not need to be restricted as long as they are not consumed excessively.  The prevention of urinary stones in summer also requires attention to the correct lifestyle. In the summer, people usually like to sit still and do not like to exercise, but this is not good for urinary stones. In addition, people who often stay up late and eat late night snacks, because the kidneys do not get enough rest, so that calcium, uric acid and other substances can not be fully discharged from the body, will also lead to the production of kidney stones. Therefore, daily kidney care is very important, pay attention to work and rest, and go to sleep before 12 pm to avoid damage to the kidneys.