According to the chemical composition of stones, dietary adjustments are made to reduce the source of stone components, regulate urinary pH and reduce the chance of stone formation.
1.Prevention of calcium-containing urinary tract stones
(1) Drink a lot of water: Drinking a lot of water can increase the volume of urine and make the urine dilute, thus increasing the solubility of various crystals that can form stones within the urine, while increasing the volume of urine discharge can flush out stone nuclei and reduce the possibility of stone formation. It is recommended to drink 2000 ~ 3000ml of water per day, as many times as possible evenly before and after meals, and make it a habit to drink water before bedtime and in the middle of the night, so that the daily urine volume can be kept at 2000 ~ 2500ml, and maintain a certain amount of nighttime urine.
(2) Diet regulation: maintain a comprehensive balance of dietary nutrition and avoid excessive intake of one of the nutrients.
(3) Dietary calcium content: The formation of calcium-containing stones is associated with hypercalciuria and hyperoxaluria. While preventing this, check to exclude diseases such as hyperparathyroidism, idiopathic hypercalciuria and renal tubular acidosis. Consume a diet with normal calcium content, limit animal protein and sodium intake. A normal range or appropriate degree of high calcium diet is of clinical therapeutic value in preventing recurrence of calcium-containing stones in the urinary tract. In patients with absorptive hypercalciuria, such hypercalciuria can be effectively converted to normal with a low-calcium, low-sodium diet. The main thing to do in these patients is to reduce the intake of milk and milk products and soy products. Eat more foods rich in plant fiber.
(4) Limit the intake of oxalic acid in the diet: patients with calcium oxalate stones should adopt a low oxalic acid diet, a low-fat diet, and need to avoid foods rich in oxalic acid such as radish, amaranth, cilantro, celery, lettuce, bamboo shoots, peppers, potatoes, soy products, cocoa, chocolate, black tea, sour plums, cola, beer, kale, almonds, peanuts, nuts, beets, parsley, spinach, rhubarb, etc. Spinach has the highest content of oxalic acid, and patients with calcium oxalate stones should be more careful to avoid eating spinach. Fat diet should be limited to 40 grams per day. In addition, calcium should be maintained at 800 mg per day to ensure that there is enough calcium in the intestine to bind oxalic acid.
(5) Limit sodium intake: sodium intake should be less than 2 grams per day.
(6) Limit excessive protein intake: high-risk groups should reduce protein food handfuls, especially to limit the intake of animal protein such as beef, lamb and pork. The daily intake of animal protein should be limited to 150 grams or less. Patients with recurrent stones should not exceed 80 grams of protein intake per day.
(7) Reduce body weight: maintain a body mass index BMI between 11 and 18 in patients with urinary stones.
(8) Increase the intake of fruits and vegetables: increasing the intake of fresh fruits and vegetables can prevent stone recurrence in patients with hypocitraturia.
(9) Increase coarse grains and fiber diet: rice bran can reduce urinary calcium excretion and decrease the recurrence of urinary stones, but avoid oxalic acid-rich fiber foods such as wheat bran.
(10) Reduce the intake of vitamin C: vitamin C can produce oxalic acid after natural transformation. It is recommended that the daily intake of vitamin C should not exceed 1.0 gram. It is not advisable to eat more such as citrus, lemon, tomato, strawberry, etc.
(11) Restrict high purine diet: Patients with calcium oxalate stones with hyperuricuria should avoid high purine diet.
(12) Vitamin B6: Vitamin B6 is one of the coenzymes in the process of oxalic acid metabolism in the body, and deficiency of the vitamin in the body can cause an increase in the excretion of oxalic acid. High dose of vitamin B6 has therapeutic effect on patients with primary hyperoxaluria.
(13) Chinese herbs: Chinese herbs with certain preventive effect on calcium-containing stones include zedoary, fatty sea, money grass, corn husk and plantain core, etc.
2.Prevention of uric acid stones
(1) Drink a lot of water: keep the daily urine volume above 2 liters.
(2) Alkalize urine: take oral sodium potassium hydrogen citrate (Youlait), potassium citrate, sodium potassium citrate or sodium bicarbonate to make urine alkaline and improve the solubility of stones.
(3) Reduce the formation of uric acid: For those with increased blood uric acid or uric acid, uric acid production inhibitors can be used in appropriate amounts, such as 300 mg of allopurinol taken orally daily.
(4) Patients are mostly obese and overweight, protein intake should be limited, total protein should be supplied at 0.8 grams to 1.0 grams per kilogram of body weight per day, restrict the intake of calories, reduce the intake of seafood, reduce sodium intake and drink less alcohol.
(5) Avoid high purine diet: Because purine forms uric acid in the process of metabolism in the body, it can not only form stones, but also be deposited in joint cartilage and kidney, especially for gout patients. It is recommended that the daily intake of purine in food is less than 500 mg. It is not advisable to eat more black tea, chocolate, cocoa, fish and shrimp. Foods rich in purines include: animal offal (liver, kidney, brain, fatty intestine, tripe pieces), poultry skin, herring with skin, sardines, anchovies and plant legumes.
3, the prevention of infected stones (magnesium phosphate amine / carbonate apatite)
According to the drug sensitivity test using antibiotics to control the infection at the same time, should remove the cause as far as possible, surgical methods to remove the infected stones. Foods high in calcium should be avoided and a low-calcium, low-phosphorus diet and acidified urine should be used. Avoid high calcium foods including milk, cheese and legumes. Avoid foods high in phosphorus, such as animal meat, offal and brain marrow. Eat more acidic foods, such as rice and noodles, so that the urine is acidic, which is not conducive to the formation of calcium carbonate and magnesium ammonium phosphate stones.
4.Prevention of cystine stones
Pay attention to drink a lot of water to increase the solubility of cystine, to ensure that the daily urine volume is more than 3 liters. Take oral sodium potassium hydrogen citrate (Youlet) to alkalize the urine. Eat a lighter diet. Consume a low protein diet based on vegetables and cereals and avoid excessive consumption of methionine-rich foods (soy, wheat, fish, meat, beans and mushrooms, etc.). Excessive salt intake can increase the excretion of cystine in the body and increase urinary calcium formation through various mechanisms, which becomes one of the risk factors for the occurrence of urinary stones. Therefore, salt intake should be limited, especially for high-risk subjects and patients. The recommended intake of sodium salt is limited to less than 2 grams per day. For urinary cystine higher than 3 mmol/24h, oral captopril or thiopronine may be appropriate. Prevention of cystine stones: limit the intake of animal protein-rich foods and eat more plant-based or alkaline foods to make the urine slightly alkaline.