Kidney stones are one of the most common diseases in urology, and acute attacks often result in severe painful visits to the emergency room. The high incidence of the disease causes worry and torment while it is derived from tiny mineral crystals. These tiny crystals form, unite, and accumulate in the patient’s urine, growing from small to large and eventually forming stones large enough to cause symptoms.
I. Why do kidney stones form?
The chemical components that form kidney stones are present in the urine and include calcium, oxalic acid, phosphorus, and uric acid. These substances will come out of their dissolved state at a high concentration, like the experiment in the middle school textbook where salt is continuously added to water and eventually crystals will precipitate. In urine, there is another class of compounds that can inhibit the precipitation of crystals and become inhibitors. When the concentration is too high or the inhibitor is too low
the stones will form. Family history, dietary habits, fluid intake, physical illness, and many other factors can have an impact on stone formation.
Why are there different types of stones?
Indeed, there are several types of kidney stones, each with a different chemical composition.
The vast majority of kidney stones will contain calcium, about 85%, including calcium oxalate or calcium phosphate. Of these, calcium oxalate is more common and pure calcium phosphate stones are very rare and often represent a definite metabolic problem. Mixed types are the most common, in which a large amount of calcium oxalate is mixed with a small amount of calcium phosphate.
The remaining 15% of stones do not contain calcium and include uric acid stones, guano stones and cystine stones.
How common are kidney stones?
The incidence rate is about 10% in white areas of the United States and between 5% and 10% in China according to incomplete statistics. Although there is a certain gap in the incidence rate between the United States and China, the huge population base of China makes the absolute value of incidence in China far exceeds that of the United States. Men have a higher incidence rate than women, and the peak age of incidence is 35-50 years old.
What is my risk of recurrence if I have had kidney stones?
Yes, kidney stone is a disease that is more likely to recur. If a man experiences a kidney stone once and does not take any precautions afterwards, the chance of him getting another one is 60-70% according to the study.
If he has had two kidney stones, the chances are 90%. Women are more fortunate and have a lower chance.
V. Can kidney stones be prevented?
1.Stone composition should be analyzed
You should know that the first step to prevent the recurrence of kidney stones is to understand the chemical composition of your kidney stones. Therefore, it is very important that stones and stone fragments are sent for stone analysis. If you are removing the stone yourself or through extracorporeal lithotripsy, filter the urine through a container with a sieve to catch the stone or debris. If the stone was removed through a lithotripsy procedure, these fragments can be sent directly to a laboratory for testing. Unfortunately, not all doctors are aware of this and not all hospitals are equipped for this test. However, after reading this article, you can remind your treating doctor to do so.
2. Laboratory tests – metabolic evaluation
If you have stones with a specific chemical structure or recurrent stones, a particularly specialized doctor will recommend a special urine test – a 24-hour urinalysis containing the various blood and urine components mentioned earlier – to determine the causes of imbalance problems or too much or too little stone formation. Of course, this test is only used in a very limited number of hospitals and doctors, so patients are mostly limited to complex cases and interpretation and measures vary from patient to patient. However, if the analysis is clear, life modification, application of nutrients or medications can improve the health level of urine thus reducing the risk of recurrence.
VI. Diet and lifestyle changes
1. Dilution – the best remedy
Maximum fluid intake is now considered to be the most effective way to prevent recurrence. By drinking 8-10 glasses of water a day, your urine becomes thinner and the crystals in your urine grow less easily, which reduces the probability of stone formation. This is proven by research, yo!
Note that at least half of your fluid intake should be water! Although there are reports that a single daily dose of coffee or tea can slightly reduce the likelihood of stone formation, drinking large amounts of caffeine-based fluids such as coffee, tea or carbonated beverages can significantly increase the risk of stone formation. The dark color of urine indicates that you are not drinking enough water, the best color is white, can you stick to it?
2. Calcium-rich foods
Since many stones contain calcium, it is logical to consider: calcium intake should also be reduced! However, this reasoning is wrong! The intake of calcium-rich foods, such as low-fat milk and yogurt, is not only not harmful but beneficial for kidney stone patients. Proper intake of such foods binds oxalic acid in the diet, which in turn lowers oxalic acid levels in the urine. So, don’t cut calcium out of your recipes!
However, it is important to note that consuming high calcium supplements however may increase stone formation, so if a doctor recommends that you take calcium supplements for your bone health, it is best to choose calcium citrate. Because citrate is an antagonist against stone formation, it is more beneficial for stone forming patients.
3. Antagonist of lithogenesis, more is better
As mentioned before some substances in the urine will antagonize the formation of calcium-containing stones, two of the most important are citrate and magnesium. Lemon juice can somewhat improve the amount of citric acid in the urine, the original juice drink is superior to enhance the amount of citric acid and liquid excellent method. Nutritional products containing magnesium, potassium and citric acid can improve the antagonistic effect of stones in the urine.
4.Supplementation of vitamin B
Vitamin B6 can reduce oxalic acid synthesis and therefore reduce the risk of calcium oxalate stones. Research shows that calcium oxalate stones patients apply magnesium oxide + vitamin B6 to improve the magnesium and citrate in the urine, while reducing the level of oxalic acid.
5.Limit protein
Foods high in animal protein (meat, eggs, cheese, etc.) will increase the excretion of calcium, uric acid and oxalic acid in the urine, which can all be components of calcium-containing stones. Furthermore, studies have shown that a diet low in animal protein and salt can help reduce urinary calcium and oxalic acid. Low-carbohydrate foods, usually with protein and fat, are not recommended for patients with a history of calcium-containing stones. Therefore, to reduce the recurrence of calcium-containing stones, eat less meat and more vegetables!
6. Reduce salty salt
Reducing salt consumption can reduce urinary calcium, this has been revealed in many studies. So, reduce to how much is qualified? Many experts believe that keeping salt to 2 grams or less per day while drinking the maximum amount of water is an effective way to best reduce the recurrence of calcium-containing stones. However, salt is found in large amounts in many finished foods, not including the salt shakers placed on restaurant and diner tables. Although 2 grams is somewhat harsh and stone sufferers should eat as little as possible, avoiding too much manufactured food is a good entry point.
7. Keep an eye on oxalic acid
Oxalic acid in the diet directly affects the amount of oxalic acid in the urine, which is the mainstay of stone formation. As a urologist, it is recommended that stone patients reduce high oxalic acid foods such as chocolate or cocoa, spinach (or other dark leafy vegetables), beets, strawberries, soy, peanuts and malt.
8. Be careful with vitamin C
Do not apply high doses of vitamin C supplements unless you think you specifically need them. The amount of vitamin C in multivitamin tablets is safe, but supplementation with vitamin C tablets alone (greater than 500 mg) can increase the occurrence of kidney stones by raising oxalic acid.
Kidney stones are a painful disease that has affected humans since the beginning of time and although there are many minimally invasive means to manage them, their high recurrence rate and severe effects are a constant reminder of their existence. However, some of the above mentioned modalities can provide some insight into their formation and occurrence, and can inhibit their attack.
Metabolic analysis will become a precise prevention tool for many stone patients, which is very limited in China. Dr. Zhang Yi is currently conducting research in this area in conjunction with a prestigious hospital laboratory and is actively collecting specimens and data in an effort to change this situation. If your kidney stones are recurrent, multiple, occurring at a young age, in children, familial, or if you have received surgical treatment, you are at high risk of being troubled by stones again.