People’s dietary variety is diverse, human metabolism is complex, so the composition of kidney stones is also diverse. Common stones can be divided into five types according to their composition: a calcium oxalate stones: the most common, accounting for more than 80% of kidney stones, formed in acidic or neutral urine, the onset is mostly in young adults, more common in men. Calcium phosphate stones: account for 6-9% of stones, formed in alkaline urine, also more frequent in male young adults. Three uric acid stones: accounting for 6% of stones, formed in acidic urine, when the urinary pH value is greater than 6.7 stones dissolve, more common in men. Four magnesium phosphate stones: 10% of stones, formed in alkaline urine, dissolve when the urine pH is less than 7.2, more common in females. V cystine stones: rare, accounting for about 1-2% of stones, formed in acidic urine, stones dissolve when urine pH is greater than 7.0. There are many factors influencing the prevention of urinary stone formation and the high incidence and recurrence of stones, thus suitable preventive measures are of great importance.
I. Basic points of stone prevention and control
1. Drink plenty of water: ensure a daily urine volume of more than 2000 ml.
2.Limit sodium salt: consume less than 5 grams of sodium chloride daily and avoid MSG.
3, balanced diet: everything in heaven and earth, people in it, the structure of the diet is most closely related to stones.
4, reduce weight: because obesity is prone to stone formation.
5, moderate exercise: can reduce the chances of crystalline retention, but also to prevent dehydration caused by excessive exercise.
6, calcium oxalate, calcium phosphate treatment including: surgical treatment + prophylaxis.
7. uric acid stones: medication.
Second, the general theory of stone prevention
The occurrence of many diseases in real life and daily diet are closely related, if we can live sometimes and eat in moderation, even most cancers may be avoided. Now on the kidney stone disease this persistent disease to remind you how to use the diet to prevent, or make already suffer from kidney stones, the stone increases slowly, or even shrink, dissolved and discharged from the body.
(a) Drink more plain water Drink more water to dilute the urine, the concentration of calcium ions and oxalate will be reduced, and calcium oxalate stones will not be formed. Studies have shown that increasing the volume of urine by 50% can reduce the incidence of kidney stones by 86%.
Drinking plenty of water has a preventive effect on all components of urinary stones. In the hot summer, the risk of urinary stone growth increases significantly when the daily urine volume is less than 1200 ml. If you can make the daily water consumption in 2000-4000 ml, this can maintain the daily urine volume in 2000 ml or more. Magnetized water is more effective in the prevention and control of calcium oxalate stones, which can be given in the morning, between meals and before bedtime. The amount of water drunk in the early morning can be 500-1000 ml. In order to maintain the amount of urine at night, drink 500 ml of water before going to bed, and then drink 300-500 ml of water after getting up to urinate during sleep, and the rest of the water is taken between meals respectively. Drinking a lot of water can promote the discharge of small stones, dilute urine can prevent the formation of urinary stone crystals, and can slow down the growth of stones.
(2) Reasonable calcium supplementation, especially dietary calcium supplementation Kidney stone patients often “talk about calcium”, wrongly believe that the culprit of kidney stones is calcium, but in fact, kidney stone patients also need calcium supplementation. There are two different perspectives in the medical field to explain why kidney stone patients need calcium supplements. Some doctors say that stones are caused by calcium in the urine, which causes calcium oxalate and calcium phosphate stones, so they take less calcium supplements. The truth is: the more calcium deficiency and the less calcium supplementation, the more it leads to high calcium content in the urine and the more likely to cause stones! These doctors do not understand that 99% of calcium is stored in the bones and teeth, and it is only when the body is deficient in calcium that it causes the calcium in the bones to be separated out into the blood and partially into the tissue fluid and urine.
The first is that supplemental calcium can combine with the oxalic acid contained in vegetables in the gastrointestinal tract to form insoluble calcium oxalate, which is excreted in the feces, reducing some of the oxalic acid absorbed by the gastrointestinal tract and excreted by the kidneys, thus reducing the chance of forming kidney stones.
The second is the “acid-base balance theory” proposed by Japanese scholars. In other words, when blood is acidic, stones are easily formed. When it is alkaline, it inhibits the formation of stones. When the blood is acidic when calcium is lacking, the blood will be alkaline when calcium is reasonably supplemented, which will help to inhibit stone formation. When a person’s body is acidic, calcium is more likely to form calcium phosphate and calcium oxalate stones with phosphate and oxalate. To prevent the occurrence of many kinds of stone disease and improve stone symptoms, we must thoroughly improve the acidic body and maintain the normal alkaline environment of the human body. In addition to good lifestyle habits, the fundamental method is to adjust the diet, neutralize acid toxicity with alkaline foods, avoid reducing the consumption of high purine foods, improve the acidic constitution, and ensure the acid-base balance of the body. In the nutritional treatment of stone patients, I always let them drink a lot of fruit and vegetable juices to slowly neutralize acid toxicity.
(iii) limited intake of sugar The results of a recent study by American scientists show that the intake of high-sugar foods can increase the chance of developing kidney stones, therefore, pay attention to eating less sweets.
(D) eat less oxalate content of food containing high oxalate foods such as tomatoes, spinach, strawberries, beets, chocolate, etc., too high oxalate intake is also one of the main causes of kidney stones.
(e) Eat less soy products Soy foods are high in oxalate and phosphate, which can fuse with calcium in the kidney and form stones.
(6) Be careful to drink milk before going to bed People who do not sleep well, drink a glass of milk before going to bed to help sleep. However, after sleep, the volume of urine is reduced, concentrated, and various tangible substances in the urine increase. And 2 to 3 hours after drinking milk, it is the peak of calcium excretion through the kidneys. The sudden increase of calcium through the kidneys in a short period of time makes it easy to form stones. Therefore, patients with kidney stones should not drink milk with high calcium content before going to bed.
(vii) Do not take too much cod liver oil cod liver oil is rich in vitamin D, which has the function of promoting the absorption of calcium and phosphorus in the intestinal membrane.
(H) Eat more black fungus Black fungus is rich in many minerals and trace elements, which can produce a strong chemical reaction to various stones, causing them to peel off, differentiate, dissolve and be discharged from the body.
III. Targeted prevention
The chemical composition of stones should be dealt with, although many of its components also exist in food, but the formation of stones than not entirely from external causes, part of the stones are generated by the body’s metabolic disorders. For mixed stones dietary control is more difficult. When the chemical composition can be determined, it is called simple stones and dietary control can be an adjunct to treatment. When it is determined that the stones are alkaline, more acidic foods are used in the diet to promote an acidic reaction in the urine, which is conducive to stone dissolution. On the contrary, for acidic stones, more alkaline food is used every day to promote the alkaline reaction of urine, and acidic stones can be easily dissolved. After careful and comprehensive examination, kidney stone patients can be treated with diet according to stone composition, or blood and urine examination. Adjusting diet and having to change dietary habits have a positive effect on preventing stone re-occurrence and eliminating stone forming factors.
1, uric acid stones There are 2 sources of uric acid in the body. Endogenous uric acid comes from abnormal purine metabolism in the body, and high blood uric acid is not easy to control. Exogenous uric acid comes from the intake of food, using a low purine diet.
(1) Restrict protein: 0.8-10.g/kg.d.
(2) Increase fresh fruits and vegetables: vegetables and fruits are rich in B vitamins and vitamin C. The metabolites in the body are alkaline and excreted by urine. Uric acid stones are easily dissolved in alkaline urine, so it is beneficial to treatment.
(3) Low energy diet: If you are overweight, you should limit the energy supply.
(4) Appropriate food: cereals are mainly fine grains, because coarse grains can produce more purines. Meat should be consumed in small amounts, within 100g/d. Fish, meat, shrimp and chicken can be eaten; green vegetables and fruits can be consumed at will; eggs and milk can be consumed appropriately. Because uric acid crystals are easily dissolved in alkaline urine, diet should be more into alkaline food.
(5) Avoid food: high purine food such as pork, beef and animal offal such as pig liver and kidney, various gravies, thick broth, sardines, dried beans, crab, clams, etc. Vegetables include spinach, peas, lentils and other beans, cauliflower, lobster, etc. Alcohol and drinks containing alcohol, strong tea, coffee, cocoa and other spices and condiments.
(6) should not drink alcohol, drinking alcohol can increase the level of uric acid, alcohol also tends to cause the concentration of urine.
(7) Patients with high blood uric acid and hyperuricemia can take allopurinol orally.
(8) oral sodium bicarbonate can make urine alkalinization.
2, calcium phosphate or magnesium ammonium phosphate stones: limit daily calcium intake, less than 500mg. if calcium phosphate stones, in addition to limiting calcium should also limit phosphorus, about limit to less than 2000mg.
(1) Low calcium and low phosphorus diet: give a total of 700mg of calcium and 1300mg of phosphorus per day. avoid foods rich in calcium, such as milk, soybeans, tofu, green leafy vegetables, etc. Foods with high phosphorus content include animal protein, animal offal and brain marrow, etc. Limit the consumption of foods high in calcium, phosphorus and protein, including fish, meat, cheese, liver, nuts.
(2) Eat more into acidic food: supply rice, noodles and other acidic foods to make urine acidic. It is not advisable to drink orange juice, cola and other alkaline drinks to prevent alkalization of urine
(3) with drugs such as ammonium chloride: is acidification of urine, oral phosphorus binding agent to reduce phosphorus absorption in the intestine, drink a lot of water. It can be combined with diuretic and antispasmodic drugs to promote the discharge of small stones. For small stones and good health, physical activity, bending and tapping the kidney area, or skipping rope can be used to promote stone discharge.
3, calcium oxalate stones: diet is more difficult to work, urinary oxalate is mostly endogenous, but can also be formed by intestinal bacteria acting on sugar, of which 33%-50% oxalate is transformed by glycine. Patients with urinary oxalate over 40mg/d should adopt a low oxalate diet and avoid taking large amounts of vitamin C. Folic acid 5mg and vitamin B610mg can be taken orally daily to prevent glycine from turning into oxalate, and drink plenty of water to facilitate urination.
Patients with oxalate stones should limit the intake of strong tea, spinach, tomatoes, asparagus, peanuts, etc.. Limit radish, spinach, amaranth, celery, lettuce, bamboo shoots, potatoes and soy products; limit cocoa, chocolate, black tea, lime, cola, beer; foods with high vitamin C should not be eaten such as citrus, lemon, tomatoes, strawberries, etc.; oral vitamin B6 and magnesium preparations are beneficial for the prevention and treatment of atopic hyperoxalate urolithiasis. Eat more alkaline food such as: milk, vegetables, fruits, etc., is the urine is alkaline.
4, cystine stones: is the generation of cystinuria, limit the food rich in methionine: eggs, poultry, fish, meat, etc.. Limit animal-based acidic foods and eat more plant-based alkaline foods to make the urine slightly alkaline. If you have cystinuria, you can adopt a low methionine diet. Drink plenty of water to reduce the concentration of cystine in the urine, so that the daily urine volume is maintained at 2000-3000ml.
5. Endemic bladder stones: Breastfeeding or replacing with cow’s milk for breastfed children can basically be prevented.