The summer is a period of high incidence of urological diseases, and some patients come to the hospital because of recurrence of stones. Looking at their very heavy hearts, I would like to discuss the topic of urinary stone composition analysis with you here. It is important to know clearly which kind of stones you have and how to treat them. I would like to discuss with you about the analysis of the composition of urinary stones and the recipes that can be used to reduce the risk of the disease and achieve better prevention and treatment.
Urinary stones are one of the most common diseases in modern society, with a high rate of recurrence. The incidence of urinary stones in China is 1% to 5%, and in the southern region, it is 5% to 10%, which is one of the three most prevalent areas in the world. The recurrence rate of urinary stones is up to 60% in 5 years and up to 100% in 20 years. Therefore, it is extremely important to effectively prevent the recurrence of stones!
The causes of stone formation are complex and have regional differences, for example, we have a higher prevalence of stones in western Fujian and northern Fujian. Therefore, accurate urinary stone composition analysis provides important clues for in-depth exploration of stone causes, and also provides an important basis for developing reasonable stone prevention and treatment measures, in addition, it helps to select the scope of metabolic assessment.
What is urinary stone composition analysis?
Urinary stone composition analysis is a method to confirm the nature of stones. It is also an important basis for the development of stone prevention measures. Composition analysis should be performed on stones whether they are expelled naturally, surgically removed or after lithotripsy. When stones recur despite drug prophylaxis, when stones recur soon after complete stone removal by lumpectomy, or when stones recur after a long period of stone free time, the composition of stones should be analyzed again.
What are the components of common stones?
The causes of stone formation are complex and have regional differences, the two most basic points for stone prevention are?
1, drink a lot of water: drink at least 2000ml of water per day (equivalent to a warm bottle), to ensure that the daily urine volume of 2000ml or more;
2, moderate exercise: facilitate the discharge of small stones, but should prevent excessive exercise leading to dehydration resulting in urine concentration;
Among the many factors to prevent the recurrence of stones, it is very important to refer to the stone composition, so as to adjust and control the diet in one direction. The type of stone varies, as do the risk factors for stone formation. The dietary modification will also be different. Here are five common types of stones. Come and take your place!
Case 1: Calcium stones – calcium phosphate and calcium oxalate stones (apatite carbonate, calcium oxalate monohydrate, calcium oxalate dihydrate)
Mixed calculi of apatite carbonate and calcium oxalate monohydrate are very common and have a high recurrence rate. In this case, the stones are more likely to recur because of the predominance of carbonate apatite in the composition. A few points need to be noted.
1, weight control: obesity is prone to stone formation, obese people should reduce their weight;
2.Regular physical examination: Urological ultrasound should be routinely reviewed every year.
Customized recipes
1, avoid oxalic acid: higher acid food mainly including amaranth, spinach, rhubarb, mango, strawberries, sesame, cocoa, chocolate, tea, various nuts (chestnuts, almonds, walnuts, etc.), should be avoided or eat less;
2, limit protein: limit the food high in protein, calcium and phosphorus, including fish, meat, liver, cheese, all kinds of nuts (chestnuts, almonds, walnuts, etc.);
3, limit the consumption of sodium: sodium can cause increased urinary calcium excretion, so the daily consumption of sodium chloride (salt) should not exceed 5 grams. Avoid MSG and chicken essence;
Case 2: Mixed calcium and non-calcium stones – uric acid and calcium oxalate stones (ammonium hydrogen urate, calcium oxalate monohydrate)
Adult ammonium urate stones are mostly associated with hyperuricemia combined with urinary tract infection and have a high recurrence rate; children’s ammonium urate stones are usually related to metabolism, mostly seen in non-breast-fed children, and are caused by a low phosphate diet. The following points need to be noted.
1, control infection: pay attention to personal hygiene to prevent urinary tract infection;
2, avoid cold: especially avoid cold in the kidney area, bladder area and feet;
3, regular physical examination: annual routine re-examination of urinary ultrasound blood uric acid, urinary routine and urine culture.
Customized recipes
1, limit purine: adult patients with ammonium urate stones should strictly limit the consumption of meat, fish, shrimp and other purine-rich foods to less than 150 grams per day;
2, consume high quality protein: eat less soy products, mushrooms, avoid eating animal offal, the main food should be eggs, milk, vegetarian dishes, fruits, but pediatric patients without evidence of urinary tract infection can be exempt from the above dietary restrictions;
Case 3: Calcium stones – calcium oxalate type (calcium oxalate monohydrate)
The ten-year recurrence rate of calcium oxalate monohydrate stones is about 30% to 50%, therefore, it is crucial to take targeted preventive measures to control stone recurrence. The following points need to be noted.
1, weight control: obesity is prone to stone formation, obese people should reduce weight;
2, regular medical check-ups: the urinary ultrasound should be routinely reviewed every year.
Customized recipes
1, avoid eating oxalic acid: higher acid foods mainly include amaranth, spinach, rhubarb, mango, strawberries, sesame, cocoa, chocolate, tea, various nuts (chestnuts, almonds, walnuts, etc.), should be avoided or eat less;
2, limit the consumption of sodium salt: sodium salt can cause increased urinary calcium excretion, so the daily consumption of sodium chloride (salt) should not exceed 5 grams. Avoid eating MSG, chicken essence;
3, often eat citrus: eating citrus fruits can increase the content of citrate (stone inhibition factor) in the urine, which can help prevent the recurrence of stones;
Case four: calcium and non-calcium mixed stones – infection, calcium phosphate, calcium oxalate type stones (ammonium phosphate hexahydrate magnesium, carbonate apatite, calcium oxalate dihydrate, hydroxyapatite)
Magnesium ammonium phosphate hexahydrate stones are infected stones with a recurrence of about 40% to 50% in ten years. Special attention should be paid to the fact that an important prerequisite for the prevention of recurrence of such stones is the complete removal of the stones. The following points need to be noted.
1. Control infection: pay attention to personal hygiene, prevent urinary tract infection, and apply antibiotics according to the urine culture results;
2. Avoid getting cold: especially avoid getting cold in the kidney area, bladder area and feet;
3, regular medical check-ups: the urological ultrasound should be routinely reviewed every year.
Customized recipes
Specific drinking water: It is best to drink acidic beverages, which are conducive to urine acidification, and can be consumed green plum fruit, apple juice, cranberry juice: However, it should be noted that magnesium ammonium phosphate stones are easily formed in alkaline urine, and thus should not be consumed alkaline beverages (such as orange juice, cola, etc.) to avoid alkalinization of urine;
Case 5: mixed calcium and non-calcium stones – uric acid and calcium oxalate type stones (uric acid anhydrous, calcium oxalate monohydrate)
Uric acid stones and lithotripsy are ideal, with a success rate close to 80% to 90%, but those containing calcium oxalate may affect the effectiveness of lithotripsy. The recurrence rate of this kind of stone is about 50%~65%, and prevention strictly according to the following measures is very effective to control its recurrence. The following points need to be noted.
1, weight control: obesity is prone to stone formation, obese people should reduce their weight;
2, regular medical check-ups: the urinary ultrasound, blood uric acid and uric acid should be routinely rechecked every year.
Customized recipes
1.Preferred foods: low purine foods such as rice, noodles, eggs, milk, vegetables, fruits, etc. should be consumed;
2, avoid oxalic acid: higher acid foods mainly include amaranth, spinach, rhubarb, mango, strawberry, sesame, cocoa, chocolate, tea, various nuts (chestnuts, almonds, walnuts, etc.), should be avoided or eat less;
3, limit purine: purine is the precursor substance of uric acid, therefore, should be strictly limited to meat, fish, shrimp and other purine-rich food, the total daily amount of less than 150 grams, less soy products, mushrooms, avoid eating animal offal; less consumption of soy products, mushrooms;
4, alkalize urine: uric acid stones are easily formed in acidic urine, alkalize urine is conducive to the dissolution of stones, can often eat citrus fruits rich in potassium citrate (an alkalizing agent);
5, strict abstinence from alcohol: should not drink alcohol, alcohol can increase urinary lactic acid excretion and cause urine acidification, in addition, drinking beer can produce a lot of uric acid in the urine and lead to the recurrence of stones;
Stones themselves are the result, not the cause. After understanding the composition of your stones, you should trace the root cause to reduce the possibility of recurrence. Although I am a urologist, my highest goal as a doctor is to have a healthy body with less medication and less injections, and to spend the summer peacefully.