Prevent Kidney Stones:

How to Prevent the Formation of Problematic Kidney Stones

By Dr. Ben Kim
DrBenKim.com

The single most painful condition that I have ever addressed as a health care provider is the acute pain associated with passing a sizeable kidney stone. More than a few women who I have treated over the years have said that passing a large kidney stone is much more painful than giving birth.

What's particularly scary about passing a kidney stone is that in most cases, there are no warning signs. One minute you are going about your normal business, and then all of a sudden, you begin to have waves of unimaginable pain on one side of your lower back.

The pain associated with passing a kidney stone typically arises when a stone grows large enough to get stuck in one of your two ureters.

Normally, your kidneys work on a continuous basis to filter water, waste products and minerals out of your blood and send them as urine down your ureters to your bladder, where your urine sits until there is enough volume to prompt your nervous system to prompt you to release urine out to the world via your urethra.

So technically speaking, because you are eliminating minerals via your genitourinary system on an ongoing basis, you are always passing asymptomatic and mostly microscopic kidney stones.

Various dietary and lifestyle factors can cause these asymptomatic and microscopic kidney stones to begin clumping together. Some of these larger stones are eliminated without your awareness, but if the circumstances are just right, some of them can grow large enough to cause a blockage of your urine flow, which is when the waves of intense pain typically begin.

Many painful kidney stones pass through the urinary system on their own within several hours to a couple of days. You may see blood in your urine for a while and require the use of strong pain medication to get through it, but if you are reasonably lucky, you should be back to your activities of daily living within a few days.

If you are unlucky and you have one or more stones that are too large to pass on their own, or if a lodged kidney stone causes enough backup of urine to causes an infection in your genitourinary system, you may require more aggressive treatment.

But let's get to what matters most to the majority of our readers: what are dietary and lifestyle factors that can increase your risk of forming large kidney stones and what are concrete steps that you can take to minimize your chances of developing them?

1. Do not eat more protein than you need.

   Even if you exercise regularly, your body requires no more than half your body weight of protein in grams per day to be optimally nourished. This means that if you weigh 160 pounds, you need no more than 80 grams of protein per day.

   When you eat excessive amounts of protein, especially animal protein, your body leeches calcium phosphate out of your bones to neutralize the acid-forming effect that protein has on your blood. After calcium is used for this purpose, it is eliminated from your body through your kidneys, and if enough of a compound called oxalate is available in your system, calcium combines with oxalate to form significant amounts of calcium oxalate, which is the most common type of troublesome kidneys stones.

   It is important to note that eating a low-protein diet has not been shown to decrease your risk of forming kidney stones - all that is known for sure is that a high-protein diet can increase your risk of developing them.

2. Do not eat too many oxalate-rich foods.

   If your health care provider determines from your health history that you have a tendency to form large calcium oxalate stones, you should not eat large amounts of the following oxalate-rich foods:

   • Nuts
   • Chocolate (any type of cocoa)
   • Coffee
   • Tea
   • Cola
   • Wheat bran
   • Spinach
   • Rhubarb
   • Beets and beet greens
   • Strawberries
3. If circumstances allow, eat oranges on a regular basis.

   Citrate found in oranges can decrease calcium oxalate formation in your genitourinary system; citrate competes with oxalate in binding to freely available calcium. A study published in the October 26 issue of the Clinical Journal of the American Society of Nephrology indicates that citrate found in oranges is a more effective binding partner with calcium than citrate found in other citrus fruits like lemons.

4. Avoid regular consumption of substances that have a strong acid-forming effect on your blood.

   Sugar, artificial sweeteners, alcohol, carbonated soft drinks (pop), refined cereals, flour products, coffee, and tobacco products all put significant pressure on your body to leech calcium from your bones to neutralize their acid-forming effects. Just as it is with eating too much protein, regular exposure to large amounts of these acid-forming substances can increase the amount of calcium that is excreted through your genitourinary system, which can increase your risk of developing large, calcium-based kidney stones.

5. Eat plenty of water-rich foods.

   Eating plenty of water-rich plant-based foods like vegetables, fruits, and cooked whole grains and legumes can promote regular production of urine, which can decrease the chance of having small, asymptomatic stones clump together in your genitourinary system to become large, problematic stones.

   Drinking large amounts of water on a regular basis to encourage regular urine formation is not something that I recommend because doing so can put unnecessary stress on your kidneys and your cardiovascular system over time. When you strive to acquire adequate amounts of water from water-rich plant foods, the natural bulk of these foods serve as a natural regulatory measure that can prevent you from introducing stressful amounts of water - and calories, for that matter - into your system.

If you find yourself or someone in your life in the midst of a painful blockage, it is best to visit your doctor or local hospital immediately. Medication for pain control, antibiotics to prevent an infection from developing, regular intake of water to encourage the stone(s) to pass, and plenty of physical and emotional rest to facilitate healing are the four key ingredients to an efficient recovery.

Your health care provider may choose to have an x-ray or CT scan taken to determine the size and location of the troublesome stone(s). The general rule of thumb that I have found to be reliable is that stones that are 4-5 mm or less in diameter tend to pass on their own, while stones that are 6 mm or more in diameter tend to require some form of intervention.

As it is with all acute and painful conditions, when it comes to kidney stones, an ounce of prevention is worth many pounds of cure.

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