Kidney Stones on the Rise in the US
February 11, 2014
Kidney stones are increasingly becoming a problem in the United States, and much of that rise can be attributed to poor dietary habits and the growing rate of obesity. Because kidney stones are caused by what we eat and our lifestyle, they are prevented through the same mechanisms as well.
Kidney stones are calcifications that form in the urine. Common risk factors include diet, obesity, and family history. Stones are made in the kidney when urine is concentrated and high in certain elements such as calcium, sodium, and oxalate. Once a stone is made, it can remain and grow in the kidney for a long period of time (months to years even). Kidney stones will fall unannounced, and can cause a great deal of pain and discomfort when they do. They can be treated with surgery or medication once they are on the way down to the bladder; this depends on the size and location of the stone. After a patient has been treated for the current kidney stone that is causing problems, our goal is to prevent more kidney stones from forming, and/or preventing any remaining kidney stones from growing. Prevention of kidney stones is almost always achieved through dietary changes. Occasionally, we may put people on medications that decrease the potential to make certain types of stones, if uric acid or calcium is elevated in the urine. A 24 hour urine study is completed that details exactly what a patient’s urine is abnormal in. Based on this study, we as the providers can emphasize particular dietary changes that need to be made.
Obesity and poor diet can cause concentration of the urine and cause crystals to form. Healthier alternatives can lower risk of forming kidney stones. Excess sodium in the urine also increases the calcium in the urine. While most stones are party made of calcium, we do not recommend decreasing calcium in the diet. However, lowering sodium intake is very crucial. Reduce sodium by avoiding fast food, eating out at restaurants, and processed foods. Reading the nutrition facts on the back of food items as well as looking at restaurant menus prior to ordering can help make healthier decisions. The FDA recommends that sodium intake should be limited to 2300mg per day. If you have high blood pressure, diabetes, or cardiovascular disease, this number may be even lower. Monitor salt when cooking at home as well. Applying these same rules to fat and sugar intake will also decrease the risk of kidney stones. Other dietary changes for kidney stone prevention include drinking plenty of water (about 64 oz. per day), minimal to moderate caffeine intake (1-2 small caffeinated beverages per day), decreasing red meat, and increasing citrate (add 1-2 teaspoon lemon juice to water each day). Avoiding oxalate rich foods is also part of prevention. These foods include spinach, nuts (peanuts in particular), strawberries, black pepper, and tea to name a few.
Aside from diet, exercise is an important factor is decreasing weight and avoiding obesity. Cardiovascular exercise in particular is recommended; about 30 minutes a day, at least three times a week. Managing major medical problems such as diabetes, high cholesterol, and high blood pressure will lower risk of obesity and therefore kidney stone formation. It is important that you have annual visits with your primary care physician for labs and physicals.
Not only are kidney stones bothersome and painful, but also carry a risk of urinary tract infections, and compromise in kidney function if severe. Addressing the rise in obesity allows us to manage kidney stone prevention as well. In our clinic, we have seen patients do very well with further stone formation once dietary changes are made.
Please call to schedule an appointment for preventative/follow-up care: 512-694-8888