Tea Time: Kidney Stones

• Symptoms
  • Severe pain in the side and back, below the ribs
  • Pain that radiates to the lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Pain on urination
  • Pink, red or brown urine
  • Cloudy or foul-smelling urine
  • Nausea and vomiting
  • Persistent need to urinate
  • Urinating more often than usual
  • Fever and chills if an infection is present
  • Urinating small amounts
• Types of stones
  • Calcium
    • Oxalate (most common)
    • Phosphate
  • Uric Acid (from gout or uncontrolled diabetes)
  • Struvite (from infection, like UTI)
  • Cystine
• Risk factors
  • Medications
    • protease inhibitors
    • antibiotics
    • some diuretics
    • seizure meds
  • IBD (crohn's, ulcerative colitis)
  • Gastric Bypass
  • Hyperparathyroidism
  • Renal Tubular Acidosis
• Treatment
  • Small stones - increased fluids, pain relievers, meds
  • large stones - sound waves, surgery, scope, parathyroid surgery
• Dietary interventions for prevention
  • General recommendations
    • Increase water intake (and decrease sugar-sweetened beverages and alcohol)
    • Follow DASH diet (increased fruits, veggies, legumes)
    • Use caution with weight loss (high protein diet, laxatives, loss of lean body mass, dehydration could increase risk of stones)
  • Calcium Oxalate stones
    • Decrease sodium
    • Get enough calcium from foods
    • Limit animal protein intake
    • Avoid vitamin C supplements
    • Decrease high-oxalate foods (spinach, beets, swiss chard, nuts, peanuts, soy foods, sesame seeds, wheat bran, chocolate)
      • Eating high-oxalate foods with a calcium source can help
  • Calcium Phosphate stones
    • Decrease sodium
    • Get enough calcium from foods
    • Limit animal protein
    • Limit phosphorus additives (preservatives)
      • fast food, ready-to-eat foods, canned and bottled drinks, processed foods
    • Cranberry juice to lower pH of urine
  • Uric Acid stones
    • Limit animal protein
  • Cystine stones
    • Increase water intake