Understanding Kidney Stones: Overview and Dietary Guidelines for Prevention and Management

What is a Kidney Stone?

A kidney stone is a solid piece of material that passes through the urinary tract and into the kidney from the ureter. It is formed from uric acid, a waste product that is normally discharged along with urine. The most common type of kidney stones results from an excess of calcium and oxalate in the urine. These minerals bind together as crystals, forming stones. Kidney stones treatment often begins with understanding the cause.

What Causes Kidney Stones?

Kidney stones can be caused by an excess of uric acid in your body or an imbalance of minerals such as calcium and oxalate. Additionally, having a diet high in fat and cholesterol can increase uric acid in the body over time. However, it's important to note that not all kidney stones are the same. Dietary management of renal calculi plays a crucial role in both prevention and treatment.

What is the Size of a Kidney Stone?

The average size of a kidney stone is about 5 mm in length. Kidney stones measuring less than 4 mm can be easily dissolved and will pass out on their own without the need for any medications. Those between 4 mm and 6 mm will only have about a 60% chance of passing on their own. Stones larger than 6 mm will likely require the intervention of a tubst.

What are the Chances of Kidney Stone Recurrence?

The chances of recurrence are 7% per year, meaning that the likelihood of reforming the stone is 35% at the end of 5 years and more than 50% at the end of 10 years. The treatment of urolithiasis involves not only the surgical or endoscopic removal of the stone but also the prevention of

further stone formation. Renal calculi dietary management is a critical aspect of this, as lifestyle changes and dietary modifications can significantly reduce the chances of recurrence.

Are all Kidney Stones the Same?

Not all kidney stones are the same; there are two distinct types: calcium-rich and uric acid-rich stones, known as calcium oxalate stones and uric acid stones, respectively.

Calcium oxalate stones

Constituting approximately 80% of all kidney stones, calcium oxalate stones are often attributed to dehydration. Additionally, a diet high in protein, oxalate, salt, and sugar can elevate the risk of developing calcium oxalate kidney stones. Certain underlying medical conditions, such as hyperparathyroidism or inflammatory bowel disease, may also contribute to the formation of calcium oxalate stones in the kidney.

Uric acid stones

Accounting for about 15% of all kidney stones, uric acid stones are primarily caused by excessive uric acid production. Inadequate intake of potassium and magnesium can also contribute to the formation of uric acid kidney stones. Specific underlying medical conditions, such as Type 2 diabetes and obesity, further increase the risk of developing uric acid stones.

Dietary Recommendations to Prevent Kidney Stones

A recommended diet to prevent kidney stones focuses on dietary adjustments that can help reduce the risk of stone formation. Here are some key principles for a kidney stone prevention diet:

General recommendations

Avoiding vitamin C supplements: High doses of vitamin C supplements can lead to calcium oxalate kidney stones due to the presence of oxalates. Studies suggest a potential risk even for individuals not prone to kidney stones, as oxalate is a by-product of vitamin C breakdown.

Avoiding vitamin D supplements

Excessive intake of vitamin D, especially without adequate sunlight exposure, can contribute to kidney stone formation. Individuals with a history of kidney stones should exercise caution and avoid vitamin D supplements.

Limiting salt intake

• Salt (sodium) increases the amount of calcium in your urine, and it's crucial to restrict intake to less than 2300 mg per day.
• To reduce salt/sodium: Choose "low salt" or "no added salt" foods, aiming for sodium content below 150 mg per serving. Note that some "reduced salt" products may still contain high sodium levels.
• Avoid adding salt at the table or during cooking.

Alternatives to salt

• Freshly ground pepper, dry mustard powder.
• Lemon juice, lime juice, vinegar.
• A sprinkle of dried herbs or chopped fresh herbs.
• Garlic, curry, chilli, onion, fresh ginger, spring onions.

Limiting oxalate-rich foods

Reducing oxalate in your diet helps decrease oxalate levels in urine. Limit the intake of:

• Rhubarb, spinach, silverbeet, beetroot, eggplant, sweet potato, celery, leeks.

• Nuts, peanut paste.

• Strong black tea, orange juice, chocolate.

• Wheat bran and wheat germ.

• Berries (e.g., strawberries, blackberries), dried figs.

Ensuring adequate fluid intake

• Drink more fluid, especially water. When you do not consume the right amount of water, you may face gastric problems and constipation.

• Consume at least 3 litres or 12 cups of fluid daily, with at least half being water (soda, mineral, spring, or plain tap water).

• Have a cup of fluid (250ml) each hour during waking hours, and a large glass of water before bedtime. Drink water if you wake up during the night.

• Spread out fluid intake throughout the day.

• Avoid strong black tea and orange juice, as they are high in oxalates.

• Refrain from grapefruit juice, cranberry juice (if more than 500ml/day), and sugary drinks to prevent weight gain. Opt for diet or low-joule drinks.

Lemon juice for citrate

Lemon juice, a good source of citrate, aids in preventing stone formation. Consume 100 ml of lemon juice daily, which can be added to water.

Ensuring adequate calcium intake Dietary calcium is essential for bones and teeth. Include 2-3 daily choices from the following list:

• 250ml milk (e.g., trim, skim, full cream, calcium-fortified soy milk).

• 200ml high-calcium milk (e.g., Physical 200g yoghurt).

• 40g cheese (2 slices) or 3 scoops of ice cream.

Foods to be included or eaten in a daily diet plan

• Grains: rice, wheat, maize, bread, barley, jowar, rice flakes, puffed rice, cornflakes.

• Legumes: red gram dal, black gram dal, green gram dal, bengal gram dal, peas, soya beans.

• Fruits and vegetables: Incorporate fruits and vegetables with both low and medium potassium levels.

• Proteins: egg whites, skinless chicken, freshwater fish.

• Dairy: milk, curd, and buttermilk (limited to 200 ml/day).

• Beverages: Tea, Green tea, green tea, barley water.

• Additional items: garlic, sago, honey, and olive oil

Foods to be avoided or limited

• Grains: Include Ragi and bajra in the cereal choices.

• Legumes: Opt for sprouts, beans, and chickpeas (in small amounts, leached, and in thin dal form).

• Proteins: Avoid organ meats, egg yolks, seafood, pork, beef, ham, and bacon.

• Beverages: Choose coconut water, fruit juices, instant coffee, and vegetable soups while avoiding aerated drinks, squashes, Horlicks, Bournvita, sugar, honey, and jaggery, especially for those with diabetes.

• Additional Items: Limit the intake of dry fruits, processed and preserved foods like pickles, papad, salted butter, sauces, ketchups, chips, salted biscuits, baking powder, cooking soda, chocolates, cocoa powder, salted cheese, and noodles.

Nutritional guidelines for kidney stone patients

• Opt for small and frequent meals throughout the day.

• Enhance protein quality by preparing combinations of cereals, pulses, and milk, such as khichdi, dhal, and payasam.

• Steer clear of excessive calcium and high-dose vitamin C supplements.

• Improve flavour in cooking by using fresh herbs, whole spices, and a few drops of lemon juice as a salt substitute.

• Keep track of daily water consumption by storing the required amount in a bottle.

• Alternatively, rinse the mouth with water or suck on ice cubes to alleviate mouth dryness and excessive thirst.

• Chewing sugar-free gum (especially for diabetics) can help control thirst.

• Avoid spicy foods, as they may increase thirst.

• Steer clear of canned foods and commercial soups, as they often contain high levels of sodium, contributing to increased thirst.

Follow a daily diet Plan to Prevent Kidney Stones

To prevent the occurrence of kidney stones, it is essential to follow a good diet plan. Below is an example of a diet plan:

• For breakfast, have a bowl of porridge along with blueberries and a glass of milk.

• Lunch can include whole grain bread, a salad with low-sodium dressing, and a glass of Yoghurt Parfait.

• Dinner should consist of wild rice, asparagus, salmon, and yoghurt dill sauce.

• Incorporate foods that are rich in calcium into your diet.

• Maintain moderate amounts of protein in your diet.

What is Considered the Best Home Remedy for Kidney Stones?

To prevent kidney stones, it is essential to follow a good diet plan. Apple cider vinegar is considered a beneficial solution for dissolving kidney stones. The acetic acid present in apple cider vinegar is known to soften the stones, facilitating their passage in the urine without difficulty. If you have a history of kidney stones, it is advisable to follow a kidney stone diet as recommended by a dietician or physician to help prevent recurrence.

How can Kidney Stones be Prevented?

To prevent the formation of kidney stones, it is crucial to prioritise adequate fluid intake and avoid dehydration. Failure to regulate water intake can result in a slowed metabolism, leading to a decrease in blood acidity—the most significant risk factor for kidney stones. Additionally, adhering to a proper diet designed for kidney stone prevention will further contribute to reducing the risk of stone formation.

Conclusion

Effective dietary guidelines are crucial to prevent kidney stone formation and maintain overall well-being. Max Hospitals, dedicated to clinical excellence and personalised healthcare, offer comprehensive solutions for those aiming to avoid kidney stones. By relying on the expertise of Max Hospitals, individuals can expect personalised dietary recommendations that incorporate cutting-edge techniques and a holistic approach. This commitment ensures a compassionate, patient-centric experience focused on preventing kidney stones, promoting optimal health outcomes. Consult with Max Hospitals for tailored dietary guidance and access to the best kidney stone doctor in Delhi or elsewhere.