Articles on kidney stone

Prevention Of Kidney Stones

Dr. Rajeev Bashetty, Urologist
Kidney stones are known to the mankind since antiquity. Lot of innovations have been done in treating the kidney stones, but there is a very little knowledge regarding the stone formation and how it can be prevented. Daily water intake is one of the important factors in the prevention of kidney stones. Diet is another factor that can promote or inhibit kidney stone formation. Others include environment, body weight and heredity.The dietary advice will be based on the type of kidney stones, which will be recommended by the Urologist. These recommendations mentioned below are general and for the most commonest kidney stone formers.FluidsWater is  inexpensive & easily available. The amount of water a person needs to drink depends on the weather and the person’s activity level. People who have had a kidney stone should drink enough water and other fluids to produce at least 2 litres of urine a day. This can be achieved by drinking about 3-4 litres of water every day. The amount should be consumed on periodic basis about a glass or two every hour. People who work in hot weather need more fluid to replenish fluid they lose through sweat. Drinking enough water helps to keep urine diluted and flushes away materials that might form stones and is the most important thing a person can do to prevent kidney stones. Soft water intake is recommended. Hard water should be boiled and cooled before consumption. Citrus drinks like lemon and orange juice protect against stone formation because they contain citrate, which inhibits stone formation.Fluid like grapefruit juice, colas, beer, wine, coffee, tea should be avoided in excess as they contain substances, which helps in the stone formation. DietThere is a misconception that eating Palak and Tomatoes should be avoided to prevent stone formation. Yes, this is true provided a person consumes them daily in large quantities. Eating palak once in a while or adding tomatoes to the daily food preparation doesn’t really harm or increases the risk of stone formation. Another misconception is to avoid drinking milk as it contains calcium. In fact milk will help in reducing the stone formation. Calcium in the stomach binds to oxalate from food and keeps it from entering the blood, and then to the Urinary Tract, where it can form stones. People who are taking supplementary calcium to maintain the bone density should take the calcium tablets along with the food.Sodium, often from salt, causes the kidneys to excrete more calcium into the urine. High concentrations of calcium in the urine combine with oxalate and phosphorus to form stones. Reducing sodium intake is preferred to reducing calcium intake.The consumption of Meat, fish and egg should be reduced as they contain purines, which break down into uric acid in the urine resulting in uric acid stones.Eating excessive chocolates and nuts like cashew should be avoided as they contain oxalate.Once a person forms a stone, his chances of forming another stone is very high. If the above recommendations are followed, there will be definite reduction in the recurrence. Most of the small stones pass spontaneously, but the larger stone may require treatment. If the stones are not treated at right time, they can cause irreversible damage to the kidney.

Understanding Kidney Stone Analysis

Dr. Anish Kumar Gupta, Andrologist
Did you recently get your kidney stone removed ?Kidney stones come in many different types and colors. How you treat them and stop new stones from forming depends on what type of stone you have.  Get the stone analysis done to know the type of stone you are having. And, then go back to your doctor to ask for more detailed advise to prevent the same.There are 4 main stone types, discussed below.Calcium stones (80 %)Most common type of kidney stones. They can be calcium oxalate and calcium phosphate. Calcium oxalate is by far the most common type of calcium stone Some people have too much calcium in their urine, raising their risk of calcium stones Even with normal amounts of calcium in the urine, calcium stones may form for other reasons Uric acid stones (5–10 %)Uric acid is a waste product that comes from chemical changes in the body.Uric acid crystals do not dissolve well in acidic urine and instead will form a uric acid stone. Having acidic urine may come fromObesityChronic diarrhoeaType 2 diabetesGoutA diet that is high in animal protein and low in fruits and vegetablesStruvite/infection stones (10 %)Uncommon type of stones. Related to chronic urinary tract infections (UTIs). Some bacteria make the urine less acidic and more basic or alkaline Magnesium ammonium phosphate (struvite) stones form in alkaline urine.These stones are often large, with branches, and they often grow very fast.People who get chronic UTIs, such as those with long-term tubes in their kidneys or bladders, or people with poor bladder emptying due to neurologic disorders are at the highest risk for developing these stones Cystine stones (<1 %)Cystine is an amino acid that is in certain foods; It is a building block of protein  Cystinuria (too much cystine in the urine) is a rare, inherited metabolic disorder. It is when the kidneys do not reabsorb cystine from the urine When high amounts of cystine are in the urine, it causes stones to form Cystine stones often start to form in childhood Stone analysis is only one part of understanding why stones form. For a detailed advise for prevention the patient will also need to undergo urine and blood tests to help decide the need for any specific advise for the same.Ask your Urologist about it in in your next visit.

Kidney Stones: Ideal Diet For Cure

Dr. Anish Kumar Gupta, Andrologist
A high incidence of Kidney stone disease, is seen these days with reports suggesting a prevalence of 1 in 7 people suffering from it.Q: What is single most Important aspect of diet to reduce chance of stonesA: Drinking enough fluid is the most important aspect. As a rough guide one should try to keep urine colourless throughout the day; this equals to a urine output of at least 2 litres per day. All extra loss by sweating must be replaced.Q: What can be taken to drink?A: Water is the best drink. Herbal tea is okay but Caffeinated tea, coffee should be consumed only in moderation Cola drinks and alcoholic beverages are not suitable.Q: Is there a specific dietary advise you give to your patients ?A: A well-balanced diet without excessive amount of calories. A high fibre diet is also important, Most important is a diet low in salt. Avoid high-salt, tinned, packet and processed foods (e.g. soups, salted chips, pickles and papad.Q: Can stone formers eat dairy products and other protein?A: Yes, but intake of protein should be restricted. A high intake of animal protein appears to increase the risk of stone formation. Q: I’ve heard that calcium is a bad thing to have in the diet if you have kidney stones. Is this true?A: Kidney stones usually contain calcium. Traditionally it was thought that it was beneficial to restrict calcium, but it has now been shown better to have a moderate or even slightly higher calcium intake. The reason for this is that calcium binds oxalate in the gut and prevents it being absorbed. A daily intake of up to 1000mg per day is recommended for calcium stone formers. It might be important to reduce the calcium in your diet, in certain specific conditions.Calcium is found in dairy products such as milk, curd, cream and cheese. A normal, varied diet will give the average person about 500mg of calcium before adding in any dairy products. Milk and curd contain about 120mg per 100cc.Q: An age old adage is “Avoid green vegetables, tomatoes and nuts”. Is this true?A: These are oxalate rich food products. It is not necessary to exclude oxalate-rich foods completely; simply eat them in small amounts. Other foods high in oxalate are: Beetroot, Strawberries, Black Tea, Chocolate.Q: Are there any other tests that can be done to investigate why stones form?A: Yes. In all patients who have had a kidney stone blood tests are done to check the kidney function and also ensure that the levels of uric acid or calcium in the blood are not too high. In high risk stone formers, or those who have had recurrent stones, then collection of two 24hr urine specimens for analysis is important. Your doctor can tell you more about this.

Renal Stone

Dr. Amar Deep, Homeopath
People can help prevent kidney stones by making changes in fluid intake and, depending on the type of kidney stone, changes in consumption of sodium, animal protein, calcium, and oxalate.Drinking enough fluids each day is the best way to help prevent most types of kidney stones. Health care providers recommend that a person drink 2 to 3 liters of fluid a day. People with cystine stones may need to drink even more. Though water is best, other fluids may also help prevent kidney stones, such as citrus drinks.Recommendations based on the specific type of kidney stone include the following:Calcium Oxalate Stonesreducing sodiumreducing animal protein, such as meat, eggs, and fishgetting enough calcium from food or taking calcium supplements with foodavoiding foods high in oxalate, such as spinach, rhubarb, nuts, and wheat branCalcium Phosphate Stonesreducing sodiumreducing animal proteingetting enough calcium from food or taking calcium supplements with foodUric Acid Stoneslimiting animal proteinTreatments:1. Apple cider vinegar helps dissolve kidney stones. It also has an alkalinizing effect on blood and urine.a. Mix two tablespoons of organic apple cider vinegar and one teaspoon of honey in one cup of warm water.b. Drink this a few times a day.2. PomegranateBoth the seeds and juice of pomegranates have astringent properties that can help in the treatment of kidney stones.Try to eat one whole pomegranate or drink one glass of freshly squeezed pomegranate juice daily. You can mix pomegranate in a fruit salad also.Another option is to grind one tablespoon of pomegranate seeds into a fine paste. Eat this paste along with a cup of horse gram soup once daily. This remedy will help dissolve the stones. You can find horse gram in Indian markets.Homeopathic medicines for renal stone:Acid Benz, Apis mel,Belladonna,Berberis vulgaris,Canthris,Sangunaria,Nitric acid,Mag phos, Medorrhinum,Nux vom are some of the Homeopathic medicines used in such condition.Some people have the tendency to reform the renal stone even after laproscopy surgery and hence they should take Homeopathic medicines to prevent as well as cure the renal stone.However you need a proper guidance for the same and follow the Doctor's advise given time to time.In case of energency even you could have to be admitted in Hospital.Do not ignore this simple yet complicated disease if you know you are having it.Also that you do not go by the products available in market for renal stone.All the best.

Carbonated Beverages May Be Hurting Your Kidneys

Ms. Swati Kapoor, Dietitian/Nutritionist
Carbonated sugar based drinks are amongst the unhealthiest beverages you can consume. Even the diet versions of these beverages are loaded with chemicals that adversely affect various organs. Studies highlight the potential negative effects that soft drinks and sugar can have on kidney health. Doctors have done studies and found that diet soda too can actually cause kidney failure and permanent kidney damage.Effect of Soda on Kidney In one study, researchers found that consuming at least two carbonated beverages per day is linked with proteinuria - or increased excretion of protein in the urine, which is a hallmark of kidney dysfunction. Drinking soda or other carbonated beverages each day may lead to hypertension and diabetes, which can cause kidney failure, reduced kidney function and kidney stones. Be it a cola, non-cola, diet soda or any other sugar-sweetened carbonated beverage, these beverages can increase your risk of serious health issues. Another study conducted in rats found that moderate fructose intake increases the kidney’s sensitivity to a protein (angiotensin II). Since kidneys regulate salt balance, this leads to increased salt re-absorption by cells in the kidneys.Major ingredients responsible for negative effects on the kidney• Soda contains high levels of phosphoric acid. Phosphoric acid gives food a tangy taste and beverages the acidic taste we’ve come to associate sodas with. Phosphoric acid is closely linked with the development of kidney stones and other renal problems and strains the kidneys. The consumption of this acid on regular basis can lead to impairment in kidney function. • One reason doctors believe this occurs is because diet sodas contains high levels of sodium. • It is also believed that the artificial sweeteners that are used in all diet sodas are to blame for kidney damage too.Options to replace soda:• Consider drinking more water and less soda. • Lemonade (non-carbonated) is healthier and an easily available option to replace soda. • Buttermilk is a good replacement to soda. • Fruit juice (without added sugar) is also a refreshing beverage to accompany your meal. • Coconut water is a light and refreshing beverage.Soda is not evil, but regular soda drinkers seem to have a lot of health problems which is now even supported by various studies, so sodas are best avoided.

Don't Expose Your Kidney to Acute Renal Failure (ARF)

Dr. Neeraj Gupta, Homeopath
Acute renal failure is a clinical syndrome in which there is rapid reduction of the excretory functions of the kidney. If immediate action is taken derangement caused due to renal failure can be reversed. CausesReduced circulatory blood volume – hemorrhage, dehydration and severe decrease in protein levels in bloodCardiac failure.Acute gastroenteritisIn shock due to septicemia or anaphylaxisThrombosis / embolism in renal arteries or aortic dissections.Accelerated hypertension.Blood poisoning during pregnancy - from toxins formed by bacteria growing in local area of infection.Disseminated intravascular coagulation.Glomerulonephritis.Acute tubular nephritis.Certain drugs which are toxic to the kidney e.g. aminoglycosides, lithium etc.Mismatched blood transfusion.Virulent malaria.Blockage of one ureter when other kidney is absent or non-functioning, usually due to calculi. Neurogenic bladder.Blockage of the urinary bladder neck, urethral stricture. Signs and symptomsScanty Urination. The urinary out put may be as little as 20 - 200 ml per day. High blood pressure or low blood pressure. Potassium excretion is diminished.Serum phosphate and sulphate levels are increased and sodium, calcium and base bicarbonate levels are decreased. Symptoms of acidosis (a condition in which the acidity of body fluids and tissues is abnormally high)Vomiting. Increased rate of breathingMental impairment.Hypertension (high blood pressure). Waste products of protein metabolism get accumulated in blood. Serum urea, nitrogen and creatinine levels are increased. Symptoms of uremia (presence of excessive amounts of urea and other nitrogenous waste compounds in the blood) Lack of appetite.Nausea and vomiting. Gastrointestinal bleeding.Anemia.Lethargy. Confusion and stupor. Inflammation of the pericardium with hemorrhagic effusion and cardiac tamponade. Dietary managementDietary changes are made to correct the fluid and electrolyte imbalance and to maintain proper nutritional status so as to minimize protein catabolism and uraemia. But these dietary changes should be done under guidance of a professional dietitian. AvoidAvoid potassium rich food, as in renal failure potassium excretion is decreased, hence serum potassium level are high which can have deleterious effects on heart, like banana. Foods rich in potassium and to be avoided are restrict potassium intake to 1,000 mg per day.Minimize or avoid protein – (0.5-0.6 gm per kg body weight) if you are not on dialysis and blood urea and nitrogen is increasing. Avoid high sodium diet – Restrict Sodium intake to 500-1,000 mg per day. Avoid phosphorus in diet, in renal disease phosphorus levels increase, which cause blood calcium levels to decrease and can lead to bone loss. avoid prolonged suffer of renal calculi & urinary infection Note:  Avoid  recurrent use gentamicin  and amikacin What can you consume?Fluid intake is regulated on basis of urinary out put, other water loss from vomiting or diarrhea. Total fluid intake should not exceed – 500 ml + previous day`s urine out put + total water loss from vomiting or diarrhea or any other causes. You should consume a minimum of 600-1,000 kcal. Generally 35-50 kilocalories per kg body weight should be consumed to maintain positive nitrogen balance.Have high calorie diet. Increase intakes of fats and carbohydrates. Reduce intake of proteins – (40 gm per day / 1.0-1.5 gm per kg body weight) if you are on dialysis or hemodialysis.Consume at least 100 gms of carbohydrate per day, it minimizes tissue protein breakdown. If on nasogastric tube feeding administer 700 ml of 15 % glucose. Sodium intake is based on measurements of sodium ions in serum and urineIf are not on dialysis you should restrict sodium intake. Restrict sodium intake to 500-1,000 mg per day.If you are on dialysis sodium can be consumed in accordance with the serum levels of sodium ion. In the recovery phase, urine out put is increased and a return of the ability to eliminate wastes. Gradually can increase intake of protein, potassium, phosphorus and sodium. Fluid and electrolyte balance should be monitored and dietary changes should be done accordingly. It will take at least six months to come back to normal routine diet.During kidney disease body`s need for certain vitamins and minerals changes. Normally in healthy condition we get adequate amount of vitamins and minerals form our regular diet, but as in kidney disease diet limits certain food groups, hence one needs to take certain vitamin and mineral supplements. Take these supplements under the guidance of your physician. Vitamin C supplements, helps to increase immunity and combat the infection.Vitamin B complex, certain B vitamins like B6, B12 and folic acid along with iron and EPO (erythropoietin, given in renal failure to avoid anemia) and iron prevents anemia. Other B vitamins like – thiamine, riboflavin, pentothenic acid and niacin helps to convert food into energy. Iron supplements can be taken, but consult your physician. You can also take calcium supplements; it binds the phosphorus from food and serves to provide extra calcium that your body needs. Along with calcium you can take vitamin D supplements, helps to keep bones healthy.Consume 2 table spoon of fresh flax seed oil, reduces / slows the process of further renal damage. Consult physicianConsult physician immediately if any of the above sign and symptoms appear, as timely treatment and management can reverse the changes and prevent any further damage of the kidney. Diet and water intake should be under strict medical guidance.You can safeguard your kidney by avoiding prolonged use of antibiotics. Do not practice self-medication especially for children. Use drugs only according to the instruction of your physician. 

Is Belly Fat Linked to Kidney Diseases?

Ms. Swati Kapoor, Dietitian/Nutritionist
Have you ever thought whether the processed foods you are eating are causing adverse health effects? Processed foods that are laden with phosphorus might increase the risk for kidney diseases.Researchers from Johns Hopkins claim that, “reducing your waist circumference and cutting down on dietary phosphorus has been linked to lower levels of protein in the urine (albuminuria). The presence of this protein in urine is one of the first indicators of kidney disease.” The study found that every one-unit increase in waist-to-hip ratio was linked to a loss of blood flow through the kidney's tiniest filters, the glomeruli, of about 4 milli litres per minute.Kidneys are the major excretory organs in our body. They are also known as the guardians of our body’s nutritional wealth. Phosphate is widely distributed in all the cells and body fluids, and plays a vital role in enzyme reactions and tissue metabolism. The metabolism of phosphate and calcium is closely linked, and these minerals usually occur together in food. The serum level of phosphorus increases in kidney failure.As dietary phosphorus is readily absorbed by the small intestine, any excess phosphorus absorbed is excreted by the kidneys. The regulation of blood calcium and phosphorus levels is interrelated through the actions of parathyroid hormone and Vitamin D.Some investigators are concerned about the increasing amounts of phosphates in our diet which can be attributed to phosphoric acid in soft drinks and phosphate additives in a number of processed foods. Serum phosphorus increases with a high phosphorus diet. High phosphate levels in the blood reduce the formation of the active form of Vitamin D (Calcitriol) in the kidneys, hence reducing the blood calcium. This further increases PTH released by the parathyroid glands and also decreases the urinary calcium excretion. Parathyroid hormone decreases tubular reabsorption of phosphate in the kidney, leading to increased excretion of phosphates.Processed foods high in phosphorus increase acidity in blood which triggers the release of stress hormones and these stress hormones increase insulin in the body. Increased level of sugar in the blood gets converted to fat and hence gets stored in the adipose tissues throughout the body. Apple-shaped people are at more risk of getting this disease than pear-shaped people.Hence, limiting the intake of processed food may help prevent risks of kidney diseases.