Kidney Stones, Kidney Health

By cleaning your blood, your kidneys keep you alive. Most of the time, we pay little attention to this crucial function; the common way most people finally learn about their kidneys is by experiencing kidney stones. That’s a painful way to become aware of an important part of the body.

Nephrolithiasis: Kidney Stones

Kidney stones affect about 9 percent of Americans at some point in their lifetimes. And they occur twice as often in men than women and twice as often in people who are obese. [1]

Fortunately, most kidney stones pass out of the body on their own, but not without inflicting great pain. When a stone is large enough (usually 3 mm diameter), it causes symptoms of severe pain (called renal colic) that can be felt anywhere from the kidney area to the bladder to the urethra. Stones can be large enough to block the flow of urine and dilate the kidney’s emptying ducts. Blood in the urinalysis and a CT scan will almost always confirm the diagnosis.

I had a kidney stone once as a teenager. It lodged in a spot that created waves of nauseating pain deep in my urethral pelvic area. I was at school when it began quite suddenly. Fortunately for me, the pain subsided en route to the doctor. My mother took me to the doctor anyway. He found a substantial clot and blood in my urine. Thankfully, that was my last personal experience with kidney stones.

When Kidneys Act Up

Nobody thinks about kidney stones until their first bout of renal colic. The smart thing to do when the pain comes the first time is to get a clear diagnosis: Go to your doctor or, preferably, your local emergency room. That’s where they’ll give you effective pain control and several liters of IV fluids to help the stone pass. If you can’t seem to pass the stone even then and if it is large and near your kidney (as shown on imaging studies), you can greatly benefit from lithotripsy (using sound waves to break up the stone).

Anyone with recurring kidney stones should ask the doctor to rule out these contributory diseases: familial hypercalciuria, cystic kidney disease, hyperparathyroidism, renal tubular acidosis, cystinuria, hyperoxaluria, hyperuricosuria and gout. Also, eliminate any kind of medicine that increases calcium or other stone components in the urine.

Naturally Dissolve Small Kidney Stones

If you are suffering kidney stone pain and want a natural way to pass the stone, consider the power of naturally diuretic teas. There are many teas to choose from that have been reported (though not in peer-reviewed scientific literature) to help wash out or “dissolve” a kidney stone safely at home. They include dandelion root, burdock root, uva ursi, stinging nettle, marshmallow root, parsley, poplar, birch, mint, bearberry and buchu teas. (There are others; this is not a complete list.)

There are also some alkaline-forming foods that can help. These include fresh lemonade, lime-aid and even orange juice. These all contain significant levels of citric acid (drink often throughout the day). Apple cider vinegar has a similar benefit (2 tablespoons per cup of water twice daily).

Stone Prevention

Nobody forgets the intense pain of passing a kidney stone, and most people eventually recognize the importance of dietary and other risk factors.

Dietary risk factors include not drinking enough liquid (allowing minerals to precipitate too easily), high animal protein intake [2] (increases urinary calcium excretion), and high intake of other foods such as table salt, [3] refined sugar [4] and phosphorus [5] (high in animal meat and dairy). Foods high in phosphorus are listed here along with low-phosphorus alternatives.

If you consider that 80 percent of kidney stones are composed of calcium oxalate and the remaining are uric acid, struvite or, less commonly, calcium phosphate stones, you might think that restriction of foods high in oxalates (like leaf vegetables, rhubarb, soy products and chocolate) would help you lower stone formation. However, recent research has shown that the intake of protein, calcium and water has a bigger influence on the formation of these stones more than intake of oxalate. And foods like black tea with high oxalate content have displayed a preventive effect.

Calcium supplementation, paradoxically, can also help. And supplementation (not restriction) is associated with a lower rate of kidney stones. Previous findings from the Nurses’ Health Study mistakenly suggested supplemental calcium intake increased the risk for kidney stone formation by about 17 percent. [6] That finding has been re-evaluated, and it is now felt that there is no risk for stone formation from calcium supplementation. [7] Additionally, a study reported this year examining 5,270 stones from patients showed the risk of kidney stones is about 20 percent to 25 percent lower in patients who consumed greater amounts of dietary calcium from dairy and non-dairy sources. [8]

The bottom-line, best dietary recommendation for those subject to calcium oxalate stone formation is to restrict animal protein and salt, take in adequate calcium (1,000-1,200mg daily) and increase the intake of alkalizing vegetables counteract the acid load produced from animal protein. [9]Also, increase citrus fruits: lemonade, lime-aid and orange juice.

For uric acid stones, you need to alkalinize the urine with an over-the-counter supplement such as sodium bicarbonate, potassium citrate, magnesium citrate or bicitra (citric acid monohydrate plus sodium citrate dehydrate). Or consider getting a prescription from your doctor for acetazolamide (Diamox), which is pretty safe. If you can get a pH test strip (with color coding) from your doctor, aim for a morning urine pH of 6.5. If you go above a pH of 7, you increase your risk of calcium phosphate stones.

Allopurinol is another one to keep in mind; it effectively lowers urinary uric acid, and therefore, lowers uric acid stone formation. Have your doctor keep your serum uric acid level below 6 mg/100 ml. There are also medications that help prevent kidney stones by lowering urinary calcium excretion. These include the thiazide diuretics such as hydrochlorothiazide (HCTZ), chlorthalidone or indapamide.

In my next article I’ll discuss kidney health and kidney cleansing.

To feeling good for life,
Michael Cutler, M.D.
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