Dear Alice,

I have had twelve kidney stones in the past five years. Every time I pass a stone the doctor tells me to follow a special diet. I follow the diet and still get kidney stones. Do you have any suggestions? Thank you.

In pain

Dear In pain,

Kidney stones (a.k.a. renal lithiasis) can be very painful, as you well know. They develop when deposits of minerals and acid salts (calcium, oxalate, urate, cystine, xanthine, and phosphate) on the surfaces of the kidneys stick together and solidify, forming a stone that can be as small as a grain of sand or as large as a golf ball. While simple lifestyle changes and medicines may help prevent kidney stones from forming, it's a good idea to determine, with the help of a health care provider, why you repeatedly develop kidney stones.

Approximately one out of ten people develop kidney stones and typically experience the following symptoms:

  • Blood in urine (appears pink-ish in color)
  • Pain on both sides of lower back
  • Fever
  • Chills
  • Urine that smells bad
  • Stomach ache that doesn't go away
  • Nausea/vomiting

List adapted from the National Kidney Foundation.

In addition, people who have had kidney stones in the past are 50 percent more likely to develop more kidney stones within ten years. Additional risk factors include:

  • Not drinking enough fluids, like water
  • Family history
  • Being male
  • Consuming a high-protein, high-sugar, high-sodium, low-fiber diet
  • Being immobile for an extended period of time (i.e., being bed-ridden)
  • Taking some medications
  • Having chronic diseases such as high blood pressure, diabetes, obesity, osteoporosis, kidney cysts
  • Other medical conditions including renal tubular acidosis, cystinuria, hyperparathyroidism, certain medications and some urinary tract infections

List adapted from Mayo Clinic.

To help prevent kidney stones from forming, you may want to consider the following dietary suggestions:

  • Drink about 14 cups (yep) of fluids per day — at least half of it is recommended to be water.
  • Drink lemonade made with real lemons, as the citrate in the lemons help prevent stones from forming.
  • Reduce daily salt intake to less than 1,500 mg per day.
  • Reduce intake of animal protein to no more than two servings of six to eight ounces each.
  • If you form calcium oxalate stones, reduce intake of foods that are high in oxalates (i.e., beets, rhubarb, collards, okra, sweet potato, spinach, almonds, star fruit, products containing soy, chocolate, tea, scallops, anchovies).

List adapted from Mayo Clinic.

Keep in mind that although most kidney stones are composed of calcium oxalate, cutting out calcium from your diet is usually not recommended, unless your intestine absorbs too much dietary calcium. A health care provider can help you determine whether this is the case.

If you have tried following your health care provider's recommended diet and this still has not helped, there may be an underlying cause, such as a chemical imbalance, at work. You may want to consider discussing this issue with the same (or different) provider.  For additional information on kidney stones, check out the websites for the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) and the National Kidney Foundation

Kidney stones may be painful, but remember that relief may be just a stone's throw away.


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