How to Prevent Kidney Stones

It is said that men can never understand the extreme amount of pain a woman suffers while giving birth but it is also said that if a man has ever passed a kidney stone he can relate.  As someone who has passed kidney stone I could not possibly imagine pain more severe than what I experienced.

One of the most common techniques of drug addicts is to fake a kidney stone in the emergency room because they know that medicine views this as the most painful experience a human being can encounter so highly addictive opioid pain meds are usually dispensed to reduce pain.

I battled a kidney stone after eating large amounts of kale and probably too many raw nuts over a 3-month period which I’ll get into later as to why this set me up for the torture I never expected. Let’s begin discussing how to prevent kidney stones naturally.

What are kidney stones?

Kidney stones develop when different types of crystals accumulate in the kidney or ureter.  The most common types of stones contain calcium usually calcium oxalate which is the most common form.  Calcium phosphate stones are much less common.  Calcium oxalate stones have been shown to come back 10 percent of the time within the first year of passing a stone and 35 percent of the time within five years.

Other forms of kidney stones include those made from uric acid, cystine and xanthine.  Struvite stones are made of magnesium, ammonium and phosphate due to a chronic urinary tract infection from bacteria usually in the Klebsiella or Proteus family.

The following table shows the incidence of different types of kidney stones in adults and children: (American Family Physician December 1, 2011 Volume 84, Number 11)

Who is most at risk for kidney stones?

Kidney stones mainly occur between the ages of 20 to 40 with a male to female ratio of 3:2.  Recent reports however are showing that the male to female ratio is getting closer together with more and more females getting stones.

Why are more and more children getting kidney stones?

The increase in kidney stones among children parallels the increase in child obesity, diabetes and high blood pressure.  Our kids are eating more and more junk food and sugar which is a recipe for acidosis which leads to kidney stone formation.  As mentioned above, insulin resistance, obesity and weight gain increase the risk of kidney stones so it makes sense that more and more kids will develop stones.

What about pregnant women?

Calcium phosphate stones are the biggest concern in pregnancy.  Pregnant women are twice as likely to develop a calcium oxalate stone and are 2-3 times more likely to have a calcium phosphate stone than a calcium oxalate stone.  Calcium phosphate stone formation is higher in the second and third trimesters due to an increase in calcium excretion and a more alkaline urine.

What are the most common causes of kidney stones?

• Dehydration
• Insulin resistance
• Geographic location such as dry, arid climates
• Abnormally shaped kidneys
• Certain medications (antibiotics, protease inhibitors, diuretics)
• Urease-producing bacteria such as Klebsiella and Proteus
• Gout
• Cystinuria
• Oxaluria
• Obesity (the more bodyfat you have the more likely you are to get a kidney stone)
• Laxative abuse
• Rapid loss of muscle mass due to extreme dieting
• Inflammatory bowel disease
• Diabetes mellitus
• Recent changes in weight either gain or loss
• Metabolic syndrome
• Hyperparathyroidism (too much calcium is released from the bone)
• Frequent urinary tract infections
• Chronic kidney disease

How are kidney stones diagnosed?

A urine test is usually the first step to identify blood in the urine.  A culture is performed if bacteria are found in the urine to identify the type of bacteria which may be involved in struvite stones.  A plain x-ray of the kidneys, ureter and bladder can often show the location and size of the stone.  Uric acid stones and stones due to protease inhibitor drugs may not show up however on an x-ray.

An ultrasound or CT scan (CAT scan) is highly effective at identifying all types of kidney stones.

A 24-hour urine can be used to measure all of the different compounds involved in kidney stone formation such as calcium, magnesium, phosphorous, oxalate and uric acid.

What are the symptoms of kidney stones?

• Most people initially feel pain and cramping in the abdomen and flanks
• Fever
• Chills
• Pain in the area of the kidneys from the lower ribs to the pelvis
• Lower back pain
• Radiating pain to the groin and genitals (scrotum and labia)
• Nausea
• Vomiting
• Diarrhea
• Blood in the urine

What is the best diet to prevent kidney stones?

This depends on the type of kidney stone you are trying to prevent so we will begin with prevention of calcium oxalate, uric acid and cystine stones which form in an acidic urine.

The first thing to do is always stay well hydrated so you are constantly flushing crystals out of the kidney.  But don’t overdo it because too much water can eliminate important electrolytes from your system.  The old eight 8-ounce glasses a day is usually sufficient for most people.  Another option is to divide your body weight by two and drink that amount in ounces of water every day. Alkaline mineral waters can be beneficial because of their mineral content and alkalizing effect on the kidney.

A diet that is rich in the alkaline-forming minerals magnesium and potassium is most beneficial because it keeps your urine more alkaline.  An alkaline-forming diet is mainly fruits and vegetables composing 60-80% of your food intake.  Sugar rapidly depletes these minerals and makes the urine more acidic which is the opposite of what you want to prevent kidney stones.

The way that you can tell if your urine pH is in a healthy range is to measure your first morning urinary pH with Hydrion pH paper.  Ideal first morning urinary pH to prevent kidney stones is 6.5-7.0.

A diet that is acid-forming will increase the amount of calcium in your urine possibly leading to calcium oxalate stone formation.  Acid-forming foods include meat, grains, dairy and legumes. Additionally, too much processed salt (sodium chloride) added to food or salty foods will increase calcium levels in the urine so be sure to use unrefined Celtic sea salt.

Adding foods or liquids that contain citrate prevents the formation of kidney stones.  The best way to do this is drink water with a half a lemon or lime squeezed into water once a day.  These citrus juices contain large amounts of citrate.

A diet that is too high in protein can contribute to kidney stones so make sure you are eating the right balance.  Your daily minimum intake should be at least .8 grams of protein per kilogram body weight.  If you are protein deficient or exercise moderately then your intake is 1.0-1.2 grams per kilogram body weight.  If you are an athlete then 1.5 grams per kilogram body weight is a safe upper limit.  As long as 30% or less of your daily calories comes from protein then you will not be eating too much protein.

If you have had a calcium phosphate stone or struvite stone then your strategy is the opposite in that you want your urine to be more acidic because these types of stones form in a more alkaline urine.  Cranberry juice and the supplement betaine can help make your urine more acidic.

If you are developing kidney stones because of insulin resistance then your goal should be to increase muscle mass and reduce body fat.  Insulin resistance is fed by sugar and processed carbohydrates that spike your blood sugar too much.

Fructose found in fruit juices however can increase your risk of kidney stone formation by 38% because fructose increases calcium levels in the urine.  Fructose also raises uric acid levels and has been linked to gout.

What about oxalates?

Oxalates are found in mostly plant-based foods and contribute to the formation of calcium oxalate stones.  The reality of oxalates is that there must be either an extreme amount of oxalates in the diet or a genetic mutation that prevents proper metabolism of oxalates.

If you have had a calcium oxalate stone before then it is worth reviewing foods that are high in oxalates and making sure you are not eating a lot of them.

As mentioned above, I developed a small calcium oxalate stone after eating large amounts of kale which has one of the highest oxalate contents of any food in the world.  Additionally, I was eating too many raw nuts which are also extremely high in oxalates so the combination was just too much for my body to process.

You can read more about a low oxalate diet by clicking here.

Are there any supplements that help to prevent kidney stones?

Magnesium, potassium and calcium all in the citrate form will have the greatest impact however magnesium glycinate and potassium bicarbonate will also be extremely beneficial because they alkalize the urine.  Men should not supplement with calcium for reasons that I point out in this article so just use magnesium and potassium.

Too little or too much vitamin D supplementation can lead to kidney stones because of the effect on calcium absorption and excretion.  1,000IU/day is an excellent general dose for most people. Make sure to get your vitamin D levels checked so that they are at least 30 ng/mL.

Excessive vitamin C supplementation for long periods of time may increase your risk of kidney stone formation.  If you are at risk then try not to exceed 1,000mg a day of vitamin C supplementation.  If you get your vitamin C from foods then you don’t have to worry about an increased risk of stone formation because foods rich in vitamin C are alkaline-forming and also contain citrates which prevent stones.

Green tea, berries and turmeric can help reduce your risk of infection associated with kidney stones.  Parsley and vitamin B6 help to promote urination which will help to regularly flush the kidney.

What should you do if you are battling a kidney stone?

Most kidney stones pass within a few days to several weeks however emergency medical treatment is always recommended.  Some stones must be monitored for 4-6 weeks to prevent serious damage to the body and even death.

Stones that are less than 5mm in diameter will spontaneously pass 90% of the time.  Stones ranging from 5mm to 10mm will spontaneously pass only 50% of the time.

It is recommended that you see a urologist if you have more than one stone, have a stone greater than 5mm, or if your symptoms are getting worse with accompanied fever, difficulty urinating or if passing the stone has become extremely difficult.  Urologist use ureteroscopy to remove stones and look for damage to the kidney.

Your doctor may prescribe antispasmodic medications if the kidney stone is greater than 10mm to help passage of the stone.  Antibiotics will most likely be prescribed if an infection is present in the urine.

Begin drinking large amounts of water and adding lemon or lime juice to the water can help break them down and pass the stone.  There are a variety of methods on the internet including drinking large amounts of Coke and downing pureed asparagus but these have not been shown to be effective.

Supplementing with extra magnesium and vitamin B6 can help increase urination to help flush the stone.  Again, the best approach is to seek medical care to be properly evaluated and to prevent anything more serious from happening.

Are there any functional medicine tests that should be done to find the underlying causes of kidney stones?

I approach all conditions trying to find the underlying causes of a health problem rather than just treat symptoms and kidney stones are no exception.  Kidney stones are a symptom of something else in the body that has become imbalanced.  I always do a thorough analysis of a patient’s diet, hormones, digestive system function, immune system, vitamins, minerals etc. so we can identify any potential imbalances that may be contributing to the kidney stones.  Anything that creates more inflammation, acidosis, electrolyte imbalances, hormone imbalances, improper digestive function etc. needs to be thoroughly evaluated and addressed.

Kidney stones just aren’t fun but with these strategies you can prevent them from forming and save yourself from a painful nightmare.