Urology

Kidney Stones: Straight Talk on Prevention

By on 09/03/2015

Kidney stones are hard to ignore when you have them and impossible to forget after you’ve passed one.

And the odds of this happening are pretty good—one out of every 11 Americans will have a kidney stone during their lifetime.

Justin Friedlander, MD

Justin Friedlander, MD

The cost of dealing with a kidney stone is no small burden, either.

Without preventative treatment, half of stone formers will develop a second kidney stone within 10 years of their first, and 75 percent will develop a second over a 20-year period.

The Urologic Diseases in America Project estimates that all these kidney stones cost the U.S. upwards of $2 billion a year in medical care and lost productivity, and this number appears to be increasing with the prevalence of stones.

So it makes sense—health-wise and financially—to stop kidney stones from returning.

“Many foods are blamed for kidney stones, from soda to chocolate to peanut butter. But unless your specific body chemistry puts you at risk of stones after consuming these foods, there’s really no good reason to avoid them.”

Unfortunately, many people don’t take the necessary precautions to prevent another one from forming.

Even worse, those who do something about it tend to avoid things that may NOT be triggering kidney stones, according to Dr. Justin Friedlander, director of the Comprehensive Kidney Stone Center,Einstein Healthcare Network, Philadelphia.

“Many foods are blamed for kidney stones, from soda to chocolate to peanut butter,” Friedlander says. “But unless your specific body chemistry puts you at risk of stones after consuming these foods, there’s really no good reason to avoid them.”

Friedlander suggests people are better off figuring out what’s prompting their bodies to form stones and making lifestyle changes based on this information.

In some people, kidney stones are caused by something outside their control, such as anatomic anomalies, a genetic predisposition, or abnormal urinary pH levels. The first step is running tests—from urinalysis to blood tests to parathyroid hormone tests. Once the results are in, Friedlander sits down with his patients and goes over the data.

“All stone formers should get enough fluids to produce at least 2.5 liters of urine a day,” he says. “Beyond that, my recommendations are specific to the patient’s unique chemistry.”

For instance, patients with calcium stones and a high level of calcium in the urine should limit their sodium intake, while those with calcium oxalate stones and high levels of urinary oxalate should avoid certain oxalate-rich foods like spinach, beets, and nuts while keeping their calcium consumption normal.

“It may require multiple studies, since a lot of these studies capture your body chemistry at a specific moment in time,” Friedlander says. “But doing this kind of leg work helps about 90 percent of my patients.”

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