How can kidney stones be prevented

Biochemical and stone-risk profiles with topiramate treatment. Am J Kidney Dis. Curhan GC. Epidemiology of stone disease. Urol Clin North Am. Risk for renal failure in nephrolithiasis. American Society of Nephrology. Chronic kidney disease. Accessed April 12, Admission for nephrolithiasis in pregnancy and risk of adverse birth outcomes. Obstet Gynecol. The influence of dietary factors on the risk of urinary stone formation. Scanning Microsc.

Crystallization inhibitors in the pathophysiology and treatment of nephrolithiasis. Urol Int. Serio A, Fraioli A. An observational and longitudinal study on patients with kidney stones treated with Fiuggi mineral water [in Italian]. Clin Ter.

Evidence for durable kidney stone prevention over several decades. BJU Int. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study.

Effects of dietary calcium, magnesium and phosphorus on the formation of struvite stones in the urinary tract of rats. Struvite stones: long term follow up under metaphylaxis. Ann Urol Paris. A critical analysis of the role of gut Oxalobacter formigenes in oxalate stone disease. Oxalobacter formigenes : a potential tool for the treatment of primary hyperoxaluria type 1. Kidney Int. Batmanghelidj F, Kohlstadt I. Water: a driving force in the musculoskeletal system. Boca Raton, Fla.

Livingston EH, Kohlstadt I. Simplified resting metabolic rate-predicting formulas for normal-sized and obese individuals. Obes Res. Metabolic risk factors and the impact of medical therapy on the management of nephrolithiasis in obese patients. Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers.

Metabolic basis for low urine pH in type 2 diabetes. Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocrinol Metab. Fructose consumption and the risk of kidney stones. Fructose-rich beverages and risk of gout in women. Arch Ital Urol Androl. Contrasting effects of potassium citrate and sodium citrate therapies on urinary chemistries and crystallization of stone-forming salts.

Pizzarelli F, Peacock M. Effect of chronic administration of ammonium sulfate on phosphatic stone recurrence. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Next: Diagnosis and Management of Rheumatoid Arthritis. Dec 1, Issue. The incidence of nephrolithiasis kidney stones is rising worldwide, especially in women and with increasing age.

B 29 , 30 , 32 Kidney stone type should be identified when possible, even on initial stone occurrence. C 10 , 31 Urine characteristics e. C 10 , 22 , 31 , 46 Patients with kidney stones should be counseled on stone-specific dietary interventions.

C 28 , 30 , 42 , 43 Patients with kidney stones should be assessed for risk of chronic kidney disease. C 5 , 26 To prevent kidney stones, medication use should be evaluated and modified as needed. Enlarge Print Table 1. Table 1. Enlarge Print Table 2. Differential Diagnosis of Urinary Calculi Clinical clues Suggested diagnoses Dysuria Urinary tract infection, interstitial cystitis pelvic pain syndrome , vaginitis, prostatitis Fevers, chills Nonspecific response to infection or inflammation Frequency High fluid intake, urinary tract infection, bladder spasms, benign prostatic hyperplasia, hyperglycemia Hematuria Kidney stones, uroepithelial or prostatic tumors, urinary tract infection, renal glomerular disease Nausea, vomiting Nonspecific response to pain, intestinal or urinary obstruction, gastrointestinal disease Pain and tenderness Abdominal Kidney stones, gastrointestinal disease Flank Kidney stones, musculoskeletal inflammation or spasm, referred pain from gallbladder on right side , pyelonephritis Groin or pelvic Kidney or bladder stones, urethritis, prostatitis, vaginitis, pelvic inflammatory disease, pelvic pain syndrome Adapted from Pietrow PK, Karellas ME.

Table 2. Algorithm for the diagnosis and management of acute kidney stones. Enlarge Print Table 3. Acute Management of Kidney Stones in Adults Management type Therapy Dosage Fluids Oral intake of water, or intravenous normal saline if patient is unable to take oral fluids At least 2 L of water per 24 hours 0. Table 3. Enlarge Print Table 4. Medications Associated with Kidney Stone Formation Type of medication Examples Agents that decrease uric acid production [ corrected ] Allopurinol Zyloprim Laxatives specific to ammonium urate stones , especially if abused Overuse of any laxative resulting in electrolyte losses Antibiotics Sulfonamides, ampicillin, amoxicillin, ceftriaxone Rocephin , quinolones, furans, pyridines Carbonic anhydrase inhibitors Acetazolamide, topiramate Topamax Ephedra alkaloids banned in the United States Herbal products used as stimulants and appetite suppressants Potassium channel blockers Amiodarone, sotalol Betapace , dalfampridine Ampyra; multiple sclerosis therapy Potassium-sparing diuretics Triamterene Dyrenium Reverse transcriptase inhibitors and protease inhibitors HAART highly active antiretroviral therapy Sulfonylureas Various therapies for type 2 diabetes mellitus Information from references 16 through Table 4.

Enlarge Print Table 5. Table 5. Read the full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue.

Purchase Access: See My Options close. Best Value! To see the full article, log in or purchase access. Author disclosure: No relevant financial affiliations to disclose. More in Pubmed Citation Related Articles. Email Alerts Don't miss a single issue. Sign up for the free AFP email table of contents. Navigate this Article. Nonspecific response to infection or inflammation. Kidney stones, gastrointestinal disease. At least 2 L of water per 24 hours. Calcium channel blockers. Allopurinol Zyloprim.

Laxatives specific to ammonium urate stones , especially if abused. Overuse of any laxative resulting in electrolyte losses. Carbonic anhydrase inhibitors. Acetazolamide, topiramate Topamax. Ephedra alkaloids banned in the United States. Herbal products used as stimulants and appetite suppressants. Potassium channel blockers. Potassium-sparing diuretics. Triamterene Dyrenium. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body.

Kidney stones are more common in men than in women, and they tend to recur. In about half of people who have had one, kidney stones strike again within seven years without preventive measures.

Preventing kidney stones is not complicated, but it does take some determination. Kidney stones form when certain chemicals become concentrated enough in your urine to form crystals. The crystals grow into larger masses stones , which may make their way through the urinary tract. If the stone gets stuck somewhere and blocks the flow of urine, it causes pain. Most stones occur when calcium combines with one of two substances: oxalate or phosphorous.

Stones can also form from uric acid, which forms as the body metabolizes protein. To prevent kidney stones, you need to prevent the conditions that make stones more likely to form. Here are the most important steps:. Drink plenty of water: Drinking extra water dilutes the substances in urine that lead to stones.

Strive to drink enough fluids to pass 2 liters of urine a day, which is roughly eight standard 8-ounce cups. It may help to include some citrus beverages, like lemonade and orange juice. The citrate in these beverages help to block stone formation.

Get the calcium you need: Getting too little calcium in your diet can cause oxalate levels to rise and cause kidney stones. To prevent this, make sure to take in an amount of calcium appropriate to your age.

Ideally, obtain calcium from foods, since some studies have linked taking calcium supplements to kidney stones. Men 50 and older should get 1, milligrams mg of calcium per day, along with to 1, international units IU of vitamin D to help the body absorb the calcium. Reduce sodium: A high-sodium diet can trigger kidney stones because it increases the amount of calcium in your urine.

A low-sodium diet is therefore recommended for the stone prone. Federal guidelines suggest limiting total daily sodium intake to 2, mg. They both contain citrate, which may prevent stones from forming. Try to drink around eight glasses of fluids daily, or enough to pass two liters of urine. The most common type of kidney stone is the calcium oxalate stone, leading many people to believe they should avoid eating calcium.

The opposite is true. Low-calcium diets may increase your kidney stone risk and your risk of osteoporosis. Calcium supplements, however, may increase your risk of stones. Taking calcium supplements with a meal may help reduce that risk. Shop for calcium supplements. A high-salt diet increases your risk of calcium kidney stones. According to the Urology Care Foundation , too much salt in the urine prevents calcium from being reabsorbed from the urine to the blood.

This causes high urine calcium, which may lead to kidney stones. Eating less salt helps keep urine calcium levels lower. The lower the urine calcium, the lower the risk of developing kidney stones. Some kidney stones are made of oxalate, a natural compound found in foods that binds with calcium in the urine to form kidney stones. Limiting oxalate-rich foods may help prevent the stones from forming.

Foods high in animal protein are acidic and may increase urine acid. High urine acid may cause both uric acid and calcium oxalate kidney stones. According to one study , men who took high doses of vitamin C supplements doubled their risk of forming a kidney stone. The herb is thought to help prevent calcium-oxalate stones from forming. Shop for Chanca Piedra herbal supplements. Use herbal remedies with caution. In some cases, switching up your dietary choices may not be enough to prevent kidney stones from forming.