registered dietitian nutritionist

How To Prevent Kidney Stones with Diet

I recently had a very unexpected event in my life — I passed a kidney stone! Let me give you a little overview of what happened:

Monday, 5:30 PM

I am driving home from work as usual and I am suddenly feeling pain in the right side of my lower back. It feels a little odd and I think maybe it’s a digestion kind of pain caused by flatulence. By the time I arrive home, I’m in severe pain and go straight to bed. I hope that laying down and stretching will somehow make things better.

6:00 PM

My husband brings me a bowl of food: rice, veggies and some turkey. It’s been a few hours since I had a meal and I feel a little hungry. I have a couple of bites and immediately feel sick to my stomach. I cannot hold the food down; it all comes back out! I’m starting to get a little worried at this point as I know none of this seems right.

6:30 PM

We decide to call 911 as I start to feel really weak, nauseous and lightheaded all at once. Three firefighters show up 5 minutes later, check me out and suggest going to the ER.

7:00 PM

I am admitted to the ER and shortly after am seen by one of the ER doctors. We go over all of my symptoms and she orders labs, urine test, IV fluids and some meds for nausea and pain.

I am well hydrated that day but as I am getting my fluids, I feel my pain dissipate a little. It goes from 8/10 to 4/10 and I’m able to sit back and relax. I do not get my medication till about 9:30 PM. By then I am pretty much pain free. Labs do not show anything significant other than hematuria (blood in urine) but *ahem* that could have been from certain events that women experience every month (gasp! I know…) Kidney stones may cause hematuria as well so this makes things a little tricky. My option is to either stay and have a CT scan to know for sure or just go home and hope for the best. My doctor feels like this is likely a back spasm and not a kidney stone from what I am describing to her.

11:30 PM

I am released from the ER (spent about 5 hours there) and we return home. I am hydrated, medicated and in good spirits. A little back spasm, nothing that some rest and sleep can’t fix, right? Boy, am I wrong. As soon as I lay down in bed, my pain is back but this time even worse — sudden, sharp, stabbing, and a 10/10!

1:30 AM

We are back in the ER. This time there is no line but once we are admitted, we wait for about 1 hour in the hallway which seems like a lifetime. I am sitting on one of the uncomfortable benches, unable to stay in one position for longer than 15 seconds. I am starting to get lightheaded again and more nauseous than ever. Thankfully, they have those emesis bags everywhere so I equip myself with a couple and I’m ready for anything at this point. I’m not sitting in the waiting room because I’m afraid I will vomit in front of all the people there. My husband is a few feet away facing the door so that we know when they call my name. I am waving at him and begging him to just go get someone to give me some pain meds. We end up spotting the gentleman who admitted me at the entrance and basically beg him to speed up this process. At this point I am laying on the bench in case I pass out. A few minutes later they call my name. I’m slightly relieved.

2:30 AM

I have another IV placed, fluids, and given some Toradol which over the next hour does absolutely nothing. I’m also waiting for a CT scan at this time. I’m taking full advantage of my emesis bag (just giving you an idea without going into too much detail, you’re welcome!) I’m wheeled around everywhere in a wheelchair. My CT scan is a little delayed as I am right outside the door sick like a dog. I’m grateful for the x ray tech who brings out a cold, wet towel for me that I place on my face. A few minutes pass and I go in to have a CT scan ( another first!)

3:30 AM

We have a diagnosis! It’s a 2 mm kidney stone that has already traveled down my ureter and it looks like it’s about to enter my bladder. Doctor suspects it will take 2-3 days for it to pass. YES! I’m relieved but also in more pain than I have ever been. I am wheeled to a little room where I am offered a bed and they have morphine on the way! Morphine?! This can’t be real. I’ve never had anything this strong. My nurse administering my first ever morphine dose tells me to just relax and let the medication do its thing. I do and next thing I know I can feel the pain slowly melt away and I drift off to sleep. Best feeling ever.

4:30 AM

Pain is back! I wake up miserable and sick to my stomach again. More emesis bags are coming my way. Great! Here we go again. This time I get more medication but it’s dilaudid instead. Same thing happens: pain relief then sleep.

5:00 AM

They are giving me a third bag of IV fluids and I am also drinking water by mouth. If I can hold it down then I’ll be released. My pain is controlled — there is light at the end of the tunnel.

6:30 AM

I am home! I have Norco and Zofran to control pain and nausea. Neither is working by the way. The only thing that is working is switching positions frequently. I sleep on and off throughout the day. I cannot hold anything down as far as food goes. I am drinking water; taking little sips every few minutes. I am urinating as often as I can to get that stone out of there. Pain is 6/10 throughout the day and it switches courses in the afternoon. I can feel it move towards the groin area; it’s less intense, something is happening! I’m also soaking in hot water which by the way alleviates my pain and so I keep going back to the tub. Hot water bath turns out to be most effective in keeping my pain down.

7:30 PM

Following a third hot bath soak, the stone comes OUT! I now am feeling a lot of burning pain all over my groin but it feels more like soreness rather than active pain. I take a Motrin (800 mg) and within 20 minutes all the pain is gone and it doesn’t look like it’s coming back. I’m gaining my appetite back (pretty much instantly) and actually eat a whole bowl of soup. I’m feeling like I was reborn!

As I am recovering from this event, I am doing some reading and I have learned a lot about kidney stones. I hope this is helpful for anyone that wants to take some extra steps to prevent formation of stones. I’m not saying this will guarantee you won’t ever get a stone but maybe it will help decrease your risk. They are extremely painful and I know for sure I will try my best to prevent another one. Symptoms come on suddenly and you never know when the pain will start. There is no warning!

The #1 way to prevent kidney stones is to stay hydrated

According to kidney.org, the more concentrated our urine is (little water), the more things bind one to another which can result in stone formation.

Solution: In my case, I downloaded a hydration app which nags me to drink water. I work in a fast paced environment and often get too much “in the zone” forgetting things as simple as drinking water.

It could be oxalate and not enough calcium

Most common kidney stones are calcium oxalate stones. Before you start thinking, what is this dietitian eating?! Keep in mind that oxalate is present in healthy foods such as grains, legumes, nuts, etc. Spinach, sweet potatoes, beets, and chocolate have high levels of oxalate. Also it’s not about restricting foods high in oxalate but rather getting enough calcium in.

Solution: I am going to keep eating a balanced diet. I’m not giving up my yams or my spinach. If there is enough calcium for my oxalate to bind to, there is no problem with eating high oxalate foods. We’re going to get into that next!

Calcium helps!

Calcium consumption is beneficial as calcium helps bind the oxalate from food in the intestines, hence, helps prevent kidney stone formation. When eating supplemental calcium, it is best to consume it with meals so that it can, again, bind to oxalate and help decrease urinary oxalate. Remember, urinary oxalate is what may contribute to stone formation. So calcium is not really the bad guy and neither are high oxalate foods!

Solution: In my case, I am not a big dairy eater. I’m planning on increasing my consumption of calcium fortified foods to hep prevent high amounts of oxalate in my urine. The idea is, again, to help calcium bind oxalate before it enters the kidneys!

Sodium can contribute to stones

Keep sodium intake at less than 3000 mg a day (even lower if you have a history of kidney stones). High sodium intake accumulates calcium in urine which can then lead to stone formation.

Solution: I don’t eat a lot of sodium so I highly doubt it was the root cause of my stone, however, controlling sodium intake is not bad idea!

Uric acid stones are a thing too

There are also uric acid stones which are formed from high uric acid concentrations in the kidneys. High-purine foods will produce a lot of uric acid that can potentially result in stone formation.

Solution: limit high-purine foods such as red meat, shellfish, and organ meats.

In addition to calcium oxalate stones and uric acid stones, there are also calcium phosphate stones and cystine stones. Once a stone is passed, it can be analyzed to determine what type it is. Once the type is determined, diet adjustments can be made to try to prevent another stone. According to National Institute of Diabetes and Digestive and Kidney Diseases, if preventative measures are not taken, stones will reoccur in half of the people who experienced them.

In conclusion, kidney stones do happen and thankfully there are some measures we can take to lessen our chance of getting them. Number one way is drinking plenty of water every single day. If you’re like me and forget, get an app on your phone to remind you. If you do drink tons of water but are still getting stones, ask your health care provider to have them analyzed to pinpoint root cause and then make appropriate diet changes.

Goodluck and may you be kidney stone free!

References:

Sorensen, Mathew D. “Calcium intake and urinary stone disease.” Translational andrology and urology vol. 3,3 (2014): 235-40. doi:10.3978/j.issn.2223-4683.2014.06.05

National Kidney Foundations (March, 2016). Six Easy Ways to Prevent Kidney Stones. Retrieved from https://www.kidney.org



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