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Prevention
By Mayo Clinic staffPrevention of kidney stones may include a combination of lifestyle changes and medications.
Lifestyle changes
You may reduce your risk of kidney stones if you:
- Drink water throughout the day. For people with a history of kidney stones, doctors usually recommend passing about 2.6 quarts (2.5 liters) of urine a day. Your doctor may ask that you measure your urine output to make sure that you're drinking enough water. If you live in a hot, dry climate or you exercise frequently, you may need to drink even more water to produce enough urine. If your urine is light and clear, you're likely drinking enough water.
- Eat fewer oxalate-rich foods. If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate and soy products.
- Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose nonanimal protein sources, such as legumes.
- Continue eating calcium-rich foods, but use caution with calcium supplements. Calcium in food doesn't have an effect on your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise. Ask your doctor before taking calcium supplements, as these have been linked to increased risk of kidney stones. You may reduce the risk by taking supplements with meals.
Ask your doctor for a referral to a dietitian who can help you develop an eating plan that reduces your risk of kidney stones.
Medications
Medications can control the amount of minerals and acid in your urine and may be helpful in people who form certain kinds of stones. The type of medication your doctor prescribes will depend on the kind of kidney stones you have. Here are some examples:
- Calcium stones. To help prevent calcium stones from forming, your doctor may prescribe a thiazide diuretic or a phosphate-containing preparation.
- Uric acid stones. Your doctor may prescribe allopurinol (Zyloprim, Aloprim) to reduce uric acid levels in your blood and urine and a medicine to keep your urine alkaline. In some cases, allopurinol and an alkalinizing agent may dissolve the uric acid stones.
- Struvite stones. To prevent struvite stones, your doctor may recommend strategies to keep your urine free of bacteria that cause infection. Long-term use of antibiotics in small doses may help achieve this goal. For instance, your doctor may recommend an antibiotic before and for a while after surgery to treat your kidney stones.
- Cystine stones. Cystine stones can be difficult to treat. Your doctor may recommend that you drink more fluids so that you produce a lot more urine. If that alone doesn't help, your doctor may also prescribe a medication that decreases the amount of cystine in your urine.
References
- Worcester EM, et al. Nephrolithiasis. Primary Care: Clinics in Office Practice. 2008;35:369.
- Kidney stones in adults. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/index.htm. Accessed Jan. 18, 2012.
- Diet for kidney stone prevention. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/kidneystonediet/index.htm. Accessed Jan. 18, 2012.
- Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/177428112-2/0/1494/0.html. Accessed Jan. 19, 2012.
- Curhan GC, et al. Diagnosis and acute management of suspected nephrolithiasis in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 26, 2012.
- Preminger GM, et al. The first kidney stone and asymptomatic nephrolithiasis in adults. http://www.uptodate.com/home/index.html. Accessed Feb. 27, 2012.
- Humphreys MR (expert opinion). Mayo Clinic, Phoenix, Ariz. Feb. 20, 2012.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 8, 2012.
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