Apr 27, 2019

This podcast is an open-ended conversation about topics in urology. The episodes are varied in format and length. If you like what you hear subscribe on your favorite podcast player or find past episodes by topic at whyurologypodcast.com.

In this episode, we will be talking about kidney stone prevention and at a very specific and common problem for kidney stone formers, idiopathic hypercalciuria, or having too much calcium in the urine, leading to a higher risk of kidney stone formation.

To prevent kidney stones we must change the composition of the urine so that it is no longer supersaturated; we need to change the urine to make it more dilute. Altering urine chemistry requires control of fluid intake, diet, and lifestyle, and sometimes additional use of medications. And because stones tend to recur, prevention requires treatment over long periods.

Our first recommendation for patients is always a change in diet, or at least adherence to certain dietary guidelines. These are guidelines that we all should be following by the way. It’s just more important if you make kidney stones.

1. Drink more water (ideally up to 3 L)
2. Reduce the sodium in your diet (less than 2000 mg)
3. Limit or reduce high oxalate foods in your diet (100 mg)
4. Moderate your animal protein (0.8 to 1.2 mg/kg/d)
5. Eat more fruits and veggies, add lemonade to increase the citrate and potassium in your diet
6. Get adequate calcium in your diet. (1000-1200 mg)

Many stones can be prevented by making those simple changes, but dietary changes may not be enough. Some patients might need medication to help with changing their urine concentration to prevent stones.