As any busy urologist in Houston knows, the summer months are truly #stoneszn. Kidney stones makes up a large part of my clinical practice, but the emergency room calls for patients hospitalized with stone disease really increases once it’s hot outside. Unfortunately, in Houston this can seem like half the year.
The old adage is definitely true: passing a kidney stone can be worse than childbirth! To make things worse, stone rates are actually increasing in prevalence. New data suggest more than 10% of the US population will suffer from at least one kidney stone in their lifetime, and half of these patients will have multiple stones, or what we call chronic stone formers.
New patients in my clinic understand I have two goals: to treat their current stones and to then prevent stones in the future. The less they have to see me the better. Since prevention is key, I wanted to share my stone prevention tips and tricks with you.
Tips for Kidney Stone Prevention:
- Hydration, Hydration, Hydration. Summer is stone season for the simple reason that we sweat and our urine becomes more concentrated than in cooler times. Spending more time outside and exercising in the heat dehydrates us. When urine volume decreases, the urine minerals tend to concentrate, and a stone is born. Thus, hydration is the easy solution. Focus on drinking at least 2L (64 oz) daily with a goal of 3L (100 oz) if you are a chronic stone former. Simple dilution of stone-forming minerals is simple and effective.
- Decrease Your Salt Intake. This tip is a bit tricky, as we all enjoy salty treats like potato chips, pretzels, deli meat, and mixed nuts to name a few. Salt is even present in our cereal and sodas so it can be difficult to avoid. Stone formers should make a diligent effort to decrease their salt loads, as high salt diets lead to high calcium levels in the urine. Avoiding fast food and planning more meals at home are some simple ways to better control the amount of salt in our diets. Most people will also benefit from a low salt diet from a heart health standpoint, as this helps lower blood pressure – think of a low salt diet as a “twofer” for your wellness goals.
- Moderate Your Animal Protein. For many Texans, including myself, this is the hardest lifestyle change. Too much protein from animal sources - including red meat, fish, chicken, eggs, and seafood – can not only decrease citrate in the urine (which prevents stones) but also increase our urinary uric acid levels. This makes us much more likely to make stones. Now this does not mean abandon meat entirely, but it does indicate we must curb our “meatatarian” ways. If you have animal protein in multiple daily meals, try your best to limit this to just once a day, perhaps for dinner.
- When Life Hands You Lemon, Make Lemonade. Citrate supplementation is the name of the game in stone prevention. Many of my patients are prescribed large horse pills called potassium citrate, as their metabolic workups show they are deficient in this mineral. An alternative is to naturally supplement your diet with citrate. Lemons, limes, and other fruit juices are high in natural citrate. For a low-sugar method, squeeze fresh lemons into a jar and pour a small amount in your water regularly. Diet lemonade preparations like crystal light packets also work great. If the acidity hurts your stomach, try a gentler version by drinking coconut water.
By modifying your lifestyle via the tips above, most stone formers can significantly decrease risks of future stone attacks. Of course, there are many more stone prevention recommendations that may need to be discussed given a patient’s specific metabolic issues.
If you are suffering from recurrent stone disease, I highly recommend scheduling an in-office consultation. An extensive metabolic workup is always recommended for anyone that has made a kidney stone more than once in their life.
Good luck during #stoneszn and keep those water bottles close by!