22

Jul

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What is a Kidney Stone?
A kidney stone is a solid piece of material that is formed from uric acid, a waste product that is normally discharged along with urine. Kidney stones can form for a variety of reasons and impact any section of your urinary tract, including your kidneys and bladder. Kidney stones commonly form when urine gets concentrated, causing minerals to solidify and stay together.

Why does it occur?
Kidney stones can be caused by an excess of uric acid in your body or an imbalance of minerals such as calcium and oxalate. Additionally, having a diet high in fat and cholesterol can increase uric acid in the body over time. However, it’s important to note that not all kidney stones are the same. Dietary management of renal calculi plays a crucial role in both prevention and treatment.

What are the Chances of Recurrence?
The risks of recurrence are 7% per year, which means that the stone has a 35% chance of recurring after 5 years and more than 50% after 10 years. Urolithiasis treatment includes not only surgical or endoscopic stone removal, but also prevention of future stone development. Renal calculi dietary control is an important element of therapy, as lifestyle and dietary adjustments can dramatically reduce the likelihood of recurrence.

What are the types of Kidney Stones?
Not all kidney stones are the same; there are two distinct types: calcium-rich and uric acid-rich stones, known as calcium oxalate stones and uric acid stones, respectively.

⦁ Calcium oxalate stones

Constituting approximately 80% of all kidney stones, calcium oxalate stones are often attributed to dehydration. Additionally, a diet high in protein, oxalate, salt, and sugar can elevate the risk of developing calcium oxalate kidney stones. Certain underlying medical conditions, such as hyperparathyroidism or inflammatory bowel disease, may also contribute to the formation of calcium oxalate stones in the kidney.

⦁ Uric acid stones

Accounting for about 15% of all kidney stones, uric acid stones are primarily caused by excessive uric acid production. Inadequate intake of potassium and magnesium can also contribute to the formation of uric acid kidney stones. Specific underlying medical conditions, such as Type 2 diabetes and obesity, further increase the risk of developing uric acid stones.

Dietary Recommendations to Prevent Kidney Stones

Passing a kidney stone is typically considered as one of the most painful experiences a person can have. In their lifetime, up to one out of every ten persons will get kidney stones. Fortunately, dietary changes if followed can prevent further recurrence of kidney stones. Dietary changes People should follow:

⦁ Avoiding vitamin D supplements

Excessive intake of vitamin D, especially without adequate sunlight exposure, can contribute to kidney stone formation.

⦁ Limiting salt intake

⦁ Salt (sodium) increases the amount of calcium in your urine, and it’s crucial to restrict intake to less than 2300 mg per day.
⦁ To reduce salt/sodium: Choose “low salt” or “no added salt” foods, aiming for sodium content below 150 mg per serving. Note that some “reduced salt” products may still contain high sodium levels.
⦁ Avoid adding salt at the table or during cooking.

⦁ Limiting oxalate-rich foods

Reducing oxalate in your diet helps decrease oxalate levels in urine. Limit the intake of:

⦁ Rhubarb, spinach, silverbeet, beetroot, eggplant, sweet potato, celery, leeks.
⦁ Nuts, peanut paste.
⦁ Strong black tea or coffee, orange juice, chocolate.
⦁ Wheat bran and wheat germ.
⦁ Berries (e.g., strawberries, blackberries), dried figs.

⦁ Ensuring adequate fluid intake

⦁ Drink more fluid, especially water. When you do not consume the right amount of water, you may also face ⦁ gastric problems and constipation.
⦁ Consume at least 3 litres or 12 glass of water daily.
⦁ Have a glass of fluid (250ml) each hour during waking hours, and a large glass of water before bedtime. Drink water if you wake up during the night.
⦁ Spread out fluid intake throughout the day.

⦁ Lemon juice for citrate

Lemon juice, a good source of citrate, aids in preventing stone formation. Consume 100 ml of lemon juice daily, which can be added to water.

⦁ Adequate calcium intake

Right amount of calcium can block other substances in the digestive tract that may cause stones. It is best to get calcium from plant-based foods such as cereals, calcium-fortified juices, breads, some types of beans, and some kinds of vegetables. Avoid Calcium supplements to prevent calcium stones.

⦁ Limit animal protein

Replace animal protein with such plant-based foods that are low in oxalate and high in protein, such as:

⦁ Sunflower seeds
⦁ Legumes: peanuts, dried peas, beans, and lentils
⦁ Soy-based foods: tofu, soy nut butter, and soy milk
⦁ Nuts and nut products: cashews and cashew butter, walnuts, almonds and almond butter, cashews and cashew butter, and pistachio

⦁ Limit alcohol, sugar and sugar-based drinks because it can increase uric acid levels in the blood. 
⦁ Avoid carbonated drinks
⦁ Avoid high dose vitamin C supplements. Excess amounts of 1000mg/day or more may produce more oxalate in the body

FOOD TO BE EATEN:

⦁ Cereals: rice, wheat, maize, bread, barley, jowar, rice flakes, puffed rice, cornflakes.
⦁ Pulses and Legumes: red gram dal, black gram dal, green gram dal, bengal gram dal, peas, soya beans.
⦁ Fruits and vegetables: Incorporate fruits and vegetables with both low and medium potassium levels.
⦁ Proteins: egg whites, skinless chicken, freshwater fish.
⦁ Dairy: milk, curd, and buttermilk (limited to 200 ml/day).
⦁ Beverages: Tea, Green tea, green tea, barley water.
⦁ Additional items: garlic, sago, honey, and olive oil

FOODS TO BE AVOIDED OR LIMITED:

⦁ Cereals: Ragi and bajra
⦁ Pulses and Legumes: Sprouts, Rajma, choley (can be taken in small amounts, leached, and in thin dal form).
⦁ High potassium fruits: Amla, Lemon, Sweet lime, Cherries, Muskmelon, Apricots, Peaches.
⦁ High potassium vegetables: Amaranth, Spinach, Coriander leaves, Potato, Sweet potato Colacasia, Yam Drumsticks leaves, Green Papaya, Tamarind leaves, tomatoes.
⦁ Proteins: Avoid meat, egg yolks, seafood, pork, beef, ham, and bacon.
⦁ Beverages: coconut water, fruit juices, instant coffee, and vegetable soups to be limited while avoiding aerated drinks, squashes, Horlicks, Bournvita, sugar, honey, and jaggery, especially for those with diabetes.
⦁ Additional Items: Limit the intake of dry fruits, processed and preserved foods like pickles, papad, salted butter, sauces, ketchups, chips, salted biscuits, baking powder, cooking soda, chocolates, cocoa powder, salted cheese, and noodles.

Nutritional guidelines for kidney stone patients

  • Opt for small and frequent meals throughout the day.
  • Enhance protein quality by preparing combinations of cereals, pulses, and milk, such as khichdi, dal, and payasam.
  • Steer clear of excessive calcium and high-dose vitamin C supplements.
  • Improve flavour in cooking by using fresh herbs, whole spices, and a few drops of lemon juice as a salt substitute.
  • Keep track of daily water consumption by storing the required amount in a bottle.
  • Steer clear of canned foods and commercial soups, as they often contain high levels of sodium, contributing to increased thirst

Sample diet Plan to Prevent Kidney Stones

To prevent the occurrence of kidney stones, it is essential to follow a good diet plan. Below is an example of a diet plan:

  • For breakfast, have a bowl of porridge along with blueberries and a glass of milk.
  • Lunch can include whole grain bread, a salad with low-sodium dressing, and a glass of Yoghurt Parfait.
  • Dinner should consist of wild rice, asparagus, salmon, and yoghurt dill sauce
  • Incorporate foods that are rich in calcium into your diet.
  • Maintain moderate amounts of protein in your diet.
  • Basic pomegranate juice after straining
  • Hydrating refresher – 1 fresh lime or lemon with a tablespoon of honey in 230 ml of water (has high levels of citric acid which helps reduce the acidity of urine)

What is Considered the Best Home Remedy for Kidney Stones?

To prevent kidney stones, it is essential to follow a good diet plan. Apple cider vinegar is considered a beneficial solution for dissolving kidney stones. The acetic acid present in apple cider vinegar is known to soften the stones, facilitating their passage in the urine without difficulty.

Verified By:

Dr. Lakshay Goel
M.B.B.S., M.S., F.I.S.C.P.
Consultant Minimal Access and Endoscopic Surgeon  

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