Prevention of Kidney Stones

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Kidney stones can be prevented through good health practices such as drinking enough water. Prevent kidney stones with the help of a practicing nephrologist in this free video.

Part of the Video Series: Kidney & Bladder Health
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Video Transcript

Hey guys, Dr. Sean Hashmi with Kaiser Permanente in Woodland Hills Nephrology. Today, I wanted to talk to you guys about how to prevent kidney stones. Now, we've already talked about a couple of other times about treating kidney stones, what kidney stones entail; but let's talk about prevention. So, what are some simple things? Well, what I tell all my patients is there's a golden rule and the rule says, if urine sits around, it will concentrate, it will get infected and it will form kidney stones. So, the best thing to do is keep the urine moving. How do you do that? The goal is to try to make at least two liters of urine a day. Now notice, I didn't say drink two liters of water a day. I said, make two liters of urine a day. If it's very hot outside, that may mean you have to drink three liters. But aim to make two liters of urine a day. Diet is very important because depending on the type of stone, you maybe doing stuff that can make you more likely to have stone. So what are those thing? People who don't eat a lot of dairy products. The calcium from dairy products that goes inside the gout can actually bind oxalate and prevent oxalate from going inside the body. Why is it important? Because oxalate can form calcium oxalate stones. Now, very key point; notice, I did not mention and I want you to take supplemental calcium. I did not say that. This is about dairy sources of calcium; foods, that makes a difference. Now, foods that are high in oxalate to begin with are important because once again, oxalate can cause stones. So, lowering the foods that are high in oxalate will lower your oxalate burden. Vitamin C; now, everybody goes crazy about Vitamin C and if you have listened to any of the other stuff I've ever said, Vitamin C isn't all that effective for the common cold. So taking mega doses is not great. There is a risk that high dosage of Vitamin C can cause stone formation because Vitamin C can convert to oxalate inside the body. Hence, you're putting yourself at risk for causing kidney stones. High amounts of meat. Meats are high in uric acid. Now uric acid stones can also form. So, that's another thing to be aware of and that can make a difference. Alcohol is another thing to cut down because that can also be associated with causing kidney stones. So, these are just a few of the things that you can be doing in terms of trying to prevent kidney stones and it does matter. I, ultimately, what it comes down to is hydrate yourself. Take things in moderation. You know, a lot of people talk about fructose and why fructose matters. Well, high fructose corn syrup can increase uric acid in the body. If you're a kidney stone sufferer, high fructose corn syrup will make your kidney stones or put you at risk for making them a little bit worse because you're putting more uric acid in the body. So these are things you just want to be aware of. So, diet modification is key when it comes to stone prevention. Hydration is key when it comes to stone prevention. Finally, there are medicines that your doctors may give you. So, a medicine like Allopurinol can lower the uric acid building inside your body; it's a xanthine oxidase inhibitor. Your doctor may give you Thiazide Diuretics because what they'll do is get rid of the calcium in the urine. They actually reabsorb calcium. Why is that important? Because calcium in the urine can bind you oxalate form calcium oxalate stones. Your doctor will also tell you you have to cut down salt in your diet. High amounts of salt in the urine will actually cause calcium to go with it and then, you'll get calcium oxalate stones. So, diuretics can be used to get rid of the calcium by using diuretics and they can also be used to get rid of some of the excess salt in your body. Dehydration will put you in a perfect place for you to have a situation where you can precipitate out stones. The last thing that's very important is Citrate. While Citrate is kind of like thinking about baking soda, it's bicarbonate, converts into bicarbonate. So, your doctor may give you a medicine called Potassium Citrate and what citrate will do is it actually inhibits stone formation. The key to finding out if you have any deficiency and which one of these medicines you need is your doctor will give you a 24 hour urine test where he collects your urine for 24 hours. He checks for all sorts of things; how much sodium, how much calcium, how much uric acid and then, he'll sit down with you, go over the results and tell you which dietary modifications to make. But a key thing that applies no matter what the situations is is aim to make two liters of urine a day. That is a statement that applies no matter which one of the stone formers you are. This is Dr. Sean Hashmi with the Kaiser Permanente in Woodland Hills talking about how to prevent kidney stones.

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