Prevention of recurrence of kidney stones

The article is written by Dr. BS Vu Hoang Huy - Emergency Doctor - Emergency Department - Vinmec Times City International General Hospital.

According to statistics, about 30% of stones recur after 3-5 years and 50% within 10 years. There is no surefire way to prevent kidney stones, especially if you have a family history of them. However, a combination of diet and lifestyle changes, as well as some medications, can help reduce your risk.

Making small adjustments to your current diet and nutrition plan can help you prevent kidney stones in the long run.
1.1 Increase fluid intake, drink plenty of water Drinking more water is the best way to prevent kidney stones. Increasing fluid intake will increase urine flow rate and decrease urine solute concentration, both of which protect against stone formation.
If you don't drink enough, your urine output will be low. Low urine output means your urine is more concentrated and salt crystals in the urine are more likely to clump and cause stones.
Many studies show that the effect of drinking lots of water reduces the risk of stone recurrence by up to 30%. People with kidney stones try to drink about eight glasses of fluid a day, or drink enough water to pass more than two liters of urine per day.
Lemonade and orange juice are also good options. Both contain citrate, which can prevent stone formation. Especially herbal juices such as psyllium psyllium cotton, corn silk, etc. have diuretic and anti-stone effects.
You can tell if you are sufficiently hydrated by looking at the color of your urine - it should be clear or light yellow. If your urine is small and dark, you need to drink more water.
1.2 Reduce animal protein intake Foods rich in animal protein are acidic and can increase urine acidity. High urine acidity can cause both uric acid and calcium oxalate kidney stones.
You should try to limit or avoid: beef, poultry, fish, pork....
Should replace animal protein with vegetable protein will help reduce the possibility of stone formation.

1.3 Binge eating and limiting sodium A high salt diet increases the risk of calcium kidney stones. When there is too much salt in the urine, calcium cannot be reabsorbed from the urine into the bloodstream. This causes calcium in the urine to be high, which can lead to kidney stones. Eating less salt helps keep urine calcium levels lower. The lower the calcium in the urine, the lower the risk of kidney stone formation. So, to reduce sodium intake read food labels carefully.Foods known to be high in sodium include:
Processed foods such as: Chips and crackers, chips,.. Food canned: Canned soups, canned vegetables, lunch meats, condiments, foods containing monosodium glutamate, foods containing sodium nitrate, foods containing sodium bicarbonate). 1.4 Limit foods high in oxalates Some kidney stones are made up of oxalates, a natural compound found in foods that binds with calcium in the urine to form kidney stones. Limiting oxalate-rich foods can help prevent stone formation.
Foods rich in oxalates are: Spinach (spinach), chocolate, sweet potatoes, potatoes, coffee, turnips, peanuts, cashews, almonds, soy products, wheat bran ....
1.5 Limit intake of sucrose and fructose The amount of sucrose sugar increases the amount of calcium in the urine thereby increasing the risk of stone formation. Consumption of fructose has also been linked to an increased risk of kidney stone formation.
1.6 Avoid vitamin C supplements Vitamin C (ascorbic acid) supplements can cause kidney stones, especially in men. According to some studies, people with high doses of vitamin C supplements double the risk of kidney stone formation. High doses of supplemental vitamin C seem to increase urinary oxalate excretion in some people and thereby increase the risk of stone formation.
1.7 Eat more fruits and vegetables Increase your intake of fruits and vegetables, which may reduce the risk of calcium oxalate stone formation. This benefit is mainly the result of increased citrate elimination.
1.8 Eat more calcium-rich foods The most common type of kidney stone is calcium oxalate stones, leading many people to believe that they should avoid calcium. But the truth is the opposite of that thought. A diet low in calcium may increase the risk of kidney stones and the risk of osteoporosis.
Therefore, increasing calcium-rich foods or taking calcium supplements with meals can help reduce that risk.
Low-fat milk, low-fat cheese, and low-fat yogurt are all good calcium-rich food choices.

In some cases, dietary changes may not be enough to prevent kidney stone formation. If you have recurrent stones, talk to your doctor about the role of medication in your prevention plan.
2.1 Talk to your doctor about medications you are taking Taking certain prescription or over-the-counter medications can lead to kidney stones.
Some of these drugs are:
Decongestants: Medicines such as ephedrine and guaifenesin that can form stones include these products when they are excreted in the urine. Diuretics: Triamterene and Loop diuretics, such as furosemide and acetazolamide, because they can increase calcium levels in the urine. Protease Inhibitors: Indinavir sulfate, a protease inhibitor used to increase CD4+ cell counts and decrease HIV-RNA titres in HIV and AIDS patients, significantly increases the risk of stone formation with indinavir. In addition, AIDS patients with hepatitis B, hepatitis C, or hemophilia and those taking the antibiotic combination TMP-SMX have an increased risk of kidney stones. Anticonvulsants: Felbamate, topiramate, and zonisamide increase the risk of stones. Steroids: Long-term use of corticosteroids may increase intestinal calcium absorption, leading to hypercalciuria and an increased risk of calcium-containing stones. Chemotherapy agents: Some cancer chemotherapy treatments lead to cell breakdown and can cause uric acid stones. Drugs that increase uric acid: Drugs in this class, such as colchicine and probenecid, cause hyperuricemia and therefore increase the risk of uric acid formation as well as calcium stones. Aspirin (salicylate) products. Antiviral drugs, such as acyclovir.

The longer you take these medicines, the higher your risk of kidney stones. If you're taking any of these medications, talk to your doctor about other drug options. You should not stop taking any prescribed medication without your doctor's approval.
2.2 Talk to your doctor about preventive medications If you are prone to certain types of kidney stones, certain medications can help control the amount of that material in your urine. The type of medication prescribed will depend on the type of stone you usually have. Example:
If you have calcium stones, a thiazide or phosphate diuretic may be beneficial. If you have uric acid stones, allopurinol (Zyloprim) can help lower uric acid in your blood or urine. If you have struvite stones, long-term antibiotics can be used to help reduce the amount of bacteria in your urine.

Kidney stone disease is a very common disease. There's no guarantee that these prevention methods will work, but they can reduce your risk. The best thing to prevent kidney stones is to stay hydrated and make some dietary changes.
If you have a condition that increases your risk of kidney stones, such as inflammatory bowel disease, ileostomy, ileostomy, persistent urinary tract infections, or obesity, talk to your doctor. about management strategies to reduce the risk of kidney stones.
If you have had kidney stones before, ask your doctor for blood and urine tests to evaluate for metabolic disorders and risk of recurrent stone formation. When you know your own risks, you can take targeted steps to prevent new stones from forming.
Periodic health check-ups help detect kidney stones early, so that you can have a treatment plan for optimal results. Currently, Vinmec International General Hospital has general health checkup packages suitable for each age, gender and individual needs of customers with a reasonable price policy, including:
Health checkup package general Vip Standard general health checkup package Patient's examination results will be returned to your home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties at the Hospital with quality treatment and services. outstanding customer service.

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