You Had a Kidney Stone…Now What?!?
If you have formed one stone, you have a 50% chance of
forming additional stones within 10 years. There are
changes you can make that may help prevent the formation
of the additional stones and/or help your stones to pass
spontaneously.
When you do not drink enough fluids, the concentration of
your urine increases, causing tiny particles of stone to
precipitate out of the urine. This leads to stone formation.
This is similar to dissolving sugar in water – a tablespoon of
sugar will readily dissolve in a glass of water. However, 8
tablespoons of sugar in a glass of water will not dissolve,
leaving a buildup of crystals in the bottom of the glass.
Illustration used with permission: http://www.merckmedicus.com/medical-media-library/Histology-of-the-normal-kidney
Guidelines for kidney stone prevention:

Increase your fluid intake. Use the color of your urine as a guide. It should be pale
yellow to clear in color. You should urinate at least 2.5-3 liters of fluid per day. To
accomplish this, you must drink over 2.5-3 liters of fluid per day (or more if
exercising or perspiring significantly).
There are now smart phone applications available which can help remind you to drink
your daily intake of water. Two applications available are Free Daily Water Intake
Calculator or Water me Daily Water Tracker

Water is the best fluid to drink. However, ice chips, popsicles, gelatin cubes, salt free
broth, clear soda pop and herbal teas, (not black tea or cranberry due to high oxalate
content), all count towards your daily fluid intake.

The 3 main beverages that stone formers should avoid are black teas, dark carbonated
sodas and cranberry juice as these contribute to stone formation.

Citrate, found in lemon & lime juice and citric fruits, can decrease your body’s ability
to make stones. It is recommended that you divide ½ cup of real lemon juice between
your 2.5-3 liters of water you drink each day.

People who have too much salt in their diet can excrete too much calcium in their
urine and therefore lead to stones. It is recommended that you keep your sodium
intake less to than 2000 mg per day. This will be very difficult if you are consuming
fast food, processed foods, canned soups or adding salt to your diet. You should avoid
seasonings such as sea salt, garlic salt, onion salt, seasoned salt and MSG as these all
go towards your daily intake of salt. If the word salt or sodium is in the first five
ingredients on the food label--DO NOT BUY IT!

Following a high protein diet, such as Atkins, South Beach, or The Zone, can
contribute to the formation of stones as well. It is recommended that you limit your
animal protein intake to less than 6 ounces per day. Discuss with your doctor whether
the benefits of this type of diet outweigh the risks of stone formation. It is usually
advisable to have a well-balanced diet including lots of fresh fruits, vegetables, salad,
whole grain products, low-fat dairy products and plant fats.

Many kidney stones are made of excess oxalate in your diet. Foods with high oxalate
include spinach, rhubarb, berries, soy, dried beans, chocolate, nuts, nut butters,
cranberry juice, sauce or dried cranberries. Please refer to the Oxalate diet handout
provided.

Too much or too little calcium in your diet can also contribute to the formation of
kidney stones. When there is too much calcium in your diet, the bones may not
absorb the calcium. Conversely, when there is too little calcium in your diet, the
body pulls calcium out of the bones. In both of these cases the free calcium floating
in your bloodstream can cause stones to form. For most people it is still advisable to
continue your calcium supplement. Also, it is important to either take your calcium
supplements or drink a glass of milk with each of your meals as the calcium will bind
with the oxalate in your diet and decrease the amount of oxalate in your urine.

Those with kidney stones should also avoid large amounts of Vitamin C as this can
contribute to kidney stone formation.
If you develop kidney stones, there are things you can do to promote the spontaneous passage of
these stones. Again, increasing your fluid intake is crucial. You should drink 2.5-3 liters every
24 hours. The use of medication to manage your pain can also help you relax, which may help
stones to pass on their own. Ensuring you maintain normal bowel function and avoid
constipation is helpful, as well as maintaining physical activity. If indicated, you may be given a
medication such as tamsulosin to help your stone pass.
Laboratory Workup
There are several laboratory tests that may be ordered to aid in your treatment and in the
prevention of future stones.
 Urinalysis is the most common test. This is done to evaluate for the presence of
blood or infection in the urine.
 You may also be asked to do a 24 hour urine collection to assess your fluid intake and
certain elements in your urine that may make you more prone to stone formation.
 Other lab tests may include checking your kidney function and levels of calcium,
magnesium, uric acid and phosphorus in your blood.
 If you pass a stone at home, please bring it to your next doctor’s appointment for
analysis. This enables us to find out what your stone is made of, which can aid in the
formation of a plan to prevent further stone formation.
There is a lot of information available on the internet regarding kidney stones. Please call us
with your questions and consider the validity of the information source before making any major
changes.
2500 E. Capitol Dr. Ste. 2600
Appleton, WI 54911
920-739-3537 / 800-529-9908