September 9, 2019

Preventing Kidney Stones

By Dr. Greg Taylor, MD


Each time I drive somewhere, I take my large water bottle. Often, I take two.  My wife hates that my bottles are too large for the cupholders in her car. One time my dad asked me if I had diabetes because he noticed how much water I drank. I just respond that I had seen too many people suffer with kidney stones (including my dad).  

Those nasty crystals, some the size of a grain of sand, can bring humans to their knees. I have seen countless people in the emergency department with stones mostly one millimeter to ten millimeters in size. That is not very large; it measures between one twenty-fifth to slightly less than one-half inch long. The big problem is that these little buggers can get stuck in a small but freakishly-important tube. This tube, called the ureter, is ten to twelve inches long and only three to four millimeters (one-eighth of an inch) wide. You have two of these. Each ureter connects a kidney to the bladder. It has a muscular wall that contracts in a coordinated way to propel urine to the bladder. When urine travels properly, you feel no pain, your kidneys filter your blood properly, and you live. When the tube is blocked, your body senses a potentially catastrophic problem and hits the panic button. Think Three Mile Island. 

Generally speaking, when a kidney stone gets stuck in the upper ureter (near the kidney), it causes severe, knife-like pain in the upper back. If the stone becomes lodged further downstream, pain can also be felt in the abdomen, in the groin, and, for men, in the testicle. The severe pain can be constant or intermittent. Physical pain is not the only result of kidney stones. These little guys are pricey. If you consider the costs of the emergency room, missed work, and potential surgery, one little kidney stone could cost thousands of dollars. It is critical to do all you can to avoid kidney stones.  

The best way to prevent kidney stones is to hydrate well. Stone-formers lower their risk of making another stone by fifty percent if they drink enough fluid to produce at least two and a half liters of urine per day. That means drinking a lot, but it is worth it. For the average person, that would mean having to urinate about ten times per day. Water is best. Citrus-containing drinks may be helpful in preventing stone formation. This includes lemonade and orange juice. I highly recommend flavoring a large amount of water with lemon juice from a lemon wedge.  

In general, drinking carbonated beverages will increase stone risk. Cola drinks that are acidified with phosphoric acid increase the risk of kidney stone formation. The general rule is to drink less soda and more water. If you pass a stone, keep it in a dry container and give it to your doctor. The stone analysis will reveal additional, more specific preventative measures.  If you have had more than one stone, you should see a urologist or nephrologist for more extensive evaluation. If you are passing a stone and having fevers, chills, and uncontrollable shaking or if you cannot keep liquids down, you need to go to the emergency room.  

Proper hydration will reduce your risk of kidney stone formation. Now that’s something we can all drink to. 


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