Stone Disease

REDUCTION OF STONE DISEASE DIET

METHODS TO REDUCE THE RECURRENCE RATE OF URINARY STONE
DISEASE

There are several significant things that, as a patient, you can do to help reduce the chance of getting another stone. Specific recommendations are
guided by stone analysis and blood tests; however, several general ideas are
important, and in fact often most valuable in helping to reduce the chance that you will get another stone.

The most important thing to do to help reduce recurrence of stone disease is simple hydration. There is no set amount of fluid that would be considered adequate; rather adjust your fluid intake based on the color of your urine. The more yellow your urine, the more concentrated it is. Your goal should
be to keep your urine pale yellow or clear. Get into the habit of looking at
your urine each time you void. If your urine is ever dark yellow, that should be a warning sign that you need to increase your fluids. Fluid intake is especially important when you anticipate a period of dehydration such as before sleep, before exercise, or before outdoor activities. Half of what you drink should be after. The remaining half can be divided among any fluids you desire, provided that you stay away from excessives of milk (calcium containing) and tea ( oxalate containing). The use of bottle water is at your discretion; however if the municipal or private water source you use is exceptionally "hard" i.e. full of minerals, such purified bottle water might be advisable.

Adjustments in dietary intake are, long term, rarely successful. Rather than providing a list of foods to be avoided, it is important to use some guiding principles in your diet, the foremost of which is to avoid dietary excesses of certain foods. For most patients, an excess intake of calcium containing products, i.e. milk and .cheeses combined with an avoidance of an excess intake of oxalate containing foods ( dietary list provided) is advisable. If you find yourself eating an excess of these foods, it is most important that your water intake increase.

The role of medications in the treatment of kidney stones is probable the least important for most patients. Some patients who form uric acid stones,
such as those patients with gout, may benefit from long term medication. The most common stone in the United States, calcium oxalate stones, may benefit from medication use; however we think you would agree that fluid and dietary management is preferable to long term medication use. Occasionally, however 24-hour urine collection and blood work is necessary to help guide medical therapy.

Please keep this reference available and periodically re-read it as we have found that many patients begin to drift away from the good habits of prevention of stone disease over time.

FOODS OF HIGH OXALIC ACID CONTENT (0.1% or over):

Beets, Beet tops, Black tea, Chenopodium, Chocolate,. Cocoa,
Dried figs, Ground pepper, Lambs quarters, Lime peel, Nuts, Parsley, Poke, Poppy seeds, Purslane, Rhubarb, Sorrel, Spinach, Swiss chard

FOODS OF MODERATE OXALIC ACID CONTENT (0.2% or over):

Beans (green and wax), Blackberries, Blueberries, Carrots, Celery, Coffee (roasted), Concord grapes, Currants (red), Dandelion greens, Endive, Gooseberries, Lemon peel, Okra, Onions (green), Oranges, Orange peel,
Peppers (green), Raspberries (black), Strawberries, Sweet potatoes