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Kidney stones - self-care

Description

A kidney stone is a small solid mass made up of tiny crystals. Your health care provider may ask you to take self-care steps to treat kidney stones or prevent them from returning.

What to Expect at Home

You visited your provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps you take depend on the type of stone you have, but they may include:

• Drinking extra water and other liquids

• Eating more of some foods and cutting back on other foods

• Taking medicines to help prevent stones

• Taking medicines to help you pass a stone (anti-inflammatory drugs, alpha-blockers)

You may be asked to try to catch your kidney stone. You can do this by collecting all of your urine and straining it. Your provider will tell you how to do this.

What is a Kidney Stone?

A kidney stone is a solid piece of material that forms in a kidney. A stone can get stuck as it leaves the kidney. It can lodge in one of your two ureters (the tubes that carry urine from your kidneys to your bladder), the bladder, or the urethra (the tube that carries urine from your bladder to outside your body).

Kidney stones may be the size of sand or gravel, as large as a pearl, or even larger. A stone can block the flow of your urine and cause great pain. A stone may also break loose and travel through your urinary tract all the way out of your body without causing too much pain.

There are four major types of kidney stones.

• Calcium is the most common type of stone. Calcium can combine with other substances, such as oxalate (the most common substance), to form the stone.

• A uric acid stone may form when your urine contains too much acid.

• A struvite stone may form after an infection in your urinary system.

• Cystine stones are rare. Cystinuria, the disease that causes cystine stones, runs in families.

Fluids

Drinking a lot of fluid is important for treating and preventing all types of kidney stones. Staying hydrated (having enough fluid in your body) will keep your urine diluted. This makes it harder for stones to form.

• Water is best.

• You can also drink ginger ale, lemon-lime sodas, and fruit juices.

• Drink enough liquids throughout the day to make at least 2 quarts (2 liters) of urine every 24 hours.

• Drink enough to have light-colored urine. Dark yellow urine is a sign you are not drinking enough.

Limit your coffee, tea, and cola to 1 or 2 cups (240 or 480 milliliters) a day. Caffeine may cause you to lose fluid too quickly, which can make you dehydrated.

Diet and Calcium Stones

Follow these guidelines if you have calcium kidney stones:

• Drink plenty of fluids, particularly water.

• Eat less salt. Chinese and Mexican food, tomato juice, regular canned foods, and processed foods are often high in salt. Look for low-salt or unsalted products.

• Have only 2 or 3 servings a day of foods with a lot of calcium, such as milk, cheese, yogurt, oysters, and tofu.

• Eat lemons or oranges, or drink fresh lemonade. Citrate in these foods prevents stones from forming.

• Limit how much protein you eat. Choose lean meats.

• Eat a low-fat diet.

Do not take extra calcium or vitamin D, unless the provider who is treating your kidney stones recommends it.

• Watch out for antacids that contain extra calcium. Ask your provider which antacids are safe for you to take.

• Your body still needs the normal amount of calcium you get from your daily diet. Limiting calcium may actually increase the chance that stones will form.

Ask your provider before taking vitamin C or fish oil. They may be harmful to you.

If your provider says you have calcium oxalate stones, you may also need to limit foods that are high in oxalate. These foods include:

• Fruits: rhubarb, currants, canned fruit salad, strawberries, and Concord grapes

• Vegetables: beets, leeks, summer squash, sweet potatoes, spinach, and tomato soup

• Drinks: tea and instant coffee

• Other foods: grits, tofu, nuts, and chocolate

Diet and Uric Acid Stones

Avoid these foods if you have uric acid stones:

• Alcohol

• Anchovies

• Asparagus

• Baking or brewer's yeast

• Cauliflower

• Consommé

• Gravy

• Herring

• Legumes (dried beans and peas)

• Mushrooms

• Oils

• Organ meats (liver, kidney, and sweetbreads)

• Sardines

• Spinach

Other suggestions for your diet include:

• Do not eat more than 3 ounces (85 grams) of meat at each meal.

• Avoid fatty foods such as salad dressings, ice cream, and fried foods.

• Eat enough carbohydrates.

• Eat more lemons and oranges, and drink lemonade because the citrate in these foods stops stones from forming.

• Drink plenty of fluids, particularly water.

If you are losing weight, lose it slowly. Quick weight loss may cause uric acid stones to form.

When to Call the Doctor

Contact your provider if you have:

• Severe pain in your back or side that will not go away

• Blood in your urine

• Fever and chills

• Vomiting

• Urine that smells bad or looks cloudy

• A burning feeling when you urinate

References

Bushinsky DA. Nephrolithiasis.In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 111.

Leavitt DA, de la Rossette JJMCH, Hoenig DM. Strategies for nonmedical management of upper urinary tract calculi. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 93.

Review Date: 9/2/2024

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.