KIDNEY STONE PREVENTION & TREATMENT
The incidence of kidney stones is steadily increasing. In fact, it is 10 times more common now than at the turn of the century. It parallels the dramatic increase in the consumption of animal proteins. It also parallels the rise in other diseases (heart disease, gallstones, high blood pressure and diabetes) associated with the standard North American diet. Over 10% of all males and 5% of all females experience a kidney stone during their lifetime. Most victims are over 30 years of age.
Kidney stones are usually composed of calcium and oxalic acid. Less commonly, stones are made of uric acid (in people suffering from gout) and other mixed minerals and amino acids (especially cystine). It is important to determine the type of stone and its cause because this leads to a better designed prevention program. If a stone is passed and caught in the urine with the help of a stainer an analysis can be done by a lab to measure its mineral content. If this has not or cannot be done the alternative is to evaluate a number of criteria. These include diet, any underlying metabolic problems or diseases, blood and urine tests for calcium, uric acid, creatinine, electrolyte levels, 24 hour urinalysis for minerals, urine culture and hair mineral analysis. A combination of these things will usually determine the composition of the stone. Any physician can help you in this respect.
The majority of kidney stones are completely preventable. Once you have a stone, no diet or supplement can reverse the problem. You need medical attention but you can certainly do a lot to prevent the problem from getting worse. Studies indicate that acute attacks of kidney stone pain that lead to hospital admission can be significantly reduced or eliminated by diet and nutritional supplement therapy alone. Occasionally, kidney stones may be the result of metabolic diseases such as hyperparathyroidism, hyperthyroidism, cystinuria, vitamin D excess (caused by over-supplementation), the milk-alkali syndrome (caused by excessive use of dairy products or antacids), destructive bone diseases, primary oxaluria, Cushing’s Syndrome and sarcoidosis.
All stone formers should drink enough water to produce 2-3 quarts of urine daily. A recent study published in the British Journal of Urology found that about 19% of those diagnosed with kidney stones were suffering from chronic dehydration. A study done on tap water in 1989 concluded that the higher the magnesium to calcium ratio in the water, the lower the incidence of kidney stones. Get an analysis done on the water you use for daily drinking. One laboratory that can do this for you is Anamol Laboratories (83 Citation Dr., Unit #9, Concord, Ont. L4K 2S4; phone:416-660-1225). It just so happens that most patients suffering from kidney stones benefit from magnesium citrate supplementation (300-400 mgs. daily). Magnesium increases the solubility of calcium oxalate and prevents precipitation in the urine. A large number of studies support its routine use as a stone preventive supplement.Irrespective of the type of stone you have, avoid sugar and refined carbohydrates. This is because sugar, including the lactose found in milk, stimulates the release of insulin which, in turn, causes a higher calcium excretion by the kidney. Sugar increases the absorption of calcium from the intestines. Most kidney stone formers benefit from a high fiber, vegetarian (vegan) diet. This is because the metabolic breakdown products of animal proteins are uric acid and oxalic acid, both of which are involved in kidney stone formation. Red meat, in particular, is very high in phosphorus which causes the body to excrete more calcium into the urine. It is therefore not surprising that vegans have a 40-60% less chance of forming kidney stones than the average population.
Contrary to popular belief, high calcium intakes do not cause kidney stones but actually prevent them. If calcium absorption from the diet is adequate, the body has no need to dissolve the calcium in bone, raise the blood levels of calcium thence depositing this calcium into the kidneys. But, what about milk and dairy products? Aren’t they high in calcium and, if so, why are they associated with a higher kidney stone formation rate? The answer is that, although large amounts of calcium are indeed found in dairy products, absorption is often poor because of allergy, lactose intolerance, the high phosphorus content or the high fat content of dairy products. All this is evidenced by the fact that virtually all bone diseases, especially osteoporosis and kidney stones are worsened by high dairy product intakes. The calcium from greens, beans and other plant sources is far better absorbed and utilized in the body than it is from dairy products. Cultures from around the world who avoid dairy products have significantly lower or non-existent incidences of kidney stones, osteoporosis and arthritis.
Kidney stone victims that have a high calcium excretion in the urine should limit their intake of high animal protein foods, sodium, vitamin D and caffeine. A high intake of milk, cheese, and antacids for the treatment of peptic ulcers may all increase the predisposition to stones. Urologists have often joked that if every adult suddenly decided to quit dairy products the resulting decrease in the number of surgical procedures would quickly put them out of the kidney stone business.
In some individuals, a high salt intake from the diet results in increased losses of calcium from the urine leading to stone formation. Vitamin D increases calcium absorption from the gastrointestinal tract and releases calcium from bone leading to stone formation in susceptible individuals. Since milk is fortified with vitamin D, this becomes another potential reason for the high association between dairy product consumption and kidney stone incidence. Caffeine may also increase urinary calcium.
Oxalate stone formers should limit their intake of high oxalate foods but only if they are also consumers of animal proteins. High oxalate foods include beans, cocoa, coffee, parsley, rhubarb, spinach, tea, beet tops, carrots, celery, chocolate, grapefruit, kale, peanut, pepper and sweet potato. Oxalate stone formers should take a supplement of pyridoxine (vitamin B6) of not less than 150 mgs. daily. Deficiency of vitamin B6 is more common than we may think. B6 deficiency prevents oxalic acid from being degraded in the body. Dietary avoidance of high oxalate foods will make only a slight difference with respect to urinary oxalate excretion. Vitamin B6 supplementation, however, may be far more crucial in the overall prevention of oxalate stones.
Vitamin A and K deficiency may help promote the formation of kidney stones. This is because both vitamins are required by the body to make a common protein found in urine which inhibits calcium oxalate crystalline growth. Low levels of glutamic acid also increase calcium oxalate precipitation. Supplementation of of glutamic acid (300 mgs. daily) may be important as a preventive in some cases.
Uric acid stone formers are helped by a vegetarian diet and supplementation with folic acid (25-50 mgs. daily) and potassium citrate (60 milliequivalents. daily). Citrate is an inhibitor of stone formation and is usually recommended as a supplement by most kidney specialists treating stones. Low levels of citrate are found in 20-60% of all patients with kidney stones. Avoidance of alcohol is important because it increases the excretion of uric acid, calcium and phosphate. Alcohol also has adverse effects on vitamin B6 and magnesium, both of which help in stone prevention.
Megadoses of vitamin C (more than 6000 mgs. daily) increase urinary oxalate excretion and may be a factor precipitating stones in a minority of cases. There is no study, however, that proves that megadoses of vitamin C leads to a greater incidence of kidney stones. In nearly 20 years of practice, I have never been able to document a single case of kidney stones stemming from vitamin C supplementation. Neither has anyone else. The conventional medical profession, nevertheless continues to spread the false information that vitamin C and calcium causes kidney stones. Several published studies claim that the opposite is true - that vitamin C and calcium supplementation prevents kidney stones. If vitamin C intake is combined with supplementation with calcium and magnesium citrate and vitamin B6 one can be even more confident about prevention.
High body burdens of cadmium have also been associated with an increased incidence of kidney stones. Cadmium excess can be reliably determined by hair mineral analysis. Excesses can be removed from the body by supplementation with zinc, vitamin B6, magnesium and vitamin C. Intravenous chelation therapy with EDTA can also be done in severe cases. Finally, if you have a history of kidney stones, avoid supplementation with the amino acid L-cystine, a build-up of which can lead to stone formation in genetically susceptible individuals. A prevention program against kidney stones must be individualized as much as possible and followed for life. Work with your natural health care practitioner in determining what works best in your particular case.
REFERENCES
Bateson-Koch, Carolee. Allergies, Disease in Disguise. Vancouver: Alive Books. 1994. Baroody, Dr. Theodore A. Jr. Alkalinize or Die. California:Portal Books, 1995.
Bland, Jeffrey. The 20-Day Rejuvenation Diet Program. New Canaan, Connecticut: Keats Publishing, 1997.
Embon, O.M. et al. Chronic dehydration stone disease. British Journal of Urology. 1990;66:357-362.
Fromberg, M. Diet and calcium stones. Canadian Medical Association Journal,1992;146(11):1894.
Gaby, Alan. Preventing and Reversing Osteoporosis. Rocklin, CA:Prima Publishing, 1994. Hughes, J. and Norman, R. Diet and calcium stones. Canadian Medical Association Journal,
1992;146(2):137-143.
Kohri, K. et al. Magnesium-to-calcium ratio in tap water and its relationship to geological features and the incidence of calcium-containing urinary stones. Journal of Urology, Nov. 1989;142:1272-1275.
Kok, D.J. et al. The effects of dietary excesses in animal protein and in sodium on the composition and the crystallization of kinetics of calcium oxalate monohydrate in the urines of healthy men. Journal of Clinical Endocrinology and Metabolism. 1990;71(4):861-867.
Norman, R.W. and Manette, W.A. Dietary restriction of sodium as a means of reducing dietary cystine. Journal of Urology, June 1990;143:1193-1194.
Robbins, John. Diet for a New America, Walpole, New Hampshire:Stillpoint, 1987. Robbins, John. May All Be Fed, Diet for a New World, New York: William Morrow and
Company, Inc., 1992.
Rona, Zoltan P. and Martin, Jeanne Marie. Return to the Joy of Health, Vancouver: Alive Books, 1995.
Smith, L.H. Diet and hyperoxaluria and the syndrome of idiopathic calcium oxalate urolithiasis. American Journal of Kidney Diseases, April 1991;17(4):370-375.
Zoltan Rona
Author