Kidney Stones Prevention

General Procedures

Diet is an important factor that can promote or inhibit the formation of urinary stones. General procedures useful for kidney stone prevention for all patients:

1. Drink plenty of fluids

• The simple and most important measure of kidney stone prevention is to drink plenty of water. Where an individual should drink 12-14 cups (more than 3 liters) of water per day. To ensure that sufficient water enters the body throughout the day, the individual should carry a water bottle with them.

• Determining which water to drink is a dilemma for many patients. But remember that to prevent stone formation, the amount of water is much more important than the quality of the water.

• For kidney stone prevention, an adequate volume of urine per day is much more important than the volume of fluid entering the body. To ensure that you are drinking enough water, measure the total volume of urine each day. This should be more than 2-3 liters per day.

• The color of your urine will tell you how regularly you drink water. If you drink enough water throughout the day, the urine will be light, clear, and often water-like.

• Light urine means a lower mineral concentration, preventing kidney stones from forming. Yellow, dark, and concentrated urine suggests insufficient water entering the body.

• It is recommended to drink plenty of fluids among physically active individuals on hot days due to a large amount of water loss from perspiration.

• The entry of fluids into the body, such as coconut water, barley, or rice, and fluids rich in nitrates, such as lemon juice and pineapple, helps to increase the total fluid entering the body and prevent stones.

Which fluids are preferred for kidney stone prevention?

Drinking fluids such as coconut water, barley water, or rice; and fluids rich in citrates, such as lemon juice, tomato, or pineapple, may help prevent kidney stones. But remember, at least 50% of the fluid entering the body must be in the form of water.

Which fluids should be avoided for kidney stone prevention?

He should avoid grapefruit juice, cranberry and apple juice, heavy tea, coffee, chocolate, sugar-sweetened soft drinks such as cola, and all alcoholic beverages, including beer.

2. Salt Reduction

Excess salt in the diet should be avoided. Thus, pickles, spicy food, meals containing a lot of salt, etc., should be avoided. Excessive amounts of salt or sodium in the diet increase the excretion of calcium in the urine and thus increase the risk of calcium stone formation. 

Therefore, limiting sodium intake to less than 100 milliliters, or 6 grams of table salt, per day is key to kidney stone prevention.

3. Reduce the intake of animal protein

Avoid non-vegetarian foods such as lamb, chicken, fish, and eggs. These animal foods are high in uric acid/purines and can increase uric acid stones and calcium stones.

Eat a balanced diet that contains plenty of vegetables and fruits, which lowers the acid load and tends to make the urine less acidic. Fruits such as bananas, pineapples, blueberries, and oranges should be eaten.

Vegetables such as carrots, bitter gourd, squash, and bell peppers should be eaten. Foods that are high in fiber, such as barley, broad beans, oats, and psyllium seeds, should be eaten. Avoid or limit refined foods such as white bread, pastries, and sugar. Kidney stones are associated with high sugar levels.

Special Procedures

1. To prevent calcium stones

Patients with kidney stones often mistakenly believe they should avoid calcium. However, a healthy diet that contains calcium, including dairy products, should be eaten to prevent stones from forming.

When the calcium-containing diet binds to oxalate and is excreted, oxalate is absorbed from the intestine, and then stone formation decreases. But when there is less calcium in the diet, unbound oxalate is absorbed from the intestines, promoting the formation of oxalate stones.

2. For the prevention of oxalate stones

• Spinach, rhubarb, fresh okra, beetroot, and sweet potatoes. 
• Strawberries, red raspberries, chico, amla, creosote grapes, cashews, peanuts, almonds, and dried figs.
• Green peppers, fruit cake, fruit jam, dark chocolate, peanut butter, and foods containing soy and cocoa
• Grapefruit juice, dark cola, and heavy or black tea.

3. For the prevention of uric acid stones

• Avoid all alcoholic drinks
• Avoid foods high in animal protein, such as organ meats (such as brain, liver, and kidneys), fish (such as anchovies, sardines, herring, trout, and salmon), pork, chicken, beef, and eggs.
• Limit legumes such as beans or lentils; vegetables such as mushrooms, spinach, asparagus, and broccoli; and sweet bread.
• Limit fatty foods such as salad dressings, ice cream, and fried foods.

This article was written and reviewed by Dr. Hassan Ali - Urologist