Treatment and Prevention of Kidney Stones

Drinking lots of water is the best way to help a kidney stone pass.

Symptomatic kidney stones may need help being excreted from the body, and in worst-case scenarios, surgery or other procedures may be necessary to remove them.

Passing Kidney Stones

Drinking lots of water — six to eight glasses per day — is the best way to help small kidney stones pass, according to the National Institutes of Health.

While the stone travels through your system, you will likely experience pain, which may be intense.

Over-the-counter pain medications, including ibuprofen (Advil, Motrin), acetaminophen (Tylenol) or naproxen sodium (Aleve), can help relieve mild pain.

For some people, the pain may be so intense that narcotics or a hospital stay is necessary.

Medications for Kidney Stones

If you are having trouble passing the stone naturally, your doctor may prescribe alpha-blockers such as tamsulosin (Flomax), which relax the urinary tract muscles, allowing the kidney stone to pass more easily.

Your doctor may also prescribe other medications to help dissolve stones, reduce stone-causing compounds, or prevent new stones from forming.

Your medication will likely be tailored to your health needs and the type of stone you likely have.

Medications for calcium stones include:

• Thiazide diuretics, including hydrochlorothiazide (Esidrix), chlorothiazide (Diuril), and trichlormethiazide (Metahydrin), which should be taken with potassium citrate to prevent potassium and citrate loss
• Amiloride (Midamor), a potassium-sparing diuretic
• Citrates, including potassium magnesium citrate, potassium citrate (K-Lyte), and magnesium citrate (Citroma and Citro-Nesia)
• Phosphate compounds, including potassium phosphate (K-Phos), cellulose phosphate (Calcibind)
• Cholestyramine (Questran)

Medications for uric acid stones include:

• Sodium Bicarbonate (Prilosec/Zegerid)
• Potassium Citrate
• Allopurinol (Lupurin, Zyloprim)

Medications for struvite stones include:

• Antibiotics (struvite stones are caused by bacteria-borne urinary tract infections)
• Acetohydroxamic acid (AHA or Lithostat)
• Organic acids, such as Renacidin (citric acid, glucono-delta-lactone, and magnesium carbonate)
• Aluminum hydroxide anti-acid gel

Alkalizing agents, such as bicarbonates, are the first line of medications for cystine stones. Other drug treatments that lower cystine concentrations may also be used (especially if alkalization fails):

• D-penicillamine
• Alpha-mercaptopropionylglycine (tiopronin)
• Captopril

Kidney Stone Removal

Standard open surgery or other medical procedures may be necessary if the stone is too large, blocks urine flow and causes infection or kidney damage, or causes severe pain.

Procedures include:

• Shock wave lithotripsy, in which high-energy sound waves from a machine (a lithotripter) break up the stone into smaller pieces
• Ureteroscopy, in which a long, tube-like instrument with a camera is inserted into the urethra to remove or break up the stone
• Percutaneous nephrolithotomy, in which the stone is removed using a nephroscope (a tiny fiberoptic camera) that's inserted into the kidney through a small incision in a person's back; if this procedure is combined with lithotripsy, it's called nephrolithotripsy

Kidney Stone Prevention

For people who are susceptible because of certain hereditary health conditions or being overweight, simple dietary and lifestyle changes can help prevent new kidney stones from forming.

The best way to prevent kidney stones from forming is to drink enough fluids.

It's recommended that you drink at least one-half gallon of water, or enough fluid to produce about two quarts of urine, each day.

Additionally, you may need to drink more water if you're losing fluids to sweating from exercising or being in hot weather.

Caffeinated drinks, including coffee, tea, and colas, should be limited to one or two cups a day, because caffeine may worsen dehydration, according to the National Institutes of Health.

Other drinks may be beneficial or detrimental to kidney stone development, depending on what type of kidney stone you have.

To prevent calcium oxalate stones, juices high in oxalates, such as cranberry and apple, should be avoided.

Drinks that raise the acidity of your urine, such as cranberry juice, are good choices for preventing calcium phosphate and struvite stones.

For uric acid stones, you can drink black currant juice, which raises urine alkalinity, but avoid highly acidic drinks.

Citrus drinks such as lemon juice, lemonade, and orange juice may help prevent kidney stones by raising the urine's levels of citrate, which stops crystals from growing into stones.

Grapefruit, on the other hand, has been associated with increased kidney stone risk.

Kidney Stone Diet

If you're prone to calcium oxalate stones, it's important to reduce your sodium (salt) intake. Sodium increases the excretion of calcium into the urine.

An easy way to do this is to limit your consumption of processed foods like hot dogs and luncheon meat, canned soups and vegetables, fast food, and frozen meals.

You should also reduce your consumption of meats and other types of animal protein, including eggs and fish, because these may also increase calcium excretion and reduce the excretion of citrate.

As you might expect, it's beneficial to reduce your consumption of foods high in oxalates, including:

• Some fruits, including rhubarb, currants, strawberries, and Concord grapes
• Some vegetates, including beets, leeks, and spinach
• Various other foods and drinks, including grits, tofu, nuts, chocolate, tea, instant coffee, and wheat bran

Interestingly, a lower intake of calcium in your diet may increase your risk of calcium oxalate stones, according to a 2012 report in the Journal of Clinical Endocrinology & Metabolism.

However, calcium supplements, as well as calcium-based antacids, increase your risk of calcium oxalate stones.

If you're prone to getting calcium phosphate stones, you'll also want to reduce your sodium and animal protein intake, while getting enough calcium from food.

For uric acid stones, limiting animal protein to six ounces a day is also recommended.

Animal proteins contain purines, substances that the body breaks down into uric acid.

Also limit:

• Alcohol
• Oils
• Legumes
• Gravies
• Mushrooms
• Spinach
• Asparagus
• Cauliflower
• Consommé, a soup of concentrated stock
• Baking or brewer’s yeast
• Fatty foods

Additionally, it's important to eat enough carbohydrates and avoid losing weight too quickly