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Renal calculi - self-care; Nephrolithiasis - self-care; Stones - kidney - self-care

You visited your doctor or the hospital because you have a kidney stone. You doctor will ask you to take some self-care steps that depend on the type of stone you have.

Your doctor may:

• Ask you to drink extra water and other liquids
• Ask you to eat more of some foods and to cut back on other foods
• Give you medicines to help prevent stones

Your doctor may ask you to try to catch your kidney stone. You can do this by collecting all of your urine and straining it. Your doctor or nurse will tell you how to do this.

A kidney stone is a solid piece of material that forms in a kidney. A stone may get stuck 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. The disease that causes cystine stones runs in families.

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, and that makes it less likely stones will 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 of urine every 24 hours.
• Drink enough to have light-colored urine. Dark yellow urine is a sign you are not drinking enough.

If you drink bottled water, read the label. Make sure it does not contain calcium or other ingredients that may be harmful. Ask your doctor if you are not sure.

Limit your coffee, tea, and cola to 1 or 2 cups a day. Caffeine may cause you to lose fluid too quickly, and that can make you dehydrated.

Follow these guidelines if you have calcium kidney stones:

• Eat less salt. Chinese and Mexican food, tomato juice, regular canned foods, and processed foods are usually 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. Some of these are milk, cheese, yogurt, oysters, and tofu.
• Lemons, lemonade, and oranges are helpful to eat
• Limit how much protein you eat. Choose lean meats.
• A low-fat diet is best.

Do not take extra calcium or vitamin D. They might cause more stones to form. Watch out for antacids that have extra calcium in them. Ask your doctor what antacids are okay for you.

Ask your doctor about taking vitamin C or fish oil. They may be harmful to you.

If your doctor 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

Avoid these foods if you have uric acid stones: alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, consommé, and baking or brewer’s yeast.

Other suggestions for your diet include:

• Do not eat more than 3 ounces of meat at each meal.
• Avoid fatty foods such as salad dressings, ice cream, fried foods, and dressings.
• Eat enough carbohydrates.

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

Call your doctor or nurse if you have:

• Very bad 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

Cameron MA, Sakhaee K. Uric acid nephrolithiasis. Urol Clin North Am. 2007;34(3):335-346.

Chandhoke PS. Evaluation of the recurrent stone former. Urol Clin North Am. 2007;34(3):315-322.

Miller NL, Evan AP, Lingeman JE. Pathogenesis of renal calculi. Urol Clin North Am. 2007;34(3):295-313.

Pietrow PK, Preminger GM. "Evaluation and Medical Management of Urinary Lithiasis." In: Wein AJ, Kavoussi LR, Novick AC, et al. (eds.) Campbell-Walsh Urology, 9th ed. Philadelphia, PA: Saunders; 2007:chap 43.