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Health Protocols

Kidney Stones

Introduction

Kidney stones form when compounds in the urine aggregate into a solid mass (Aggarwal 2013). Kidney stones can cause extreme pain and urinary blockage in severe cases (UMMC 2013).

About 7% of women and 13% of men in the United States will have at least one bout of kidney stones requiring medical attention in their lifetime (Aliotta 2015). Unfortunately, kidney stones have a high rate of recurrence: without treatment, the risk of a second episode of kidney stones is as high as 50% during the seven years following the first occurrence (Xu 2013). Thus, taking steps to reduce kidney stone risk after a first episode is of the utmost importance.

Increasing fluid intake is one of the most effective ways to prevent kidney stones, since greater urine volume decreases the concentration of stone-forming compounds. Dietary habits such as increasing fruit and vegetable intake and decreasing intake of animal protein may play a role in reducing susceptibility to some types of kidney stones, since the foods we eat influence the composition of our urine (Heilberg 2013).

One important consideration for kidney stone formers is often overlooked: people who have a history of kidney stones may be more susceptible to chronic kidney disease. In fact, the association between kidney stones and chronic kidney disease is independent of major kidney disease risk factors like high blood pressure and diabetes: stone formers are at twice the risk for developing decreased kidney function and chronic kidney disease compared with non-formers (Keddis 2013; Frassetto 2011).

Generally, small kidney stones will pass with no medical intervention other than pain management and hydration. Doctors sometimes prescribe medications to relax the ureters and ease the passage of the stones. Larger stones, and stones that fail to pass or cause especially severe pain or obstruction and infection may require more aggressive therapies such as antibiotics, lithotripsy (therapy utilizing ultrasound shock waves to break stones into smaller fragments), or surgery to remove stones (Antonelli 2015).

A fundamental aspect of kidney stone management is analyzing the chemical composition of the patient’s urine and kidney stones (if available). Different stone types require different treatments. A 24-hour urine profile is a useful tool in determining the type of stone(s) a patient has or is prone to developing (LabCorp 2015). Calcium oxalate, calcium phosphate, and uric acid stones are the most prevalent, and these differ in their causes and treatments. For instance, calcium oxalate and uric acid stones are best addressed by raising urine pH while calcium phosphate stones require lowering urine pH (Xu 2013; Sakhaee, Maalouf 2012; Healy 2012; Curhan 2012; Coe 2015).

Several natural interventions may help prevent certain types of stone formation. For example, supplemental magnesium and calcium, particularly in their citrate forms; vitamin B6; and probiotics may help prevent calcium oxalate stones, the most common type of kidney stones (Negri 2013; Zimmermann 2005; Taylor 2004; Caudarella 2009; del Valle 2013; Sakhaee 2004; Ettinger 1997; Ferraz 2009; Curhan 1999).

Not long ago, it was assumed that calcium intake, from diet or supplements, contributed to kidney stone risk. Some physicians even went as far as telling kidney stone patients to restrict calcium intake. But this theory has been disproven, and low calcium intake is now known to increase kidney stone risk. Calcium supplementation was not associated with kidney stone risk in a rigorous analysis of data from 10 studies (Martini 2002; Candelas 2012). 

In this protocol you will learn about the different types of kidney stones and how they form. Factors that increase kidney stone risk will be described, and little known connections between kidney stones and several chronic health conditions will be reviewed. You will also learn about how kidney stones are typically treated, and ways to reduce kidney stone risk with dietary strategies and natural interventions.

Given the underappreciated connection between kidney stones and chronic kidney disease, readers of this protocol should also review Life Extension’s Kidney Health and Chronic Kidney Disease protocols, which describe more general strategies for preserving kidney health.