How To Prevent Renal Stones

• Renal stones are also called as kidney stones.
• Renal stones are very common problem in most of the temperate climate.
• One of the most common cause considered to be is the less intake of water and hot climate.

Constituents of stone

• These stones consists of following chemical components:
1. Calcium oxalate.
2. Calcium phosphate.
3. Uric acid.
4. Mixture of magnesium ammonium phosphate.
5. Cysteine.
6. These substances crystalizes in organic matrix in kidney or urinary bladder.
7. These substances are poorly soluble in aqueous (water) solution.
8. Their solubility depends upon the pH of urine.

Formation of stones depends upon

1. Urine flow which depends upon water intake.
2. Excessive excretion of above chemicals excreted in urine.
3. Absence of the substances that inhibit the stone formation.
4. Calcium oxalate stone
   1. These are the most common stones and occurs world wide.
   2. These are more common in the tropical and subtropical countries.
   3. These are associated with concentrated urine or increased calcium oxalate excretion in the urine.
5. Uric acid
   1. These are more common in the raised level of uric acid.
   2. Diet rich in proteins may lead to uric acid stone formation.
   3. These are common in people who take lot of fish in their diet.

Prevention of the various stones
Calcium Oxalate Stones

1. Reducing sodium intake.
2. Reduce animal protein, such as meat, eggs, and fish.
3. Avoid taking calcium supplements with food.
4. Avoiding foods high in oxalate, such as spinach, rhubarb, nuts, and wheat bran.

Calcium Phosphate Stones

1. Reducing sodium intake.
2. Reducing animal protein.
3. Avoid calcium from food or taking calcium supplements with food.

Uric Acid Stones

1. These form in high protein diet.
2. Excessive eating fish may lead to uric acid stone formation.
3. Decrease the animal protein like Beef, lamb, goat , chicken.
4. There is high concentration of uric acid in fish.
5. Other factors
6. Which leads to kidney stone formation include :
   1. Genes.
   2. Environment.
   3. Body weight.
   4. Fluid intake.

Prevention in the long run in patients once they have stone formation

1. Diet is one of several factors that can promote or inhibit kidney stone formation.
2. Four major types of kidney stones are :
   1. calcium stones.
   2. Uric acid stones.
   3. Struvite stones.
   4. Cystine stones.
3. Fluid intake is the main key to prevent the stone formation.
4. People with history of stone formation should have enough water and fluids, so that they will have urine output of at least 2 liters per day.
5. Sodium salt causes the kidneys to excrete more calcium into the urine.
   1. High concentrations of calcium in the urine combine with oxalate and phosphorus to form stones.
   2. Reducing sodium intake is preferred to reducing calcium intake.
6. Meats and other animal protein e.g. s eggs and fish contain purines, which break down into uric acid in the urine.
7. Calcium from food does not increase the risk of calcium oxalate stones. Calcium in the digestive tract binds to oxalate from food and keeps it from entering the blood.

Dr.Riaz Bhutta