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LiveScience
Ah, summer. The sun, the sand … and kidney stones.
August is peak season for developing kidney stones. Doctors have seen a sharp increase in patients with stones in general — a rise by as much as 30 percent in the past decade — likely tied to diets high in refined sugars, salt and animal protein. (More on this below.)
But the primary reason for the summertime kidney blues is dehydration. As the mercury rises, we sweat more. Without proper hydration, the body's fluids become more concentrated with dietary minerals, such as calcium. This increases the risk that the minerals will concentrate into stones.
More than 10 percent of Americans will develop at least one kidney stone during their lifetime. Many get their first stones as early as their mid-20s.
Some people who have had stones might tell you it can be more painful than childbirth, as these often-jagged crystals slowly make their way through your delicate and narrow urinary track. Forming a stone just once increases your risk of forming another by at least 50 percent.
So, this is something worth preventing. And the easiest way, particularly in the summer, is to drink plenty of fluids. [ 5 Wacky Things That Are Good For Your Health ]
The ins and outs
William Haley, a nephrologist at Mayo Clinic's Kidney Stone Clinic in Jacksonville, Fla., recommends drinking two liters, or about eight cups, of non-caffeinated liquid per day. Water is best. But output is more important than input, Haley said. You should shoot for producing a whopping 2.5 liters of urine daily.
"If you don't void [urinate] every couple of hours, you're not drinking enough," Haley told LiveScience. Fear not if you'd rather not measure your output in a cup. A very full bladder holds about half a liter of urine. Haley said the general rule of thumb is to drink until there's little yellow in your urine.
What to drink is a stickier issue. John Milner, a urologist at Loyola University Chicago Stritch School of Medicine, has said that iced tea can promote the formation of the most common type of kidney stone, the calcium oxalate stone. Tea, particularly black tea used for iced tea, is high in oxalates.
The "most common type" he refers to is the calcium oxalate stone. Tea, particularly black tea used for iced tea, is high in oxalates. While there is no proof of a connection, anecdotal evidence suggests that drinking glass upon glass of iced tea on hot days is what helps make the American South the so-called kidney stone belt.
No scientific studies support this connection, however. At best, this is advice for chronic stone formers; anecdotal evidence does suggest that drinking glass upon glass of iced tea on hot days is what helps make the American South the so-called kidney stone belt.
Milner also recommends lemonade because the citric acid in lemons inhibits urinary crystal formation. But lemonade comes with baggage — lots and lots of sugar. Hence, back to Haley's advice that water is best. You can add a lemon wedge. Many foods contain water, too.
Our kidney stone diet
The reasons for the nationwide increase in kidney stones are complicated and, for the most part, not well understood. But a diet high in refined sugars, salt and animal protein — that is, the typical American diet — does seem to be a factor.
The meat-heavy Atkins and South Beach diets, for example, have brought in many new patients with stones to the Mayo Clinic, Haley said.
Animal protein, when digested, acidifies the urine and promotes crystal formation. Excess sodium passing through the kidneys causes more calcium to enter into the urine, raising the risk for stone formation. High-fructose corn syrup, particularly when accompanied by low levels of magnesium, also increases urinary calcium excretion. (Good sources of magnesium include dark leafy greens, whole grains, nuts and seeds.)
But dietary contributions can be counterintuitive: Grapefruit, high in citric acid like lemons, promotes stone growth; non-fat dairy products, high in calcium, reduce stone risk. Dietary calcium in general reduces the risk while supplemental calcium increases the risk. [ 10 New Ways to Eat Well ]
And then there are those oxalate-containing foods, such as tea. The list of oxalate-containing foods include the healthiest foods on the planet: blackberries, blueberries and kiwifruit; Swiss chard, spinach and most dark, leafy greens; almonds, cashews and other nuts; tofu and other soy products; and good ol' wheat germ, a health-food store staple.
Considering that Americans likely aren't developing more kidney stones from eating these foods, advice to cut back on oxalates for the general population might be shortsighted.
Summertime and the passing's uneasy
It could be that those people forming calcium oxalate stones have a propensity to do so, Haley said. There also could be a threshold, in which a diet high in animal protein, sodium and refined sugars, coupled with oxalates and dehydration, increases the risk for stone formation, Haley added.
Both Milner and Haley recommend seeing a doctor if you think you have passed a stone. It might have been too small to feel (this time!), but it could have caused blood in the urine. Analysis of your urine could determine what minerals are being excreted and what foods you need to avoid.
Complicating the situation even further is global warming. It is getting hotter; and Haley, among others kidney specialists, doesn't rule out this factor, given the strong relationship between summer heat and kidney stones.
Which brings us back to Haley's top recommendation, regardless of your kidney stone history: "Hydration, hydration," he said.
Christopher Wanjek is the author of a new novel, " Hey, Einstein! ", a comical nature-versus-nurture tale about raising clones of Albert Einstein in less-than-ideal settings. His column, Bad Medicine, appears regularly on LiveScience.
Leave a Comment:
Apparently the writer needs an editor.
So basically, the usual crop of solutions for any mild disorder of human health: lots of water, not too much of this, not too little of that...
This article is certainly confusing: "Milner also recommends lemonade because the citric acid in lemons inhibits urinary crystal formation."
Then, "Grapefruit, high in citric acid like lemons, promotes stone growth."
What to do with those lemons then? Eat or not?
I have had only one kidney stone in my life, which was definitely more excruciatingly painful than childbirth. Two shots of morphine helped with the pain - love that drug! What made it worse was that the stone didn't pass, but was lodged at the beginning of the urinary tract. The first doctor I had in the ER just told me to drink more water and sent me home. The ER nurse thought he would have to remove it, but I don't think he really cared.
When the pain started up again just a week later, I went to a different ER, had a different urologist and he had to go up and get the kidney stone through minor surgery. No more pain, no more kidney stones and that was over 10 years ago.
I love lemons and lemonade, more than iced tea, and still enjoy them. My lemonade is made with Truvia, so no highly refined sugar. I also like salt. I work outside at an amusement resort, so hydrate constantly, especially this summer with temps in the 100s and holding. I drink mostly water, but Gatorade has helped when I start to feel weak and dizzy.
This article is extremely confusing. Some people simply have a tendency to make kidney stones, probably for no one reason. Since it doesn't seem like anyone has a definite idea about what causes them - I guess avoiding iced tea and a diet heavy with meat, may help in their formation - I'd rather not read these articles. Too many factors involved and not everyone is the same.
Like everything else: NOT in excess!!!
Like everything else: NOT in excess!!!
I suffered my first kidney stone 3 weeks ago - at age 47. OMG, I thought I was going to die. Went to the ER and they gave me 3 shots of "something" they said was more powerful than morphine.
Apparantly, it passed, but I didn't realize it. A friend said it might have broken apart. Maybe the percoset covered the pain.
I wonder why they state that once you have one, you're more likely to get one in the future.
I've been cutting down on diet soda and increasing my water intake. But 8 glasses of water per day and my eyeballs would be swimming!
This was solved years ago. Moving on!
Tea causes my kidney stones. Tea consumption goes up in the summer because more ice tea is consumed so it would make sense that kidney stones would go up in the summer. Also explains why they are more prevalent in the south where iced tea is a staple.
I take extra potassium, magnesium and B12. As long as those are in my vitamin regimine the stones stay away. If I stop taking them I'll get another stone within two to three months. A multi-vitamin does not seem to do the trick though.
When I have one I drink tons of water and I have been lucky enough to pass them so far.
B6 is another one. It reduces oxalate formation, if I recall correctly. Take your citrates.
"You should shoot for producing a whopping 2.5 liters of urine daily."
Yup, and if you think that's too much, just do what I do. Cut the top off a gallon jug and keep it under your desk.
Ahhhhhhhhhhhh...........
I used to have kidney stones and saliva stones on a regular basis. During one attack a friend suggested drinking cranberry juice. I laughed but a bottle of cranberry juice is not a big medical investment. Perhaps an old wives tale but within 24 hours the stone was gone and I have not had a reoccurrence of any type of "stone".
I have been getting stones since I was 19 and for the past for the last 34 years have been getting them every 2-3 years since, sometimes from both kidneys simultaneously. I have passed some big ones without much pain and others have caused me to roll on the floor with such severe pain, that I have nearly passed out. One thing, I have noticed is that Urologists are far slower at ordering morphine shots for pain relief, if you go to the emergency room. The pain can be severe for several hours and then dissipate for day, week, or longer. So urologists like to send you home with a script for a painkiller, percocet, vicodin, etc....totally useless with this kind of pain. So be sure to to talk to your doctor about what after hours treatment will consist of....because by the time today's emergency rooms treat you, hours after arrival, you will be lucky to get any kind of relief. And if you urologist belongs to a shared practice, which is likely, dont expect his/her partner to offer up morphine if they are on call. I have been through it all, have had by my count over 30 stones and todays treatments dont seem to have changed much since the late '70s. the best option in my opinion is to immediately see an urologist if you feel any kind of discomfort in your kidney area of the body, lower part of the back, either side of the spine. He can order xrays and determine if you have kidney stones. If you do, push for prophylactic treatment, in this case, extra-corporal shock treatment. It will bust up the big stones in smaller more manageable stones that can be passed through the ureter and into the bladder, from where and discharged through normal urination. Most urologists have never had a stone, so they cannot imagine the pain involved, so be insistent that action be taken and soon, if you have one or more. Good luck!
Aside from some poor editing and repetition, this article matches my personal experiences. I had terrible recurring stones in my mid-20s, about 10 years ago, that left me in agony for days, and eventually in the hospital overnight on IV drip and morphine. The amount of pain these stones cause cannot be overstated, in my opinion.
My diet at the time was that of a typical bachelor: tons of processed and fast foods, soda daily, alcohol nightly, and gallons of coffee all day at work. I rarely drank any water. After the hospital experience I smartened up by cutting out almost all soda (only an occasional non-cola one now), reduced coffee intake to one or two small "good" coffees instead of gallons of crap office coffee, and I started eating much better with food cooked from scratch instead of from a package (getting married helped with that change, I'll admit!)
Most importantly I got in the habit of drinking lots of water throughout the day, as this article described, and staying hydrated really is the key. Coconut water is also magical for those times when I'm feeling a bit dehydrated. Thankfully with this no stones have recurred. Things that have triggered twinges for me in the past are grapefruit juice (dangerous stuff), eating too many nuts, and eating too many dark leafy greens like spinach, so I avoid all those things when possible.
I got a kidney stone after a couple of motorcycle related accidents. Large bruises as well as muscle death release chemicals into the blood that the kidney's filter. I had a bad combo of both. Comically as my bruises 'drained' away I started peeing dark bruise-colored pee. Shortly thereafter, Kidney stone. I hadn't drank enough to flush all the toxins and myo/hemoglobin crap out of my kidneys and it crystallized.
I was in bed for 2 weeks from the pain. So keep that in mind the next time you have a sports injury, it CAN spawn a kidney stone.