Stone crusher

Dr Rajesh Gulia

According to current estimates, kidney stones will develop in one in 10 people during their lifetime. Clearly, prevention is paramount when dealing with kidney stones. General guidelines for prevention include moderate protein intake, minimal salt ingestion, and drinking enough clear liquids to generate two liters of urine per day. A low oxalate diet has proved beneficial for preventing calcium oxalate stones.

Which fluid to drink

While water is the mainstay, lemon juice increases urinary citrate and may prevent calcium stones. Whether one uses the recommended half cup of lemon juice per day straight up or diluted, is a personal choice. Lemonade is another frequently recommended choice. Lemon juice has potent nutritional benefits for the kidneys, possibly providing protection against kidney stone development.

Two to four ounces of lemon juice offers plenty of citric acid and a variety of other nutrients and antioxidants, all of which may be helpful for supporting kidney health. Always consume lemon juice in its raw, natural form by juicing organic lemons yourself. Never purchase bottled lemon juice, as these products are usually pasteurised and stripped of their raw enzymes and vital nutrients. If you like your lemonade on the sweeter side, I suggest adding stevia.

Cranberry juice

Cranberry juice has been long used for the treatment of urinary tract problems and is now shown to be protective against the formation of calcium oxalate kidney stones. Use only unsweetened cranberry concentrate and mix 1 cup of the juice with 3 cups water. The juice is very tart and can be sweetened with honey or stevia.

Tart cherry juice

Cherries and cherry juice relieve gout, which is cause by uric acid crystals in the joints; the same uric acid that can cause kidney stones. Tart cherry juice is high in potassium, antioxidants and anthocyanins, chemicals that prevent uric acid from forming into crystals.

Other juices

There are various opinions when it comes to the benefits of orange juice. It, too, increases urinary citrate levels, but there is concern that it could raise oxalate levels. Likewise, grapefruit juice has been associated with increased risk of stone formation. Soft drinks, via their phosphorus content, may lead to increased risk for kidney stones.

Calcium controversy

Calcium supplements, in excess, will increase your risk for forming kidney stones. Given all of the studies and commentaries, the simple take home message is that a diet containing normal amounts of calcium along with salt and animal protein reduction will likely protect against stones better than a low calcium regimen.

So what would be a straight forward routine recommendation to prevent kidney stones for the majority of patients? It would be to limit salt, drink adequate and appropriate fluids, moderate animal protein intake, minimize sugar intake of all forms, ingest adequate amounts of calcium, and strongly consider intake of high fiber plant foods containing phytate.

(Gulia is a Chandigarh-based urologist)