Non-invasive, Natural Remedies, and Prevention

Urinary Stone Disease - Non-invasive, Natural Remedies, and Prevention

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Our Approach to Urinary (Kidney) Stone Disease

Urinary stones develop for many reasons, and the solutions can be complex. Doctors at Columbia University Department of Urology at New York-Presbyterian Hospital have had tremendous success treating kidney stones and prompting them to dissolve with dietary changes, and vitamin and mineral supplements. We are researching the most effective holistic therapies and herbal or natural medicines to treat metabolically active (recurrent) urinary stone disease.

Diagnosis of Urinary (Kidney) Stone Disease

To determine the underlying cause of recurrent stone disease we perform a metabolic evaluation and extensive blood and urine studies. This information helps us determine which dietary modifications and medications will prompt the stone to dissolve and most effectively prevent the stone disease from progressing.

Treatment for Urinary (Kidney) Stone Disease

Treatment for stones composed of calcium is limited to therapies that will not also affect the bones, which are also composed of calcium. Specific changes in diet along with medications and herbal and holistic remedies can prevent these stones from increasing in number and in size. Some people develop calcium phosphate stones because they have an endocrinological disorder called hyperparathyroidism. Their stones may disappear when the disorder is treated.

Why Stones Form

Many patients attribute their kidney stones to an excess of calcium in their diet, so they shun dairy products including cheese and milk. Not only does this raise their risk of osteoporosis and bone fractures, but most patients, even those with calcium oxalate stones, need more calcium in their diet to stop their kidney stones from forming and growing. This paradox can be explained by a recent discovery: if calcium and magnesium levels in the diet are low, unbound oxalate is readily absorbed in the intestinal tract. Increased oxalate absorption leads to more oxalate in the urine and to kidney stone formation. People who have had bowel surgery, ulcerative colitis, Crohn's disease, intestinal problems, diarrhea, lactose intolerance, celiac sprue, and malabsorption syndromes are more likely to have this problem. Kidney stone formation can be arrested when patients supplement their diets with calcium or magnesium.

Stones composed of uric acid and cystine form in an acidic environment and become soluble when the urine pH (alkalinity) is raised. Doctors can sometimes partially or completely dissolve these stones with a combination of dietary change and medications. Some people develop uric acid stones because they have a citrate deficiency. We have successfully dissolved uric acid stones by having patients add 4 ounces of lemon juice to their diet each day. Lemon juice has a high concentration of citrate, a naturally occurring inhibitor of kidney stones that is found in everyone's urine.

Prevention of Future Urinary (Kidney) Stone Disease

People who have had one kidney stone are more likely to develop others. Without preventive treatment or changes in lifestyle, patients can develop a new stone within a year or two of the first one. About half of patients develop another stone within 5 to 10 years, and 80% will at some time in their lives. To help lower the chance that a patient will develop another stone, doctors recommend the following measures.

Hydration:
People who have had a stone should drink 64 ounces of water throughout each day. Drinking plenty of fluids also reduces the risk of urinary tract infections - a major cause of struvite stones.

Dietary Changes:
Depending on the composition of the stone and the results of laboratory tests, doctors may advise patients to eat less of certain foods. Patients with calcium oxalate or uric acid stones may need to reduce the amount of meat products and table salt in their diets and increase fiber.

Medication:
Some patients with stones benefit from prescription medications. Doctors may prescribe diuretics such as hydrochlorothiazide to decrease calcium excretion. Potassium citrate binds calcium and helps to remove it safely. Allopurinol causes the body to produce less uric acid and is sometimes prescribed for patients with gout. It will also reduce their risk of forming uric acid or calcium oxalate stones. Doctors treat cystine stones with a combination of approaches: a drug called alpha mecaptoproprionylglycine (Thiola); potassium citrate, which makes urine less acidic; and they have patients drink four liters of water a day.