09/14/2009 - Articles

Kidney stones? How to eat and drink if you have kidney stones

By: The Swiss Association for Nutrition (SAN)

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How to eat and drink if you have kidney stones

Kidney stones are considerably more common in times of prosperity, whereas in times of shortage (e.g. world wars) substantially fewer stone disorders are recorded.

Eating the right foods in the right amounts will help to prevent kidney stones. What are the foods to avoid witey stones? What can you eat if you have kidney stones? How to eat and drink with kidney stones? Is there a diet for Kidney Stones? These are some questions we will try to address here. 

In this article:

Causes of Kidney Stones

Kidney stones are considerably more common in times of prosperity, whereas in times of shortage (e.g. world wars) substantially fewer stone disorders are recorded. Men are more frequently affected than women. Most kidney stones are 95% crystalline, while the rest is organic material. The following distinctions are drawn between different kinds of stone based on their crystalline composition: 80-85% are calcium stones (usually calcium oxalate, less commonly a mixture of calcium oxalate/calcium phosphate or pure calcium phosphate), 5-10% are uric acid stones, 5-10% are "infection stones" (struvite and carbonate apatite), and 1% are rare varieties, e.g. cystine stones.

No kidney stone disorder can be explained by nutrition alone. However, diet does play a crucial role in calcium and uric acid stones, triggering the formation of stones in people with a predisposition. Major studies have shown that excessive consumption of meat protein leads to a marked increase in kidney stones. The main risk factors for calcium stones are a low volume of urine, increased excretion of oxalic acid and calcium (less critical), and a deficiency of citrate, which inhibits crystallization in the urine. Overly acidic urine is the main risk factor for the formation of uric acid stones.

Fluids - the most important element for kidney stone patients
One should drink enough fluid to produce a urinary volume of at least 2 litres a day. On days of profuse sweating or major physical exercise (heavy work, sport) a daily fluid intake of 3 or more litres (over 12 glasses or cups) is recommended. It is important that the fluid intake is distributed as equally as possible over the course of 24 hours, i.e. one should also drink before going to bed (an over-concentrated nocturnal urine encourages crystallization and stone formation). Almost all beverages are suitable, but bicarbonate and calcium-rich mineral water as well as fruit juices are particularly beneficial. On the other hand, the formation of stones is promoted by large quantities of black tea or iced tea (high oxalate content), cola (very acidic) and beer ("liquid binges" lead to an increase in oxalic acid and uric acid excretion).

Vegetables, fruits and nuts
Vegetables and fruits increase the urinary excretion of the stone-inhibiting citrate. The consumption of foods with a high oxalate content (spinach, rhubarb, beetroot, chard and nuts) should always be kept to a minimum or combined at the same time with foods providing a plentiful supply of calcium (e.g. spinach with a cheese gratin), which prevents the absorption of large quantities of oxalate from the intestine which would lead to an increase in it's excretion in the urine.

Meat, poultry, fish
An excessive intake of protein from meat and fish increases the risk of stone, because the urine is over-acidified and the excretion of oxalate, calcium and uric acid increases, whereas the excretion of citrate - which provides protection against stone formation - is decreased. The intake of these foods must therefore be reduced in cases of calcium and uric acid stone.

Milk and dairy products
Contrary to earlier views, a restriction of calcium is no longer recommended. Large-scale studies in tens of thousands of cases have clearly shown that, with an increase in calcium intake up to about 1,200 mg/day, the risk of stone formation significantly falls - and does not rise, as was once wrongly assumed. A total calcium intake of 1,200 mg/day, of which 800 mg should come from dairy products, is thus recommended.

Salt
The sodium contained in common salt can increase the risk of stone formation, probably by increasing the urinary excretion of calcium. On the other hand, a drastic reduction of salt leads to a decrease in urinary volume. A slightly reduced salt intake (to about 8 g per day) is therefore recommended.

Sweets
Excessive consumption of foods rich in sugar increases the urinary excretion of calcium and thus possibly also the risk of kidney stone. Probably more important, however, is the fact that chocolate, pralines and products containing cocoa have high oxalate content.

Prevention of Kidney Stones - Dietary recommendations

Many factors affect our dietary behaviour: individual needs and desires, our day-to-day condition, the social environment, the food currently on offer, advertising etc. The following recommendations ensure a balanced and varied diet that provides an adequate intake of energy, nutrients and protective substances and thus a healthy approach to nutrition. The figures quoted are intended for the "average person", i.e. for adults who engage in normal physical activities and thus have an average energy and nutrient requirement. The figures would vary for other groups (such as children and adolescents, top athletes, pregnant women etc.). The quantities and portions given are likewise average values; they cannot be adhered to precisely every day. Those passages which appear in italics are particularly important for persons with a tendency towards kidney stones.

How to eat if you have kidney stones:

Fats and oils:
Use 2 teaspoonfuls (10 g) of high-quality vegetable oil (e.g. sunflower oil, thistle oil, corn oil, olive oil, rapeseed oil) per day, unheated, e.g. for salad dressings.
Use not more than 2 teaspoonfuls (10 g) of cooking fat or oil per day (e.g. peanut oil, olive oil) for the preparation of meals.
Do not eat more than 2 teaspoonfuls (10 g) of spreading butter or margarine per day on bread.
Do not eat more than one high-fat meal per day, such as deep-fried or breaded food, cheese dishes, fried potato, sausage, cream sauce, puff pastry, cakes, chocolate.

Sweets:
Eat sweets in moderation - exercise restraint especially with chocolate, pralines and chocolate cakes.

Meat, fish and eggs and pulses:
Do not eat more than one portion (80 - 120 g) of meat a day 2 - 4 times a week; more is unnecessary, less is no problem. Do not substitute salted meat products, such as ham, sausage, or bacon, for meat more than once a week. Do not eat offal (liver, kidneys, tripe, sweetbreads) more than once a month (1 portion = 80 - 120 g).
Plan to eat 1 - 2 portions of fish a week (1 portion = 100 - 120 g).
Eat 1 - 3 eggs a week, including processed eggs e.g. in cakes and pastries, soufflees or creams.
Pulses, pulse products: eat 1 - 2 portions of lentils, chickpeas, kidney beans (1 portion = 40 - 60 g, dry weight) and tofu (1 portion = 100 - 120 g) per week.

Milk and dairy products:
Eat 3 - 4 portions of dairy products per day (1 portion = 2 dl milk or 1 cup of yogurt or 30 g hard cheese or 60 g soft cheese).

Cereal products and potatoes:
Eat at least 3 portions of carbohydrate-rich foods per day, such as bread, potatoes, rice, cereal, or pasta, preferably wholemeal products. The size of the portion depends on the degree of physical activity the person engages in.

Fruit:
Eat 3 portions of fruit a day (1 portion = 1 apple, 1 banana, 3 plums or a dish of berries), ideally raw.

Vegetables:
Eat 3 - 4 portions of vegetable per day, at least one of them raw, e.g. as a dip or a mixed salad (1 portion = 100 g raw or 150 - 200 g cooked vegetable).
Exercise restraint, however, with spinach, chard and rhubarb (preferably eat these vegetables together with dairy products, e.g. spinach with cheese gratin).

How to drink if you have kidney stones:

Beverages:
Drink at least 3 litres of liquid per day, preferably unsweetened and alcohol-free beverages. Black tea or ice tea and cocoa beverages should only be drunk in small quantities.

Alkoholic drinks:
Do not drink more than 2 glasses of wine or beer a day. Plan to have at least 1 day a week without alcohol! 

  • Drink at least 2 litres (8 glasses) of unsweetened beverages or water daily
  • Add less salt when preparing your meals, and eat salty food in moderation
  • Eat less meat (not more than 2-4 portions a week)
  • Exercise restraint with oxalate-rich foods
  • Preferably eat high-fibre foods 

If you are concerned about Kidney Stones, you might want to read these articles

Source

How to eat and drink if you have kidney stones R. Griffith, Copyright: Swiss Association for Nutrition, Berne, 2000

Created on: 12/08/2002
Reviewed on: 09/14/2009

Your rating: None Average: 4.4 (103 votes)
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Anonymous wrote 1 year 35 weeks ago

Im dealing with very large kidney srones right now. I have six of them, three in each kidney.
The biggest one being 1.5 cm's. I am going to be having surgery to get them out in a couple of
Weeks. If anyone has had to have the surgery, please let me know all about the recovery please.
Thank u.

Anonymous wrote 1 year 34 weeks ago

I had a 6mm stone in my right ureter last month. They first tried to go up the ureter and pull it out, but it was too big. They also inserted a stent. I was a little sore the first couple days, but then I ended up getting a bladder ifected and going back to the er because I was so sick. About a week and a half later they did a lithotripsy. I was sore that day where they had done the treatment, but felt pretty good the day after. I went back to work two days after but was very sore that night. I did have a lot of pain when some of the bigger pieces pass. I hope this helps a little. I don't know exactly what they are doing to you. I will tell you having the stent was the worst part. I had this intense feeling that I needed to urinate constantly and got no relief when I did. It also hurt to go. Unfortunatley it was a neccesary evil. Good luck to you

Anonymous wrote 1 year 35 weeks ago

i've been getting kidney stones for the past 3 years and they keep coming back !! been told so many different things on how to prevent them, and nothing seems to be working ! i also had to have the first one surgically removed because of the size it was and the type of stone it was . the recovering process is very long and painful. seems to me that i never get a good answer or if any at all from the dr" s...

Anonymous wrote 1 year 35 weeks ago

Very Nice! Hope this will help me.

Anonymous wrote 1 year 38 weeks ago

This is a very poorly-written article (non-native English speaker?!?). In second paragraph: ..."What are the foods to avoid witey stones?" WITEY STONES?!? Try Googling that and you ONLY will get THIS article, how about some proofreading/editing? There are MANY more better sources out there for kidney stone info. and answers!

Anonymous wrote 1 year 38 weeks ago

I LIKEE JELLOCAKES!!

Anonymous wrote 1 year 40 weeks ago

Another article that contradicts my known theories. Just like all theses "professional opinions' are ritled with misinformation. Confusing the general public. I am amazed that any of our parents lived to 80 or 90 years old. Maybe it all the artificial chemicals that are found in our food supplies today. You know "better living through chemistry."

Anonymous wrote 1 year 41 weeks ago

I was desperately trying to find an article that explained whether milk was bad or not for someone with kidney stones. Thank you for the good information!

Anonymous wrote 1 year 42 weeks ago

As painful, and it was pretty brutal, as having the stone (more like a rock at 10mm) was, twas nothing compared to the absolute torture of the 15 minutes it took putting in the stent. The fear of stents will keep you honest on your low salt/oxalate diet. Like to know what I can eat to keep up my weight. So nice the MD and dietician say its okay to have 3-4 portions of dairy a day. Got severe lactose intolerance too. At 55 I can't wait to hit 80+, then I will eat whatever I want and check out with a smile on my face.

Anonymous wrote 1 year 51 weeks ago

Everyone has stated how horribly painful kidney stones are but I didn`t find that to be the case in my situation. I have passed two stones within a year(3&4mm) I had alot of burning sensation from my kidneys and discomfort but nothing excruiating.My doctor told me mine was a genetic issue so regardless what I eat, unfortunately i`m always going to be prone to them.

Anonymous wrote 1 year 46 weeks ago

You didn't find the pain unbearable because you have clearly never had one get stuck since you are passing them. I guarantee if you ever have one get stuck in your ureter tube you will be on the ground in unbearable pain and heading to the emergency room.

Anonymous wrote 1 year 45 weeks ago

I hear that!! Been there three times this past year with my husband. He passed one last month about 6mm. Had one blasted 9mm. Now 6 months later Dr. discovered he has 2 more, one 7mm and the other 20mm.....

Anonymous wrote 1 year 38 weeks ago

I agree they are horrible, going through one right now. Started 7 days ago. Mine is stuck some where, had ultrasound today but of course they wont tell you anything, also have a low grade fever. These things are diffinitly nothing to joke about. This is my 4th one and still havent learned to eat right.

Anonymous wrote 2 years 1 week ago

Did I see 8 g (eight grams) of sodium touted as a 'slightly reduced' salt intake? What?! THREE grams of sodium is an excessive amount! This article is clearly unrealiable.

Anonymous wrote 1 year 43 weeks ago

3g of sodium is 3000mg so yes, we don't measure sodium in grams, we measure it in milligrams.

Anonymous wrote 2 years 7 weeks ago

What are the impacts (positive or negative) with drinking large amounts of coffee?

Thanks to the responder.

Anonymous wrote 1 year 42 weeks ago

Depending on what type of stone you are prone to can be a trigger. Coffee is on the "Medium oxalate" list (see this website for complete list: http://www.branwen.com/rowan/oxalate.htm) So if you get calcium or uric acid stones coffee can induce the occurrence, but I don't know what coffee in moderation would look like, cup or ounce-wise. :)

Anonymous wrote 2 years 10 weeks ago

thanks... my friend is havin a kidney stone. now i can
tell him wat all he can eat... and wat 2 avoid.

Anonymous wrote 1 year 35 weeks ago

wat

Anonymous wrote 2 years 11 weeks ago

I started having stones about age 51. Despite how anyone describes the pain, it's far worse than you could ever imagine. When it comes to diet, there is confusion as to what juices you can drink and foods you can consume. It's consistant that soda's and sweet tea's are out. I do believe it is best to consult with a nutritionist, pharmacist and a uriologist. You need a team of professionals. I recently completed a 24 hours urine and blood study which is supposed to tell you what your system has and what it needs which helps determine where frequent stone buildup comes from. Here is the most important thing: Do drink lots of water and don't dehydrate. If you ride a bicycle or motorcycle, wear a camel pack and sip water as you ride. Get regular check ups and scans of your kidneys. If you develop a stone that is beginning to pass, consult your doctor about Flomax. Finally....Prayer does help.

Anonymous wrote 2 years 13 weeks ago

I recently suffered from kidney stones, the pain is almost unbearable but I read an article about treatment for kidney stones that make me feel better. A lack of pyridoxine (vitamin B6,) can cause kidney stones. Foods like cereals, liver, bread or spinach are rich in pyridoxine that you can eat if you have kidney stones.
Some changes in your diet can be made to prevent kidney stones. Your doctor (nutritionist) will be able to prepare a Kidney-stones diet to prevent kidney stones.

Anonymous wrote 2 years 15 weeks ago

Great article, here are some other foods to avoid with kidney stones: sweet potatoes, rhubarb, black tea, spinach, peanuts, grapes, strawberries, celery but there are some other.
If you have kidney stones, you need to avoid foods that cause oxalates stones.

Anonymous wrote 2 years 15 weeks ago

Good Job

Anonymous wrote 2 years 15 weeks ago

Good Job, Great Explaination and Recommendation.