Patient's question:
No symptoms, had a nodule on the kidney for 6 yearsDoctor's answer:
Main manifestations of kidney stones:1. Clinical manifestations vary greatly among individuals, depending on the cause, composition, size, number, location, mobility of the stone, presence of obstruction or infection, and the extent of pathological damage to the renal parenchyma. Mild cases may show no symptoms, while severe cases can lead to anuria, renal failure, toxic shock, and even death.
2. When a stone becomes lodged at the junction of the renal pelvis and ureter or descends within the ureter, renal colic may occur. This is sudden, recurrent, lancinating pain that is severe and unbearable, causing the patient to restlessly move about. The pain radiates from the waist or flank to the bladder area, external genitalia, and inner thigh. Sometimes, profuse sweating, nausea, and vomiting may accompany it.
3. Due to the severe damage to the mucosa caused by stones, hematuria is often visible to the naked eye. Pain and hematuria are frequently triggered during periods of increased physical activity. When stones are complicated by infection, leukocytes may appear in the urine, accompanied by symptoms of frequent urination and dysuria.
4. When secondary acute pyelonephritis or renal abscess occurs, systemic symptoms such as fever, chills, and shivering may develop. Bilateral upper urinary tract stones or complete obstruction of renal stones can lead to anuria.
Guidelines for treatment:
1. Symptomatic treatment: Spasmolytics, analgesics, fluid replacement, anti-inflammatory agents, and traditional Chinese medicine.
2. Stone expulsion therapy: Suitable for patients with stones <1.0 cm in diameter, good renal function, no infection, short duration of illness, and mobility.
3. Stone dissolution therapy: Medication, increased fluid intake, urine pH adjustment, and dietary modifications. Suitable for uric acid and cystine stones.
4. Extracorporeal shock wave lithotripsy (ESWL).
5. Percutaneous nephrolithotomy with lithotripsy.
6. Surgical treatment: Depending on the condition, options include pyelolithotomy, renal parenchyma incisional lithotomy, partial nephrectomy, nephrectomy, nephrostomy, and extracorporeal renal incisional lithotomy.
Self-care tips for kidney stones:
1. Patients experiencing nausea and vomiting should seek medical attention promptly, follow doctor’s advice for fluid replacement, and monitor electrolyte balance.
2. Drink plenty of water, at least 2000–3000 ml daily. In addition to abundant daytime fluid intake, drink 500 ml before bed, and 200 ml after urination upon waking.
3. Increase physical activity, such as jumping, to facilitate stone expulsion.
4. Adjust diet appropriately to prevent recurrence. Calcium stone patients should reduce intake of high-calcium foods like milk, while oxalate stone patients should limit spinach, potatoes, beans, and strong tea. Phosphate stone patients should follow a low-phosphorus, low-calcium diet and take oral ammonium chloride to acidify urine. Uric acid stone patients should reduce purine-rich foods like animal organs, meat, and beans, and take oral sodium bicarbonate to alkalinize urine, which also aids in dissolving uric acid stones.
Home treatment measures for kidney stones
Kidney stones result from imbalances in colloidal and crystalline metabolism in the body, associated with factors such as infection, nutritional metabolic disorders, urinary tract foreign bodies, urine stasis, and geographical/climatic conditions. Men are more prone to this condition than women. Those over 30 are at higher risk than younger individuals. It is rare in children. Pain may persist for several days during stone passage, causing severe renal colic. The location of pain corresponds to the stone’s position. Small stones may show no symptoms and only be detected via X-ray. Larger stones may cause unilateral loin pain, renal colic, and hematuria. Occasionally, stones may become lodged in the ureter, obstructing one side of the urinary flow. Complications of kidney stones include acute pyelonephritis, which can progress to chronic renal failure. The recurrence rate of kidney stones is relatively high—once you have had one, it is likely you will develop another. Changing lifestyle habits can help prevent and reduce the growth and occurrence of stones.
There are several types of kidney stones. Once your doctor identifies your stone type, the following methods can help reduce the risk of recurrence:
● Drink plenty of water
Regardless of your stone type, the most important preventive measure is to increase fluid intake. Water dilutes urine and prevents the accumulation of high-concentration salts and minerals that form stones. A suitable daily fluid intake is 2 liters of urine output, which is sufficient. If you work outdoors in intense sunlight all day, you may need to drink 2 gallons of water.
● Increase dietary fiber
Adding bran to your diet can help prevent stones.
● Control calcium intake
About 80% of stones are formed from calcium or calcium-containing products. If your previous stone was primarily calcium-based, pay attention to your calcium intake. If you are taking nutritional supplements, consult your doctor first. Next, check your daily intake of high-calcium foods, including milk, cheese, cream, and other dairy products. Milk and antacids may contribute to kidney stones.
● Check your antacids
Some common antacids contain high levels of calcium. If you have calcium stones and are also taking antacids, check the product label to confirm high calcium content. If it does, switch to an alternative medication.
● Avoid foods high in oxalates
Approximately 60% of stones are calcium oxalate stones. Therefore, limit your intake of oxalate-rich foods, including beans, beets, celery, chocolate, grapes, bell peppers, parsley, spinach, strawberries, and cruciferous vegetables. Also avoid alcohol, caffeine, tea, chocolate, figs, mutton, stone fruits, bell peppers, black tea, and poppy seeds.
● Stay active
Sedentary individuals are more likely to accumulate calcium in the blood. Exercise helps calcium flow to its proper bones. Don’t sit around waiting for stones to form—go outdoors or engage in physical activity.
● Apply heat
Applying heat to the renal area, cupping therapy, or electrotherapy can relieve pain. Hot baths are also beneficial for stone passage.
● Eat foods rich in vitamin A
Vitamin A is essential for maintaining the health of the urinary tract lining and helps prevent stone recurrence. Healthy adults should consume 5,000 IU (International Units) of vitamin A daily. One cup of carrots provides 10,055 IU of vitamin A. Other vitamin A-rich foods include green broccoli, apricots, cantaloupe, pumpkin, and beef liver. (Note: High doses of vitamin A can be toxic. Consult your doctor before supplementing.)
● Monitor protein intake
Kidney stones are directly linked to protein consumption. Proteins can increase uric acid, calcium, and phosphorus in the urine, leading to stone formation. If you have had calcium stones, pay special attention to whether you are consuming excessive protein, especially if you have a history of uric acid or cystine stones. Limit high-protein foods to 180 grams daily, including meat, cheese, chicken, and fish.
● Reduce salt intake
If you have calcium stones, reduce salt consumption. Limit your daily salt intake to 2–3 grams.
● Supplement nutrients
① Magnesium oxide or magnesium chloride: 500 mg daily. Reduces calcium absorption. Studies show daily magnesium intake can reduce recurrence rates by 90%. Unlike calcium oxalate, magnesium oxalate is less likely to form painful stones.
② Vitamin B6: 10 mg, twice daily. When combined with magnesium, B6 reduces oxalate levels in urine, a common mineral in kidney stones.
③ Protease enzyme: Follow product instructions, take between meals. Aids digestion.
④ Vitamin A emulsion or capsules: 25,000 IU. Treats damaged urinary tract linings.
● Avoid L-cysteine
If you have a history of kidney stones or currently have kidney stones, avoid L-cysteine. This amino acid buildup can crystallize in the kidneys, forming large stones that block renal function.
● Eat more watermelon
Watermelon is a natural diuretic. Consume it regularly and alone, not combined with other foods. It helps cleanse the body but should not be eaten with other foods.
● Limit vitamin C intake
If you are prone to calcium oxalate stones, limit vitamin C intake. Exceeding 3–4 grams daily may increase oxalate production, raising stone risk. Avoid high-potency vitamin C supplements.
● Avoid excessive vitamin D
Excessive vitamin D can lead to calcium buildup in the body. Limit daily vitamin D intake to no more than 400 IU (Recommended Dietary Allowance).