To Prevent Kidney Stones: Go Easy On Soda And Drink Lots Of Water
If you've had a kidney stone and want to spare yourself the agony of a repeat episode, here's some simple advice: Drink more water.
In a guideline published Monday in the Annals of Internal Medicine, the American College of Physicians recommends increasing fluid intake and spreading throughout the day.
It may take eight to 10 glasses of water over the course of a day to comply. The recommendation calls for achieving at least 2 liters of urine a day.
It might also help to cut back on colas. A study cited by the American College of Physicians found that kidney stone patients who agreed to change their beverage habits and abstain from soda — specifically colas acidified with phosphoric acid — cut their risk of a recurrence by about 15 percent.
The evidence isn't concrete, but it's suggestive, says ACP President Dr. David Fleming. If he sees patients with a history of stones, he asks how many sodas they're drinking a day. "If I find out they're drinking three or four Diet Cokes a day, I would strongly suggest they cut that back to one or none," Fleming tells Shots.
So what might explain the link between colas and kidney stones? It's not exactly clear, but researchers know that phosphorus acidifies urine. "And an acid environment is conducive to stone formation," Fleming told us.
Now, upping the amount of water you drink is no guarantee against a recurrence. But a five-year study found that participants who reached the two liter of urine threshold by hydrating were less likely to have a recurrence compared with people who didn't increase their fluid intake, 12 percent and 27 percent, respectively.
So, despite the fact that it's not a cure-all, drinking more water is about the most effective strategy that people prone to forming kidney stones can try. "This is the main recommendation," Fleming told us.
And there may be other dietary strategies that help as well. For instance, this study found a diet rich in plant based foods and fiber can cut the risk of recurrent kidney stones.
And if these strategies fail to prevent recurrences? "Medication can be very helpful," Fleming told us.
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Transcript
AUDIE CORNISH, HOST:
And here's another story about a simple approach to dealing with a difficult medical problem. Kidney stones are a common condition - and painful. As NPR's Allison Aubrey reports, the American College of Physicians has a new guideline aimed at preventing recurrent kidney stones in people who are prone to them.
ALLISON AUBREY, BYLINE: Kidney stones are tiny clumps of crystals that cause agony as they pass through the narrow tubes leading to the bladder.
DAVID GOLDFARB: The kidney stone was like a big chef's knife being stuck in my back.
AUBREY: That's David Goldfarb, a physician who had his first attack at age 28.
GOLDFARB: I was nauseated, vomiting, very, very sweaty, and we had to drive to the hospital...
AUBREY: ...Where it took a heavy-duty painkiller to stop the excruciating pain until the stone passed. Goldfarb now directs the Kidney Stone Prevention Program at New York University Langone Medical Center. He says once you've had a kidney stone, you never want to go through it again. And he says drinking lots of water every day, throughout the day, can help prevent the likelihood of a recurrence.
GOLDFARB: My prescription is about 96 ounces...
AUBREY: ...Which is 12 glasses if you're drinking eight-ounce servings. That's a lot of water.
GOLDFARB: It's a lot of fluid, but you'd be surprised that when people understand that this is going to help them prevent kidney stones, they become motivated, and they find a way to do it.
AUBREY: Goldfarb has been giving this advice to his patients for years. And while it does not work for everyone, the American College of Physicians has now issued a recommendation to do just this - hydrate. The advice is based on a study that found among people who were prone to kidney stones, those who started drinking extra fluids throughout their day cut the risk of recurrence by nearly 50 percent compared to people who did not change their fluid intake. Now, it does seem to matter what people choose to drink. Experts say water is best, whereas soft drinks and soda, especially colas, may not be a good choice for kidney stone sufferers. Here's ACP President David Fleming.
DAVID FLEMING: For patients that I have with stones, if I find out they're drinking three or four Diet Cokes a day, I would strongly suggest that they cut that back to maybe one, or none, on a daily basis because that could be beneficial for them.
AUBREY: Fleming says the evidence on cola is not concrete, but it is suggestive. The thinking is that the phosphoric acid that's used to acidify colas can be conducive to the formation of kidney stones. Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.
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