Diet with kidney stones: the underlying principles

The diet prescribed by urologists and nephrologists for kidney stones can not be the same for all who suffer from kidney stone disease. Therapeutic diet should correspond to the chemical composition of the stones formed in the kidneys.

So, what is the diet for kidney stones? And, most importantly - which of them is needed for you?

[1], [2], [3], [4], [5]

Treatment of kidney stones with diet

Although the development of nephrolithiasis ( nephrolithiasis ) is due to a number of reasons, the mechanism of calculus formation is triggered by disturbances in the formation and utilization of chemical compounds that make up urine. Such compounds include: sodium and potassium salts of uric acid (urates), calcium and ammonium salts of oxalic acid (oxalates), calcium salts of phosphoric acid (phosphates) and calcium salts of carbonic acid (carbonates).

The fundamental principles on which the treatment of kidney stones in the diet relies are the restriction of the intake of food from the body of precisely those substances whose metabolism has deviations from the norm. Alternatively, as an option, it is recommended to introduce into the habitual diet products that contain substances that help neutralize the stone-forming factors.

For example, in violation of purine metabolism, urate stones are deposited in the kidneys, as uric acid is the final product of the metabolism of purine bases. A person does not have a uricase enzyme that breaks down uric acid salts, so an excess of purines leads to an increase in the content (more than 70 mg / L) of uric acid either in the blood (hyperuricemia) or in the urine (urine acid diathesis or hyperuricuria). Poorly soluble in water uric acid - in the form of crystals of urate sodium - deposited in the joints (with all known gout), and with high urine acidity (pH <5-5.5) - crystallizes in the renal pelvis or bladder.

In addition, the diet for kidney stones should take into account that the formation of concrements is determined by the level of acidity of urine. Thus, oxalate stones are formed in weakly acid urine (pH = 5.8-6.5), and alkaline urine (pH> 7-7.5) is a fertile medium solely for the crystallization of phosphoric acid salts. On this basis, foods that are capable of or alkalinizing urine, or increase its acidity, are recommended.

General recommendations for all types of kidney stones are reduced to an increase in the amount of fluid consumed: during the period you should drink at least two liters, half of which should be water. This is necessary to provide the level of daily diuresis that is therapeutically necessary for nephrolithiasis. And it is necessary to reduce the amount of salt - so that the fluid in the body is not delayed.

The retinol (vitamin A) content depends on the condition of the urinary tract mucosa, therefore it is impossible to tolerate its deficiency in the body. But ascorbic acid (vitamin C) and calciferol (vitamin D) require prudence. Ascorbicum (with excessive use) helps to increase the acidity of urine, and vitamin D activates the reabsorption (re-absorption) of calcium in the intestine and phosphorus in the kidneys. Although the relationship between these vitamins and the emergence of nephrolithiasis is not recognized by all specialists.

Diet with oxalate kidney stones - oxaluria

Diet with oxalate kidney stones prescribes to completely eliminate the use of foods that contain a lot of oxalic acid or oxalates: potatoes, eggplants, tomatoes, carrots, zucchini, green leafy vegetables (spinach, sorrel, parsley, celery), green and bitter pepper, garlic, beans and soy products, as well as all kinds of nuts.

What can not be eaten with kidney stones caused by oxaluria? Specialists of the National Cancer Institute (American National Cancer Institute) are strongly advised not to lean on buckwheat, millet, maize (corn porridge) and rye bread; Minimize the addition of spices such as black pepper, ground ginger, coriander, curry, cloves, cinnamon, anise seeds to dishes.

In the "black list" of oxalate-containing fruits and berries came: apples and pears; oranges and tangerines; kiwi, persimmon and pineapple; apricots and peaches; dark plums and prunes; raspberries, strawberries, red currants, gooseberries, grapes of dark varieties.

Many oxalates contain cocoa (and, of course, chocolate), coffee (including soluble), beer, black tea, decoction of wild rose berries, juices - orange, grape, carrot, tomato.

And what can you eat with kidney stones? With oxalate stones, the diet can include: meat and bacon; a bird; fish (except sardines) and seafood; eggs; milk and cheese; pasta, wheat bread, rice, oatmeal, mushrooms, sugar, honey. In the list of allowed products, cabbage (white, colored, kohlrabi) was found; cucumbers and green peas; radish and red pepper; watermelons, melons and pumpkin; bananas and avocados; grapes of green color; apples (without peel) and apple juice. And, of course, green tea.

Patients with oxaluria, doctors prescribe pyridoxine (vitamin B6). In addition, replenish the supply of this vitamin will help yeast (baker or beer), fish, beef and beef liver, chicken and egg yolks.

[6]

Diet with urate kidney stones - uraturia

Since the formation of urate stones from uric acid salts is promoted by the increased pH of urine, the decrease in its acidity (alkalinization) is the basis of the diet with urate kidney stones.

For this purpose, cabbage, cucumbers, tomatoes, radish, peppers, beets, carrots, celery, apricots (fresh and dried fruit), peaches, apples, cherries, currants, gooseberries, grapes, prunes, figs, watermelon, melon . The level of acidity of urine helps to balance the use of oatmeal, boiled "in the uniform" of potatoes, citrus juice (orange, lemon), milk (only fresh raw).

It is very important to know what can not be eaten with kidney stones with uraturia. As the increase in uric acid content provokes acid metabolites of the cleavage of proteins of animal origin (in particular, sulfur-containing amino acids and urea), the diet should be mainly vegetable-lactic. So you have to give up meat (special red), meat broths, offal, sausage and canned food. Although dieticians have an alternative for those who can not cope with this restriction: strictly "dose" the use of meat and cook it according to the rules that will reduce the amount of slag.

First, the daily portion of meat should be determined from the calculation - one gram for each kilogram of body weight. Secondly, meat should not be stewed, not fried or even baked, but cooked. And, having drained the water after the first boiling, again fill the water with a whole onion and a small carrot (which after the end of cooking is thrown out).

[7], [8], [9]

Diet with phosphate stones of the kidneys - phosphaturia

Given that the crystallization of calcium salts of phosphoric acid occurs with an excess of calcium and phosphorus against the background of alkaline urine, it becomes clear which diet for kidney stones is necessary in this case.

To reduce the supply of these macronutrients, the specialists in the therapeutic nutrition of the National Renal Fund of the United States (NKF) recommend not using milk and dairy products (primarily curds and cheeses), sea fish and seafood, buckwheat, pearl barley, oatmeal, eggs, beans, grapes and garlic, eggplant and cucumber, salad and pumpkin. To absorb calcium interferes with beets, sorrel, spinach, and also chocolate.

Diet with phosphate stones of the kidneys should simultaneously provide a change in the reaction of urine from alkaline to acidic, for which it is necessary to include in its menu: meat, lard, offal, fats and oils, legumes, cereals, corn, rice, nuts and seeds (walnut, sesame, peanuts, sunflower), sugar-containing foods, tea, coffee, a variety of spicy seasonings. Fried dishes are also not forbidden.

Domestic nutritionists prescribe to their patients with phosphaturia diet 14 used with urolithiasis - with full nutrition and restriction of alkaline products. And the list of recommended (except for those mentioned above) marked the fish, absolutely all cereals, mushrooms, pumpkin, green peas, sour apples and berries.

Recommended by some doctors diet 7 for kidney stones is intended for patients with chronic nephritis (inflammation of the kidneys) or for a period of recovery in the acute form of this pathology. This diet limits salt intake (no more than 7 grams per day) and is aimed at "moderate shaking of kidney function, impact on high blood pressure and swelling."

[10], [11], [12], [13]

Diet with calcium kidney stones - hypercalciuria

The filtration of calcium cations (Ca ²⁺ ) is carried out by the kidneys, while in the case of an increase in the content of this macroelement in the blood - its concentration increases in urine.

Diet with calcium kidney stones suggests the maximum reduction in the use of foods rich in calcium, and this, especially milk and all products based on it. In addition, it is recommended to limit the consumption of meat, since the protein of animal origin increases the level of calcium in the urine. But, the fact is that both oxalates and phosphates (as indicated at the beginning of the section) are calcium calculi. So in almost all varieties of kidney stones calcium is present, and therefore in the environment of professionals of therapeutic dietology the term "diet with calcium kidney stones" has no circulation. And the appointment of dietary nutrition in nephrolithiasis is carried out taking into account the content of Ca in the stones, but the fundamental principle - with what acids it came into reaction. And since in most biochemical processes in the body calcium and phosphorus are involved in the form of calcium phosphate, then with calcium stones, the same diet as in phosphaturia (especially calcium in most foods in the form of calcium phosphate) can be recommended.

NKF experts say that in order to prevent the regulation of the amount of calcium in the diet to prevent hypercalciuria can only in rare cases, because the body does not absorb more calcium than necessary. According to most foreign physicians, the calcium contained in calcium foods does not affect the risk of kidney stones. After all, concretions are formed when calcium binds to acids, in the case of oxaluria - with oxalic acid, which is one of the strongest organic acids of the carbon group. It easily binds cations of metals such as iron and magnesium, not to mention calcium, which is an alkaline earth metal.

By the way, if you are interested in a diet with coral kidney stones, then you need to clarify: there is no such diet. Coral, or rather coral, called concrements of different chemical composition, having a similar to the colonies of marine polyps branched form. And the shape of the stones - as superfluous - the therapeutic diet does not take into account.

To kidney stone disease does not overshadow your life, you need to take responsibility responsibly to what is included in your daily diet. And a steadily maintained diet with kidney stones will greatly facilitate the course of the disease.

[14], [15], [16], [17], [18]