Kidney Stone Medications | Diet for Uric Acid and Urate Stone

Kidney Stone Medication

Uric Acid and Urate Stone:

• A low and moderate purine diet is prescribed for the uric acid stone former.
• Urine should be kept at high pH level (7.0 or more) there by increasing the solubility of urates to 100%.
• 50% sodium citrate solution of 1-2 teaspoon full 4 times a daily is needed.
• Allopurinol is also essential in people with high serum uric acid.
• The combined use of thiazides and allopurinol seems to be more rational but toxicity of enhanced due to it.

Below given food items are causative factors and are to be avoided:

• Red meats, offal and fish which are rich in purine should be avoided.
• Sufficient sodium citrate and sodium bicarbonate are given to keep the urine slightly alkaline.

Calcium Oxalate Calculi:

• Cellulose phosphate and thiazide diuretics- these agents are used in the treatment of hypercalciuria. When the case is one of diet independent hypercalciuria, best treatment is cellulose phosphate which binds calcium in the gut limiting its availability.
  When the primary defect is failure of tubular calcium re-absorption, thiazide diuretics can be prescribed.
• When there is increased gut absorption of calcium, dietary calcium restriction is the appropriate means.

Following things are to be avoided:

• Rhubarb, strawberries, plums, spinach and asparagus which are rich in oxalate, should only be taken if they are accompanied by cream or milk, as then oxalates are precipitated as an insoluble calcium salt in the intestine and are not absorbed.
• At all times a diet adequate in calcium and magnesium is necessary; calcium oxalate is rendered less soluble in the presence of magnesium ions.

Phosphate Calculi:

• Urine acidifier should be used to keep the urine in the acidic medium. Sodium and potassium acid phosphate daily is effective. Ammonium chloride should also be used as another urinary acidifier. Phosphates in diet should be restricted.
• Aluminium gel 40ml thrice a day and night is also very useful to reduce phosphate calculi recurrence.
• Phosphorus in the diet should be restricted to a maximum of 1400mg/day.

Cystine Calculi:

• Sulphur containing proteins such as eggs, meat or fish are restricted and proteins with low sulphur content substituted.
• Carbohydrate and fats are unrestricted.
• The urine must be kept alkaline permanently and to this end sodium citrate and sodium bicarbonate are given in sufficient quantities, the patient testing the reaction of his urine night and morning.
• Penicillamine may be prescribed to prevent cystine calculi recurrence.
• Pyridoxine given daily also ceases stone formation and may also help to dissolve some stones.
• Indomethacin has been found to reduce calcium secretion. This may help in preventing stone formation.

Recumbency (long recumbent position due to) Calculus:

• In people doomed with long recumbency, sodium phytate taken by mouth forms insoluble calcium phytate, thus removing by the bowel one source of hyper-calcuria.
• Other food items to be restricted are peas, soybeans, beetroot, cauliflower, carrots and almonds.

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