No More Kidney Stones: The Experts Tell You All You Need to Know about Prevention and Treatment PDF
Preview No More Kidney Stones: The Experts Tell You All You Need to Know about Prevention and Treatment
NO MORE KIDNEY STONES NO MORE KIDNEY STONES The Experts Tell You All You Need to Know about Prevention and Treatment REVISED AND EXPANDED EDITION John S. Rodman, M.D., R. Ernest Sosa, M.D., and Cynthia Seidman, M.S., R.D., with Rory Jones John Wiley & Sons, Inc. Copyright © 2007 by John Rodman, M.D., R. Ernest Sosa, M.D., Cynthia Seidman,M.S.,R.D.,and Rory Jones.All rights reserved. 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Library of Congress Cataloging-in-Publication Data: No more kidney stones / John S.Rodman...[et al.].—Rev.ed. p. cm. Includes bibliographical references (p. ). ISBN 978-0-471-73929-6 (pbk.) 1. Kidneys—Calculi—Prevention. I. Rodman,John S.,1946– RC916.R63 2006 616.6'2205—dc22 2006042148 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 CONTENTS Preface xi Acknowledgments xv About This Book xvii PART ONE WHAT YOU NEED TO KNOW ABOUT KIDNEY STONES 1 THE KIDNEY STONE “BOOM” 3 What Are Kidney Stones? 5 Why Do Some People Get Kidney Stones? 5 The Stone “Boom” 5 Prevention Is the Cure 6 The Dietary Prescription 6 Preventing Kidney Stones 6 Commitment to Change 7 2 THE URINARY SYSTEM 9 The Urinary System and How It Works 9 The Balance Concept 12 How Trouble Starts 13 3 HOW YOUR KIDNEYS BALANCE YOUR BODY 14 Why Balance Is Important 15 Elements of Balance 15 How the Kidneys Keep the Body in Balance 15 What Happens When the Body Gets Out of Balance 18 How to Keep Your Sewer System Unclogged 19 4 NOT ALL KIDNEY STONES ARE CREATED EQUAL 20 Four Types of Kidney Stones 20 Calcium-Containing Stones 21 v vi Contents Uric Acid Stones 22 Cystine Stones 25 Struvite Stones 25 Bladder Stones 26 Importance of Stone Analysis 27 5 HOW AND WHY KIDNEY STONES FORM 28 Genetics 28 Diet and Lifestyle 28 What Is a Kidney Stone? 29 Discouraging Crystal Formation 30 What Kidney Stones Are Made Of 30 The Conditions That Favor Crystal Formation 31 The Best Inhibitor of Kidney Stones 31 Making a Uric Acid Stone 32 6 WHY KIDNEY STONES ARE SO PAINFUL 34 Kinds of Pain 34 Three Areas Where Stones Hang Up 38 Secondary Symptoms 39 Never Make Your Own Diagnosis of a Stone 40 Treating Pain 40 When Hospitalization Is Needed 41 7 HOW MUCH WATER DO I REALLY HAVE TO DRINK? 43 Causes of Low Urinary Output 43 How Much Is Enough? 44 Hard Water,Soft Water 44 Mineral Water 45 How to Consume More Water 45 The Role of Fluids 46 8 DIETARY TROUBLEMAKERS 47 How Much You Eat Is Just as Important as What You Eat 47 Animal Protein Is Animal Protein 48 Protein and Kidney Stones 48 The Calcium Controversy 49 Salt 53 Contents vii Oxalate 54 Vitamins and Kidney Stones 55 Alcohol 58 The Dietary Troublemakers 59 9 MEDICAL CONDITIONS THAT CAN CAUSE KIDNEY STONES 60 Bowel Disease 61 Medullary Sponge Kidney (MSK) 63 Hyperparathyroidism 65 Milk-Alkali Syndrome and Ulcers 65 Anatomic Abnormalities 66 Paralysis and Immobilization 68 Renal Tubular Acidosis (RTA) 69 Acquired RTA in Glaucoma Patients 69 Cystinuria 70 Oxalosis 70 10 DIETING YOUR WAY TO A KIDNEY STONE 72 The Problem with Rapid Weight Loss 72 Fad Dieting 73 Fad Health Regimens 75 Eating Disorders 76 Laxative Abuse 77 How Stone Formers Should Diet 78 11 MEN AND STONES 79 Why Men Make More Kidney Stones 79 Pain Patterns 82 12 WOMEN AND STONES 84 Why Women Make Kidney Stones 84 13 THE WORKUP 89 Risk Assessment 89 The Workup 90 Translating Your Workup into a Risk Assessment 99 Where Are You on the Risk Ladder? 101 viii Contents PART TWO THE PLAN 14 NO MORE KIDNEY STONES 105 Diet Is Not a Four-Letter Word 105 The Master Plan 106 Tips for Staying on the Plan 108 15 FINDING THE DIET THAT IS RIGHT FOR YOU 110 Rating Yourself 110 How Much Do You Have to Change? 111 Do You Consume Too Many Troublemakers? 111 How to Know if You Are Eating Too Much Protein 115 How to Know if You Are Drinking Enough Fluids 117 Do You Weigh Too Much? 119 Food Diary 119 Classic Stone-Forming Profiles 120 16 LIFESTYLES OF THE KIDNEY STONE FORMER 130 Bathroom Access 130 Fluid Loss 132 Ultraviolet (UV) Light Exposure 132 Eating Patterns 133 Change in Lifestyle 134 17 OPERATION OXALATE 136 Why Dietary Oxalate Is Important 136 The Problem with Oxalate Recommendations 137 Key Issues in Oxalate Control 138 Oxalates and Seasonal Foods 139 18 MODIFYING RECIPES AND CONTROLLING PORTIONS 142 Recipe Modifications 142 Portion Control 146 19 HEALTH-FOOD STORE HAZARDS 147 Supplements 147 Muscle-Building Protein Supplements 149 Herbal Teas 149 Contents ix Natural Weight-Loss Regimes 150 Hair Regrowth 150 Beverages 150 Vegetarian Burgers 151 Laxatives 151 Energy Bars 152 The Juice Craze 152 Pastas 153 Candies and Cookies 153 Read Labels in the Health-Food Store 153 20 SPECIAL OCCASIONS Parties and Other Excuses to Cheat 154 Thanksgiving 154 Barbecue 158 Wedding Banquet 159 Breakfast Buffet 162 Four Pitfalls of Special Occasions 163 21 ETHNIC CUISINES 164 Chinese 164 Mexican 167 Greek 168 French 169 Japanese 170 Italian 171 American 173 Indian 175 22 STAYING MOTIVATED 178 How Far Can You Deviate? 179 Diluting the Mistake 179 PART THREE MEDICINES, SPECIALISTS, AND PROCEDURES 23 CHOOSING A SPECIALIST 183 Who Does What 183 How Do You Find Out Whom to See? 185
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