From the Guidelines
Men are more likely to develop kidney stones than women, with a lifetime prevalence of 13% for men and 7% for women. The risk of developing kidney stones can be attributed to various factors, including genetics, environmental exposure, and lifestyle choices. Key risk factors for kidney stone formation include:
- Dehydration
- High-sodium diets
- Excessive animal protein consumption
- Obesity
- Family history
- Certain medical conditions, such as inflammatory bowel disease
- Medications, such as topiramate and some diuretics
Prevention strategies should focus on addressing these risk factors through lifestyle changes and medical interventions. Drinking plenty of water, at least 2-3 liters daily, is essential to produce clear or light yellow urine and reduce the concentration of stone-forming substances in the urine 1. Dietary modifications are also crucial, including:
- Reducing sodium intake to less than 2,300 mg daily
- Limiting animal protein
- Avoiding foods high in oxalate, such as spinach, nuts, and chocolate, if you form calcium oxalate stones
- Maintaining adequate calcium intake, 1,000-1,200 mg daily, from food sources rather than supplements
For individuals with recurrent stones, medications may be prescribed based on stone type, such as:
- Thiazide diuretics, like hydrochlorothiazide, for calcium stones
- Potassium citrate to raise urine pH for uric acid stones
- Allopurinol for uric acid or calcium oxalate stones in patients with high uric acid levels
Regular exercise and maintaining a healthy weight also reduce the risk of kidney stone formation. These prevention strategies work by diluting stone-forming substances in urine, reducing crystal formation, and creating less favorable conditions for stone development 1.
From the Research
Risk Factors for Kidney Stones
- Men are at higher risk of developing kidney stones compared to women, with an age-adjusted hazard ratio (HR) of 2.32 (95% CI 2.20,2.45) 2
- However, recent data suggest that the difference in risk between men and women is decreasing, with women being relatively more affected than before 2, 3, 4
- Risk factors for kidney stones in men and women include waist circumference, high blood pressure, diabetes, use of thiazides, and dietary intake 2
- Urine supersaturations for calcium oxalate and uric acid are higher among men, primarily due to higher oxalate, uric acid, phosphate, and lower pH 2
- Women under the age of 50 who have been pregnant have more than double the odds of kidney stones compared to those who have never been pregnant 3
- Obesity, bariatric surgery, and dieting are associated with increased risk of kidney stones in women 3
Prevention Strategies for Kidney Stones
- Fluid intake to promote urine volume of at least 2.5 L each day is essential to prevent stone formation 5
- Dietary recommendations should be adjusted based on individual metabolic abnormalities 5
- Properly dosed thiazide treatment is the standard therapy for calcium stone formers with idiopathic hypercalciuria 5
- Potassium alkali therapy is considered for hypocitraturia, but caution should be taken to prevent potential risk of calcium phosphate stone formation 5
- For absorptive hyperoxaluria, low oxalate diet and increased dietary calcium intake are recommended 5
- Pyridoxine has been shown effective in some cases of primary hyperoxaluria type I 5
- Allopurinol is used in calcium oxalate stone formers with hyperuricosuria 5