Kidney Stones

Calcium Phosphate %

8-10%

Calcium Phosphate pH + Issues

Alkaline: CRANBERRY JUICE

• Primary hyperthyroidism: Reabsorb Ca outside bones = ^calcium levels for stones

Calcium Phosphate Tx

• ^ hydration

• Cranberry juice

• ^Ca foods, NOT supplements

• Decrease sodium (increase vasc space and Na pulls water out of the vasculature and into interstitial)

Calcium Oxalate %

70-80%

Calcium Oxalate pH + Issues

Independent pH = Just drink LOTS of fluids (no alcohol)

• Family Hx

• Idiopathic hypercalcuria and hyperoxaluria

Calcium Oxalate Tx

• ^ hydration

• Decrease sodium/animal protein

• Thiazide diuretics: Pull in Ca and Na to decrease Ca binding w/ oxalate

• NO VIT C SUPP

• ^Ca in foods

Oxalate ^ Foods

• Spinach, Rhubarb, Asparagus

• Nuts, Cabbage, Tomatoes, Beets

• Chocolate, Tea

• Worchestershire sauce, parsley

Uric Acid %

5-8%

Uric Acid pH + Issues

Acidic: Make Alkaline!! (with potassium citrate)

• Males, Jewish

• GOUT*****

• Genetics

• ^ purines coming in/not getting rid of enough uric acid {renal system or ingestion habit issues)

Uric Acid Tx

• ^ hydration

• Decrease urinary concentration of uric acid

• Alkalinize urine with K citrate (binds K+ out and K+ is an acid)

• ALLOPURINOL: Decreases formation of crystals from excess uring and rids uric acid - help with GOUT too

• Decrease urinary purines

Purine Foods

• Sardines, herring, mussels

• Game: Goose, venison

• Meat-based soups

• Organ meet: Sweetbread, kidney, liver

Cystine Stones %

1-2%

Cystine Stones pH + Issues

Acidic: Make Alkaline with K+ citrate

• Genetic

• Defective absorption of the amino acid cystine in GI tract and kidney: Transferred to the renal calculi (meatus of the kidneys) and stones form

Cystine Stones Tx

• ^hydration

• Alpha penicillamine and tiopronin to prevent cystine crystallization: Binds to cystine to go through the GI tract without being absorbed into the vascular system and kidneys

• K citrate for alkalinize the urine (bind K/acid out)

Struvite Stone %

10-15%

Struvite Stone pH + Issues

Alkaline: Make more acidic- CRANBERRY JUICE

• 3-4X more common in women then men

• Always after UTI (usually Proteus)

Struvite Tx

• ^ hydration

• Antimicrobials- b/c UTI

• Acetohydroxamix acid (Lithostat)

• Indirectly lowers urine pH

• Surgical removal

• Acidify urine: Cranberry juice

Acidic Urine Crystals

• Uric Acid

• Cystine

Alkaline Urine Crystals

• Calcium Phosphate

• Struvite

Independent pH Crystals

• Calcium Oxalate