Drink more fluid to cut risk of further kidney stones, say doctors

Date: Nov-05-2014 The American College of Physicians have issued new guidelines for

people who have had a kidney stone to help them reduce their risk of

another one. One of the recommendations is to increase fluid intake to achieve 2 liters of urine a day.

The new ACP guidelines recommend that people who have had a kidney stone increase their fluid intake to reduce the risk of developing another.

If increasing fluid intake fails to prevent further stones, patients

should take a medication containing a thiazide diuretic, citrate or

allopurinol, say the recommendations.

The new guidelines are published in the Annals

of Internal Medicine, along with a patient summary.

"Increased fluid intake spread throughout the day can decrease stone

recurrence by at least half with virtually no side effects," says Dr. David Fleming, president of the American College of Physicians (ACP). "However, people

who already drink the recommended amount of liquids, or when increased

fluid intake is contraindicated, should not increase their fluid

intake."

About 13% of men and 7% of women in the US will have a kidney stone at

some point in their lifetime. A kidney stone is the result of tiny crystals

sticking together in urine to form a lump large enough to cause severe pain

when urinating. It can also cause other problems like bleeding and damage

to the kidney.

Research shows that without treatment, there is a 35-50% chance of

patients having another kidney stone within 5 years of the first one.

While drug and dietary treatments are often recommended, it is not clear

whether these can prevent kidney stone recurrence. Also, doctors often test

a stone to find out what it is made of, as they believe it can guide treatment

to prevent future stones. However, the ACP say it is not clear whether this is

useful.

To arrive at the new guidelines, the ACP carried out a review of

scientific evidence published between 1948 and 2014. This took into

account the benefits and harms of drug and dietary treatments to prevent

recurring kidney stones.

Reducing cola, dietary protein consumption might help prevent further kidney

stones

The reviewers found some evidence that reducing intake of cola drinks

might help prevent further kidney stones. However, they did not find evidence to suggest tap water was any better or worse

than a specific brand of mineral water.

There is evidence that thiazide diuretics, citrates or allopurinol

effectively reduce recurrence of kidney stones made of calcium in patients

with at least two past stones. Kidney stones made of calcium are the most

common type.

However, the ACP note that "the quality of available research varies, and studies comparing one

treatment with another are limited."

The ACP reviewers state that patients already receive advice about

changes to diet to prevent further kidney stones. This includes reducing

intake of foods containing oxalate, such as beets, rhubarb, spinach,

strawberries, nuts, chocolate, tea and wheat bran.

The guidelines also suggest

reducing dietary animal protein and purines (compounds that break down into

uric acid), and maintaining normal dietary calcium.

In September, Medical News Today learned of a study

reported in the American Journal of Kidney Diseases that suggests

kidney stones may increase the risk of heart

disease and stroke.

Written by Catharine Paddock PhD

Not to be reproduced without permission.

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Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.