Two liters a day helps keep kidney stones away

One of the biggest risk factors for developing kidney stones is chronic dehydration.  We are not talking about this kind of dehydration:

We are talking about mild, chronic dehydration.  This type of dehydration does not result in a parched and thirsty feeling.  However, your body knows how much fluid it needs to function correctly and will adjust the amount of urine you produce in order to make sure it gets enough water for the basic life processes.  The end result is if you do not drink enough fluid or get enough fluid through the food you eat, your urine will be more concentrated and in turn, the minerals that cause stones will be more concentrated in your urine.

When minerals are more concentrated in urine it is easier for them to form crystals by sticking together.  Calcium and oxalate make up the majority of kidney stones and these two things love to bind together in concentrated urine.  Usually the crystals are washed out with urine flow but if they are lodged in the kidney they can stay there and act as a place for more crystals to be deposited, eventually resulting in a visible stone.  Small stones may pass on their own with urine flow.  This could be something you are totally unaware of, or if the stone is big enough and gets stuck, you would be VERY aware of it.

Working or playing outside when it is hot will cause sweating and increase your fluid requirements.  A good rule of thumb is for every hour you are sweating you should increase your fluid intake by at least 16 ounces or one pint.   Drinking alcoholic beverages speeds up urine production and can make dehydration worse, so if you are out in the sun enjoying a cocktail (or two... or three...) you should drink extra water as well.

Concentrated urine is obviously yellow and may have a strong odor.  Here is an easy chart to look at to tell if you are dehydrated or not based on the color of your urine:

If you make around 2 liters of urine a day this will help protect you against dehydration.  The problem is, in order to make that much urine you need to drink a lot.  Very few people really do drink enough to do this.  A little more realistic goal may be to try to drink at least 2 liters of water or other fluid a day.  This will ensure a good production of urine unless you are sweating heavily, have a fever, diarrhea or other source of fluid loss.

Drinking at least two liters (about 2 quarts) of water a day can be difficult.  It is better to drink it gradually than all at once, and preferably not just before bed unless you don't mind getting up at night to go to the bathroom.

We recommend starting out slowly, adding a glass of water to each meal and one or two in the midmorning and midafternoon.  Work up to the two liters a day slowly and you will be more likely to be able to continue to do this on a regular basis.  Drink up!

Kidney Stones

If you've recently had a kidney stone you might want to skip this post to avoid painful memories...

Cincinnati is considered to be in the "Stone Belt" of the United States.  For some unknown reason,  kidney stones are common in this area.  Men get stones approximately 3 times more frequently than women do, and once you have one stone, your chance of having another one rises.

Kidney stones that do not cause complete blockage may cause dull or intermittent pain, usually in the flank area or high up in your back.  If a stone is blocking farther down the ureter (tube between the kidney and bladder that carries urine made by the kidney) it can cause a complete obstruction.  This means PAIN and SUFFERING.  This pain may be sharp and excruciating.  It can be bad enough to cause vomiting and it may seem you can't find a comfortable position to lie in.  The pain can radiate down into your groin or into the scrotum or genitals.

If you are having pain like this, the best thing to do is go to the nearest emergency room.   If the doctors suspect a kidney stone, you will get a CAT scan.   The upper left picture shows a CAT scan with an arrows pointing to stones in the kidney.  Of course, pain can be caused by other things so the doctors will certainly check you out for other possibilities.

If you have a stone, your treatment will likely involve control of pain,  IV fluids and anti-inflammatory medicines as well as medicines that may help you pass the stone.  Being admitted or sent home depends on a number of factors such as whether or not the pain can be controlled with oral medicines, if you can drink enough fluids to stay hydrated and whether or not you have a urinary tract infection.

If you are discharged from the ER, follow up as soon as possible with a urologist.  We hold open appointment times every day for urgent visits such as these.  The correct treatment for your particular stone will be discussed with you at the time of your visit.

If you know you have a stone here are the warning signs to call your urologist and then go immediately to the closest ER:

1. Pain that cannot be controlled with oral medicines at home

2. Nausea or vomiting that prevents you from drinking and eating

3. Fever over 101 degrees

4. If you have a single kidney or have a transplanted kidney.

The best source of general information on the web for more information about stones is from the NIH.  Here is the link:

http://kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/

 Just 21 more days until spring!