5 tips for preventing kidney stones.

Have you ever passed a kidney stone before? If so, you know it's terrible! 

The key to making changes that stick is to add them into your life intolerable ways, like moderation, so you can be successful long-term. Here are 5 dietary recommendations that can help prevent kidney stones.

1) Drink more water

We want to try and make about 2.5 liters of urine in a day. 

I know we don't all pee in a measuring cup, or hopefully not many of us at all. My workaround here is: If your urine is clear, you're hydrated. If it's yellow, drink more water. Not soda or juice, more water.

2) Eat less salt

While most kidney stones are calcium-based, it's how much salt the kidney sees that really 

matters. The more salt your kidney sees, the more calcium your kidney shoots into your urine. When I say salt or sodium here, they're interchangeable and mean the same thing. I have a lot of patients who say "doc, it's not a problem - we don't add table salt so I think we're good there." You might be good there but humor me for a second. The majority of salt in our diet comes from canned, boxed, packaged, processed, and fast food. And we all need salt to live but we don't need too much. The diet we should get is about 2 to 2.3 grams of salt in a day (or 2,000 milligrams to 2,300 milligrams). Remember that 1 gram is 1,000 milligrams. The reason this matters is I want you to look at the labels of the things you buy. It'll say sodium in milligrams and it'll give serving sizes. This will give you a rough idea of how much salt you have in your body daily. See where your big salt loads are and where you can make some changes. The easy changes are buying from packages or companies that have less salt in them upfront. Also, low and no salt added foods are available, you just have to look for them a little bit - and I don' think you're going to miss the taste. For all those foods that don't have a label, like produce, or if you eat out at chain restaurants, you can actually google that stuff. Most of the time you can find out how much sodium. Overall, get a rough idea of where you are. Are you at 3 grams a day? 2 grams a day? 4 grams a day? See where you can make some changes.

3) More citrate

Have you ever had someone say "If you have kidney stones, just drink lemonade!"? 

That's where this comes from. Lemons have citrate in them. Citrate is a molecule that inhibits the ability of calcium to stick together and make a kidney stone. Limes also have a lot of citrates. You can buy them, slice them up, squeeze them in your water - consider that your vitamin. If you're going to do whole limes or whole lemons, drink through a straw or gulp it so you don't hurt the enamel on your teeth. If you don't like lemons or limes, then you can get a lot of citrate from fresh tomatoes. If you make uric acid stones, citrate will actually dissolve them because citrate helps with some acid/base status in your body and stones have a lot to do with acid/base status. So, the other thing here is that it's water-soluble. This means that any excess that you have you're just going to pee out. Therefore,  it's hard to have too much citrate.

4) Eat less animal-based protein

For people who like numbers, I tend to say 70 grams or less. 

For people who like portions, go for 4 to 6 ounces twice a day and that should be the amount of animal-based protein you have because it's higher in acid and will help you make more stones. People who are vegetarians make fewer stones. Also, soy-based protein has less acid, so there is less likely for kidney stones there.

5) Lowering oxalates

This one gets a little tricky. 

The most common stone is calcium oxalate. Oxalates are naturally in all sorts of plan material. They're also in lots of stuff that is good for us such as Spinach Nuts Berries Tea Coffee Chocolate Alcohol, Therefore, it gets tough to say a low oxalate diet since that may take some stuff away. Also, they're pretty high in potato chips and french fries, so we can all probably do a little better there. With Vitamin C, if you have more than 500 milligrams, that's going to increase your oxalate contents - so try and stay below 500 milligrams. Final thoughts on kidney stones Now a lot of people rightfully ask, "Wait for a second, if calcium stones are what we're making, why not drop calcium?" The answer for that is that low calcium diets increase your ability to make stones. If I give you that mechanism, you're probably going to fall asleep. Just recognize that calcium supplements and normal calcium diets are OK. Now, some people have medical problems that make or cause them to make a lot of stones. For all this information, please see your doctor as well. However, recognize that these are great dietary tips to reduce your ability to make stones.