Prevention of urine stone

prevention of urine stone by diet and food supplement

1. Prevention of Urinary Stones
by Diet & Food Supplements
Associate Professor of Pediatric Nephrology
Tabriz Children‘s Hospital
[email protected]

2. Major risk factors for stone
formation include:
Dehydration
Diet (high-protein, high-salt diet)
Heredity

3. General Advices for almost all children
to prevent kidney stones:
•An Increase in Fluid Intakeis recommended.
Therefore, an increase in urine output to more
than 1.5 L/m
2
/day is the single most
important aspect of stone prevention.
•Reducing Salt Intake to less than 2-3 g/day is
helpful for most children especially those at
risk for calcium, oxalate or uric acid stones.

4. To help prevent kidney stones, drink enough
water to keep your urine clear , and
preferably colorless.

5. Dietary choices can affect kidney stone development. Children may
need to change certain eating habits,such as drinking more fluids
and modifying their favorable diet.

6. Thebestwaystopreventortreat
kidneystonesinchildrenbydiet
dependsonthetypeofstone
producedandunderlyingcauses:
Hypercalciuria
Hypocitraturia
Hyperoxaluria
Uric Acid Lithiasis
Cystinuria

7. Calcium Stones
•Sodium restricted Diet
•Patients should avoid vitamin C, A and D supplements.
•Citratesupplementation
•High protein intake increases calcium excretion; so all
patients should receive the Recommended Dietary
Allowanceof protein for age.
•Any unusual excess of calcium intake should be curtailed.
•Calcium or Protein restriction is not recommended
because of the risk of osteopeniaand increased intestinal
oxalate absorption.
•Because potassium depletion increases calciuria, patients
should receive adequate dietary Potassium, particularly if
they are taking diuretics.
Hypercalciuria
Hypocitraturia

8. Dietary Hyperoxaluria
(Calcium-Oxalate Stones)
•Normal people absorb < 5% of dietary oxalate.
•Foods rich in oxalate can absorption 25 -50%
•Low calcium diets urinary oxalate excretion.
•Vitamin B6 supplementation is of limited value.
•Orthophosphate supplementation may help.

9. HyperoxaluriaCa-Oxalate Stones
Limiting or avoiding high-oxalate foods:
Fruits:
Berries کشمت و توت عاونا
Concord or purple grapes روگنا عاونا یضعب
Red Currants،زمرق شمشک عاوناFigsریجنا
Fruit cocktail اه هویم بآو هویم طولخم
Plums یتخرد هجوگ و ولآ عاونا
Tangerines یگنران
ومیل و لاقترپ تسوپ
هدرا و دجنک
یلیجآ یاه هناد(ینیمز ماداب ، قدنف)
Beverages: Chocolatemilk, Hot cocoa،ریعشلاام ،لاوک یاه هباشون ،یاچ ، هوهق
Vegetables:
زبس گرب لکش هب تاجیزبس ، جانفسا لثم
، ینساکيرفعجسفرک ، ، يهاش ،رگنك
ردنغچ و وبل عاونا
ایوس
راد سوبس درآ ، مدنگ سوبس
یگنرف هجوگ ، ناجمداب ، ملک عاونا
هیماب ، زبس لفلف
ریسوم ، هچزایپ
Rhubarb ساویر

10. Uric Acid Lithiasis
•Hydrationis always essential.
•Limiting dietary sodium intake may decrease urinary uric
acid (and calcium) excretion.
•If these measures fail or if patients have recurrent
symptoms, Base supplementation with citrate or
bicarbonate may be indicated.
•Dietary purinerestriction is of limited value;
•most children do not consume significant quantities of
purine-rich animal-protein foods, such as: mushrooms,
meats, anchovies (fish), mussels (shellfish), goose, brain,
kidney, liver, cauliflower and asparagus (هبوچرام) .
•In the patient with a low urinary pH or confirmed
hyperuricosuria, dietary restriction of protein, purineand
sodium is indicated.
•Allopurinolis of limited value.
UrateStones

11. Cystinuria
Prevention & Treatment of CystinStoneincludes:
•Encouragement to drink lots of fluids to help move
the stone along.
•Extra potassium citrate (Citrus Fruits)
Creating abundant urinary flow and urinary
alkalinization.
•In children, a regular diet to support growth is
recommended.
•Low-methioninediet (essentially a low-protein
diet) sometimes recommended in severe cases.
CystineStones

12. StruviteStones
•Prevention of struvitestones rests on
prevention of Urinary Tract Infection.
•Encouragement to drink lots of fluids to
Create abundant urinary flow my help.