Kidney and Urinary Stone Prevention and Cure

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

An article in the New York Times, October 28, 2008, by Laurie Tarkan, illustrates how health problems that most of us thought were someone else's problem are now becoming more of a personal concern for a large percentage of the public. Urologists in some parts of the country are reporting a dramatic rise in the number of patients with kidney stones, and particularly children and women. Recent statistics find that about 12 percent of men and 7 percent of women get a kidney stone at some point in their lives, but most experts agree that the current numbers have risen much higher, especially in women.

To prevent this dramatically painful, and sometimes threatening, event from occurring in your life, understanding the causes and utilizing preventative medicine, especially Complementary Medicine, with herbal prescription, nutrient medicine, dietary changes and acupuncture, may be the ticket. Urinary stones have been treated successfully for centuries with Traditional Chinese Medicine. As always, the added benefit with Complementary Medicine is that it provides improvement in general health and preventative medicine beyond the specific prevention or cure of kidney stones because it is a holistic medicine.

Kidney and urinary stones (renal calculi, or nephrolithiasis) occur when minerals in the body combine with other substances and accumulate in the small ducts and tissues of the organ, in a process called supersaturation, eventually forming a thick sludge, and then stones. These stones may accumulate without symptoms and even sometimes pass unnoticed. Certain factors contribute to the inability of the body to pass the stones easily, as well as the formation of the stones. Ductal scarring from inflammatory processes, hardness and sharpness of the stone surface, and excess of certain conjugating chemicals in the body that are insufficiently processed and broken down are the principle culprits. Of course, poor diet, inadequate fluid intake, obesity, metabolic deficiencies, genetic propensity and chronic inflammation are important factors. More important, though, is the healthy function of the kidney and liver, regulation of acidity or alkilinity, health of the large intestine, and hormonal regulation of minerals in the body.

The time to deal with this problem is now, not when the symptoms occur. Attention to your health with the help of a professional holistic medical practitioner can prevent this and other health problems before they occur. Understanding the health factors that cause or contribute to the formation of stones in the kidney and urinary bladder is all-important to prevention.

Kidney stones are concretions formed in the urinary tract from salts of organic or inorganic acids. Many people assume that kidney stones are always formed from calcium salts and either uric acid or oxalic acid, but this is not always the case, and different dietary regimens may be needed for the specific types of urinary stone formation. In fact, simple dietary tips like cranberry juice are dependant on whether your stone formation is acid or alkiline. There is no one-size-fits-all advice, although, since a slight majority of cases involve oxalates and calcium, we frequently see advice based on this type of stone. Unfortunately, the answer to prevention is not as simple as avoiding calcium and oxalates in the diet. The preferred method is to analyze the stones themselves, when they pass, in a laboratory, and to target specific causes and contributors to the type of stone formation. If this is not practical, analysis of the individual by a professional in a holistic manner is perhaps the best way to arrive at an individualized dietary regimen and treatment protocol.

Kidney stones aren't always visible on X-ray, and screening for kidney stones is sometimes problematic. If the urinary stones are composed of a solid mineral like calcium, they show up on the X-ray, but many stones do not. Dr. Gary Curhan, associate professor at Harvard Medical School, was asked to explain the calcium association and advice to the above stated New York Times reporter. He stated: "Some people believe that if you have a calcium stone, you should go on a low-calcium diet, and that's absolutely the worst thing to do". His explanation confirms that even in calcium salt oxalic acid stones, that the problem is the metabolism and not just an excess of calcium. In fact, he states that calcium supplementation as well as avoidance of calcium may both contribute to calcium stone formation. If calcium supplements are of poor quality or type, and these pills are taken between meals, instead of with calcium rich foods, and/or calcium regulation is poor in the body, such as in hormonal deficiencies, this could result in circulating calcium conjugating with other acids and forming stones with excretion. The problem, once again, is not a simple mechanism, but often involves the whole health, thus demanding a holistic approach to treatment and prevention.

One theory that explains the rise in kidney stone incidence in the last 20 years involves the study of nanobacteria that produce the mineral apatite, which is seen in the core of almost all kidney stones. Analysis of stones in a clinical setting found that 97% of consecutively collected stones in a hospital setting contained these nanobacteria. Nanobacteria are extremely small bacteria that thrive in populations of other bacteria and in acidic environments. The deposit of apatite by these nanobacteria may lead to the supersaturation, or unnatural salt attraction, that causes stone formation. The classic treatment of kidney stones in Traditional Chinese Medicine utilizes herbs that treat bacterial infection in deep tissue while promoting easier urination and dissolving stones. These herbs were discovered by observing effects over thousands of years, but recent research confirms their efficacy. In vitro studies show that certain herbs can break up calcium oxalate aggregation, and herbs such as Bushy Knotweed, or Hu zhang, the source of the now popular reservatrol, are shown to be antimicrobial, antiviral and antioxidant. This Chinese herb is also native to much of the U.S., although herbicides have eradicated it from a number of states. In Traditional Chinese Medicine, a number of Chinese herbs are combined in formulas to treat kidney stones to achieve the specific treatment goals, and these goals are made more clear when lab analyses and patient history reveal potential contributors to stone formation.

Dietary recommendations in Complementary Medicine are also important in holistic treatment protocol. Randomized trials have shown that people who made appropriate dietary changes reduced the risk for stone formation by 40 percent. Clinically, physicians generally observe a much higher success with correct dietary changes helping their patients with kidney stone formation prevention. The key to this protocol is careful individualized professional advice. When this advice is combined with successful treatment and attention to contributing health problems, this is a ticket for success. Integrating your medical care with Complementary Medicine may increase your chances of success. Dietary advice is not as simple as avoiding the foods containing calcium, oxalates, or other metabolites found in stones, but involves more complex dietary aids to healthy metabolism.

What are the contributing health problems in kidney stone formation? The rapidly rising incidence of females with kidney stones points to hormonal imbalances, such as menopause, subclinical hypothyroidism and diabetes, or metabolic syndrome with insulin resistance. There is a high association of stone formation with osteoporosis, high blood pressure and diabetes in current study. Hyperparathyroid disease, an underdiagnosed imbalance, is now thought to be responsible for about 5 percent of kidney stones. Primary hyperparathyroidism is generally discovered when patients complain of fatique, depression, weakness, or when the main complications of primary hyperparathyroidism are evident, which are kidney stones or osteopenia (bone density that is mildly low). Clinical hyperparathyroidism is diagnosed by a simple blood test using radioimmunassay, and excess levels of urinary calcium are also checked. Repeat test of urinary calcium excretion that indicate high levels of excretion, coupled with repeat tests that show either normal or low circulating parathyroid hormone, are the usual markers for the diagnosis. Transitory hyperparathyroidism has also been noted, and if suspected, periodic monitoring of the urinary calcium should be performed for some time. A single normal lab value does not rule out this disease. Incidence of hyperparathyroidism associated with chronic renal failure, often subclinical and underdiagnosed, is also thought to be a growing problem. Subclinical hyperparathyroidism is a growing concern among medical specialists in the United States, and is often coupled with a subclinical hypothyroid dysfunction. The term subclinical refers to a health problem that does not exhibit the standard symptoms that are a red flag to the clinical doctor, and may not produce the clinical signs and lab values expected. These syndromes are often more difficult to diagnose and requires a more thorough analysis.

Subclinical hyperparathyroidism is a complex endocrine imbalance, and is associated with poor hypothalamic function, subclinical hypothyroidism, insulin resistance, calcum imbalance, D3 deficiency, deficient estrogens, poor diet, stomach dysfunction, especially gastric hypofunction, or even competition from the parathryroid hormone receptor protein. Common symptoms include rheumatic pain, bone pain, focal osteoporosis (which may not show up in standard tests for bone density, depending on the site tested), fibrocystic osteosis, neuromuscular hypotonia (poor muscle tone), hypophosphatemia, or increased excretion of phosphorous, nitrogen or calcium. Of course, all of these do not need to be present to indicate a potential sublcinical hyperparathyroid disorder. Diurnal cortisol may also be abnormal in subclinical hyperparathyroidism as increased adrenalin is released when parathyroid hormone stimulates increased serum calcium (due to calcium channels in the controlling metabolism). When the cause of kidney or urinary stones is not clear, which is the case in a larger percentage of patients, exploring the possibility of subclinical endocrine, or hormonal, imbalances should be considered.

With the rising incidence of urinary stones in children, the problem is thought to be linked to childhood obesity increases as well as dietary changes. The popularity of fast food, high-fructose corn syrup, salty snacks, sweets, and trans-fats, spurred by massive marketing campaigns, is causing alarming metabolic dysfunction at an early age. This rising metabolic dysfunction is directly responsible for the physiology of urinary stone formation. As a patient, and a parent, you need to understand more about your body's physiology and how to prevent these type of health problems.

To insure success with treatment and prevention of kidney stones, Complementary Medicine may be utilized both the treat specific cases and to address the need to improve your health holistically. Traditional Chinese Medicine utilizes herbs that have been successful for centuries and are backed up with modern clinical studies. To insure success, these herbal formulas are combined with acupuncture, attention to contributing health problems, and specific diet changes and nutritional supplements. If the stones are too large, or if alarming symptoms occur, such as fever, chill and persistent vomiting, indicating possible infection and sepsis, you may need to seek immediate hospitalization, but if the stones are smaller and symptoms do not indicate immediate risk, TCM offers treatment to complement suggestions of your urologist.

The different types of urinary stones and how to prevent recurrence in a specific manner:

The reason that the calcium oxalate stone is found in the majority of cases of severe pain due to urinary stones is that these stones are sharp edged and get lodged more easily in the irregularly star shaped canals with branches that make up the renal calices, renal pelvis and ureters. These sharp edged stones are sometimes called staghorn stones, which may be made of calcium oxalate, cystine or struvite. The smoother stones, made of calcium urate or magnesium ammonium phosphate are often larger stones, but do not lodge in painful canals. These type of stones usually pass more easily, or get lodged in the upper ureter or at the entrance to the bladder. Pain occurs with these stones when the muscular action generated to propel urine occurs, whereas sharper stones involve long bouts of persistent sharp pain. In many cases, these smoother stones pass unnoticed or unreported to medical doctors. Read below to understand the metabolism of oxalate stone formation, and the steps you can take to prevent occurence, or recurrence of these painful stones.

The general belief has been that calcium urate, or uric acid, stones may be due to excess meat consumption in the diet with excess uric acid produced, while the magnesium phosphate, or base, stones may be seen more frequently in vegetarians. This is somewhat of an oversimplification, but has some validity in studies of kidney stone patients. A look at each type of stone makeup reveals the various reasons that could cause these stones. Different cultures report different percentages of the various types, probably due to local dietary customs. Analysis of your stone when it passes is the best way to evaluate the type of stone metabolism you need to focus on, but patients may also rely on statistics of stone type occurence, as well as professional assessment to judge the most likely type of stone formation associated with your individual health profile.

Diagnostic aids include a 24 hour urine test, where levels of excretion of calcium, sodium, oxalate, uric acid, citrate, and creatinine, a product of protein metabolism, are observed, and urine pH is tested. X-ray, ultrasound and CT scan, as well as intravenous pyelogram are used in diagnosis. Almost all cases are diagnosed only after reports of blood in the urine or severe pain episodes. When the stone passes with urination it may be collected for anaylysis. If all conservative measures to aid urinary passing fail, surgical removal, with risk, is an option, and in these cases, the stone is also collected for laboratory analysis so that a preventative program can be specifically devised. In prevention, one may look to specific dietary changes and treatment before such episodes.

Types of stones and how to prevent them

The uric acid stones: 5-40% of cases analyzed: urates form when common uric acid is not broken down sufficiently by urate oxidase. Urates are the common crystal found to cause gout. An Italian study found that 27% of stones were made of urates, and worldwide, various studies report a range of 5-40%, depending on the population. Uric acid urinary stones may be formed with or without calcium salts. Acidic urine is linked to many of these stone formations. Gout is also associated with acidic urine and uric acid excess in the blood. Acute incidences of gout, the majority of which are associated with acidic urine, result in severe inflammatory joint pain, usually in the feet, but milder cases of joint inflammation, or arthritis, may also be attributed to excess urate accumulation and acidity in the body. Digestion and metabolism of meat produces uric acid, and if the urinary acid level is high, the uric acid may not dissolve easily. A simple pH strip can be used to gauge urinary acidity, and use of specific potassium salts, or even sodium bicarbonate, as supplements, can be very effective in resolving this systemic acidity. Chronic gastrointestinal acidity may eventually result in systemic acidity and stomach dysfunction should be addressed holistically, rather than with dependence on acid blocking medications (Re: The Journal of Urology, vol. 168, issue 4, 2002; Uric Acid Nephrolithiasis). Of course, if your diet has a high percentage of meat, too many simple carbohydrates, and a low percentage of fresh vegetables and whole grains, you should start making changes. This type of diet not only creates excess uric acid, but also creates excess acidity in the body, and contributes to excess prostaglandin 2, or PGE2, which contributes to chronic inflammatory conditions.

Cysteine stones are formed from an acid found in small quantities in most proteins, which is abundant in keratins, and acts to bind and stabilize large proteins such as insulin. The dietary source is found in many common foods, such as garlic, oats, wheat germ, broccoli and red peppers, but cysteine is also produced by the liver. Homocysteine excess is noted in cardiovascular disease, neurodegenerative disorders, and autoimmune disorders. Homocysteine is a nonprotein amino acid, but there is a strong relationship between cysteine and homocysteine levels in the body. The key to this metabolism may be found in liver dysfunction, but kidney function is also a concern in studies, and differing excretion rates may be found in the population. In addition, there is an independant association with Vitamin B12 and folic acid deficiency.

Cystine stones: less than 1% of cases analyzed: are due to metabolic processes where cysteines are linked improperly, which occurs in protein residues. As stated, these may form as painfully sharp staghorn stones. Fortunately, they are believed to make up less than 1% of stones in the adult population, and are generally linked to a genetic defect that is autosomal recessive. Diagnostically, excess cysteine, ornithine, lysine or arginine may be seen in urinary studies. Cystine stones will not be seen on X-ray. Increase in urinary pH increases the solubility of cystine, and maintaining proper fluid excretion by drinking the right amount of fluids throughout the day also decreases the risk of cystine concentration in these individuals. Proper fluid intake is generally considered to be about 6-8 cups of fluid per day.

Oxalate stones: greater than 50% of cases analyzed: form when the salt of oxalic acid is attracted to calcium deposits. To prevent recurrence of oxalate stones, both oxalate metabolism and regulation of circulating calcium is important. Of course, hormone deficiencies, especially of estrogen and activated hormone Vitamin D3, commonly lead to calcium deposits in our tissues, and consumption of calcium supplements when the calcium regulation is poor may be a big contributor as well. Chronic myofascial syndromes and inflammatory disorders may also be a key contributor to calcium deposits, leading to formation of calcium stones. You might read my article on calcium metabolism to educate yourself to this important aspect of health. Oxalic acid is found in many plants and vegetables, particularly the buckwheat family, and the Oxalis family, but is also used in industrial products such as stain removers, some household cleaners, and auto waxes. Industrial oxalic acids are more likely to accumulate in our liver, since they do not break down as easily. Oxalic acid intake in food, by itself, probably has little to do with excess oxalic acid, which might accumulate in cases of hyperoxaluria. Primary hyperoxaluria is due to an alterations in the amino acid alanine and the D-glycerate dehydrogenase enzyme, and the source of the metabolic dsyfunction is thought to be the liver. Avoidance of liver stress, by reducing the intake of pharmaceutical drugs and alcohol consumption when appropriate, may help improve the liver metabolism. Simple avoidance of foods with oxalic acid has not been proven to be effective.

Studies show that improved liver metabolism can decrease oxalate saturation, and that taking Vitamin B6 can also help. B6 pyridoxine is an essential cofactor for amino acid transformation, enzyme activation, mineral balance, acts as a mild diuretic to aid urinary flow, and inhibits the toxic chemical homocysteine, which is linked to formation of atherosclerotic plaques, another source of calcium deposition. The active metabolite of Vitamin B6 is called P5P, a pyroxidine phosphate. Studies show that a combination of magnesium and B6 may prevent the formation of new calcium oxalate kidney stones. Magnesium deficiency leads to excess calcium deposits in soft tissue, which is perhaps the most important single factor in the formation of oxalate stones. There is some evidence that magnesium supplementation may help convert oxalates in the liver metabolism, as well as prevent calcium deposits in the tissues. Magnesium is a vital catalyst in enzyme activity, and deficiency may be linked to the dehydrogenase enzyme deficiency in hyperoxaluria. A magnesium and potassium aspartate supplement may be the best type of consume. Probiotic regimens were also shown to help prevent oxalate stone formation in scientific studies. Healthy function of the lower bowel helps regulate the calcium reabsorption in the large intestine, and probiotics help restore the healthy flora and fauna. When the biotic balance is unhealthy, or when there is chronic inflammation of the large intestine, excess calcium may enter the kidneys and contribute to the growth of the calcium oxalate stones. A Japanese study showed that steaming or boiling vegetables, instead of high heat frying, resulted in decreased oxalate saturation in circulation also. One study found a specific protein that inhibits calcium oxalate stone formation in acidic urine, and it has been speculated that acid conditions in the body, as well as liver dysfunction and protein deficiency may contribute to oxalate stone formation. Coenzyme A is useful in the conversion of oxalates, also. To increases coenzyme A, a product of cellular metabolism that is not available from foods or supplement pills, you meed to take pantothenic acid, an essential nutrient, and may benefit from taking L-cysteine, L-cystine or N-acetylcysteine. L-cystine converts easily to cysteine, and supplies this component of Coenzyme A. If you have the rare genetic condition of cystinuria, which creates cystine stones, or if you have a serious type of diabetes, you have to be cautious about taking supplemental cysteine.

To summarize the known aids in prevention of recurrence of oxalate stones, which are by far the most common stones seen in patients with kidney stones that result in hospital visits, it is recommended that the patient be evaluated for potential nutritional deficiencies, hormonal imbalances, liver stress, and chronic inflammatory disorders, such as myofascial pain syndromes, arthritis or irritable bowel syndrome. Various supplements and food nutrients may be helpful, especially magnesium, Vitamin B6, pantothenic acid, and probiotics. The amino acid L-cysteine is needed, but may be produced in the healthy liver, or supplemented as N-acetyl cysteine. Acetyl-L-carnitine may also aid the oxalate metabolism and improve healthy liver function, especially in cases of fatty liver. Your herbalist may recommend specific herbal formulas to aid liver function, detoxify calcium deposition, and improve intestinal health, as well as specific formulas, tinctures and bioidentical hormones to improve calcium regulation via improved hormonal, or endocrine balance. Vitamin D3 cholecalciferol, may be useful to improve calcium regulation, and intake of a quality supplement along with daily exposure of the skin to sunlight, is necessary to improve active D3 hormone metabolism.

Struvite stones: less than 5% of stones analyzed: these stones are composed of magnesium ammonium phosphate. They may form around other stones when there is an excess of certain bacteria. Unfortunately, struvite forms branching staghorn stones, with numerous sharp edges that can be very painful, and the presence of the bacteria that accompany struvite may create kidney infections. These stones are also found in vegetarians and are believed to be associated with unhealthy levels of urease splitting bacteria in the gut, rather than acidic metabolism. Probiotics are thus recommended. Struvite stones are mainly seen in women, and are thought to be linked to a history of urinary tract infections, or other inflammations and infections as well, including irritable bowel syndrome. Certain infectious bacteria overgrowths produce urease, and these include Pseudomonas, Klebseilla, Proteus, Morganella and Providencia. Heliobacter Pylori, commonly called H. Pylori, also produces urease, and many scientists now believe that H. Pylori overgrowth is a response to increases in gastric urea, which is a byproduct of protein digestion. Normally, increased protein consumption results in a feedback response of increased urease formation by the liver, and here too, a high percentage of meat and fast food in the diet may be a big contributor. When stomach or liver function is not optimal, excess urea or deficient urease may stimulate high levels of the symbiotic H. Pylori bacteria. Herbs to clear and balance gut flora and fauna, as well as urinary infection, followed by a probiotic regimen may help this condition very much. Restoration of proper stomach and liver function must also be a concern. Phosphates are salts or esters of phsophoric acid, which is used as a buffer in pharmaceuticals, and high intake of pharmaceutical medicines may also be a factor in these stone formations. The principal concerns are overly alkaline urine, with a pH of greater than 7.0, and chronic or acute overgrowths of urease producing bacteria.

Xanthine stones are formed from alkaloids that are used as bronchodilators and stimulants. Derivates of these aldaloids include caffeine, chocolate, and the drugs theophylline and theobromide. Normally, xanthine is converted to uric acid by a specific enzymes, xanthine oxidase. Some people have a genetic propensity to acquire an inability to produce this enzyme, and extreme cases, which are rare, lead to kidney failure.

Apatite in stones is frequently seen clinically and study has led to a theory that these stones are formed as a result of a nanobacteria infection. Nanobacteria produce carbonate apatite on their cell walls, and in a study of kidney stones collected from 72 consecutive patients at a hospital in Finland, apatite and these nanobacteria were found in 97% of the stones. The study of Randall's plaques suggest that apatite may initiate kidney stone formation. It is also suggested in study that acidic kidney conditions may lead to higher colonies of nanobacteria and apatite stone formation. Hyperparathyhroidism has also been linked to this acidic kidney environment. Apatite is often seen combined with uric acid in stones.

Urinary stones usually recur, unless the stone formation was in response to local surgery or bowel/urinary tract inflammation, and because of this frequent recurrence rate, surgery is usually discouraged. Repeated surgical removal comes with great risk to the patient. Lithotripsy, which breaks up the stones with sound waves, also has its critics, with many specialists noting that repeated lithotripsy still does not achieve passage of all the stones, and that some of the stone fragments are sharp and lodge easily in the canals. A Mayo Clinic study showed that repeated lithotripsy increased the risk of diabetes and hypertension, perhaps due to injury to the healthy kidney tissues. For these reasons, arthroscopic and laser technologies have been created to break and remove stones with less risk to the patient.

Certain drugs can increase the risk of developing kidney stones. Diuretics prescribed for hyptertension and other disorders that aren't potassium sparing may cause excess excretion and accumulation or calcium. Calcium antacids taken in excess may contribute to excess excreted calcium that is not properly conjugated with another carrier. Protease inhibitors, used in the treatment of HIV, may also cause kidney stones, as wll as acyclovir, prescribed for herpes sores, sulfonamides, found in various medications, and triamterene, in diuretic. Overuse of ephedra, which is now banned from use by anyone other than a licensed herbalist due to the prevalence of use in diet pills and sports supplements, may also cause kidney stones. The Licensed Acupuncturist is usually a licensed herbalist, and has learned to never overprescribe this Chinese herb, commonly called mahuang.

The basic reasons for kidney stone formation must not be overlooked in the holistic treatment regimen. While these reasons may be varied, diagnosis of the particular type of urinary stone, either by analysis when they are passed, or by careful history and assessment with specific laboratory results and checking urinary pH, will help to formulate the right treatment and preventative regimen. Time spent in diagnosis with a knowledgeable Complimentary Physician, such as a Licensed Acupunturist, working with the information from your specialist M.D. in an integrative manner, may make the difference in treatment and prevention.

Hormonal imbalances relating to Kidney stone formation

The hormonal, or endocrine system, regulates our metabolism. Regulation of calcium and other minerals is important because these molecules are very large and highly charged, easily conjugating with other charged molecules. Circulating levels need to be tightly controlled because these large and highly charged molecules, conjugated with other molecules, can easily accumulate in our tissues, especially at the capillary beds in organs and joints. Since kidney stones are usually made of these conjugated molecules, as well as other metabolites that are not easily broken down, the healthy function of the endocrine system is vital to maintaining a metabolism that does not result in stone formation. Large cohort studies in recent years have shown that patients with a history of gallstone formation, another health problem linked to a variety of hormonal imbalances, have a much higher risk for acquiring kidney stones, or urinary lithiasis. Obviously, a more holistic approach to prevention of these stones is needed.

Hyperparathyroidism is seen in more than 5% of kidney stones clinically. Some cases of primary hyperparathyroidism are due to cancerous growths, but an increasing incidence of sporadic hyperparathyroidism is seen today and the cause has eluded modern study. This probably indicates a broader hormonal imbalance. Synthetic hormones in hormone replacement therapies and contraceptives are one of the main causes of hormone imbalances. Hyperparathyroidism associated with subclinical hypthyroidism is a concern. Studies indicate that levels of parathyroid hormone and dietary phosphate are key components of stone formation in the kidney, and that pH, or acidity, levels also plays a significant role.

Dr. JS Rodman, of the Cornell University School of Medicine in New York states that stones in patients with hyperparathyroidism often contain apatite salts in addition to calcium oxalate because parathyroid excess may create a renal tubular acidosis. Apatite is a phosphate mineral used as a fertilizer for tobacco and other crops, and runoff has contaminated the water supply. It is also a component of older flourescent bulbs, which discarded also adds to environmental accumulation. Apatite is also one of the few minerals produced by the body and is a component of tooth enamel. Flouride works to protect teeth from acidity by combining with apatite in the tooth enamel. The source of the apatite in kidney stones has also led to the discovery of nanobacteria that produce apatite, and these nanobacteria were found in 97% of the apatite stones analyzed (1999 Kidney Intl. vol. 56:5:1893-1898; Ciftcioglu N. et al, Univ of Kuopio, Finland).

Excess generation of a type of hormonal Vitamin D in hyperparathyroidism results in excess intestinal absorption of calcium and secondary excess of oxalic acid. The problem may be related to impaired response to 1,25-hydroxyvitamin D initially with early hypocalcemia. Patients with hyperparathyroidism and hypocalcemia with elevated 1,25-hydroxyvitamin D were given 4 weeks of Vitamin D3 supplementation and their hyperparathyroidism and hypocalcemia resolved (New England Journal of Medicine 1978 May 4;298(18):996-9; MH Brooks). Because of the complexity of this issue, there is still controversy about the use of Vitamin D3 hormone supplementation to resolve hyperparathyroidism and prevent stones, but there is general agreement from scientific studies that hormonal Vitamin D3 deficiency is very prevalent in the current population in the United States. Research has indicated that D3 supplementation could reverse slowly progressive hyperparathyroidism with hypercalcemia both by countering the dysfunction of the parathyroid gland due to chronic deficiency of D3 and by the effects of D3 on intestinal absorption of calcium

Sarcoidosis is also a source of kidney stone formation. This disease may cause overproduction of types of Vitamin D, as well as potential kidney damage, resulting both in poor regulation of circulating calcium as well as potential problems with efficient excretion and inflamed tissues in the kidney ducts. Sarcoidosis is a systemic tissue disorder of unknown cause. It is often detected due to tissue irritation of the lungs, resulting in persistent dry cough and shortness of breath, which leads to X-ray to rule out TB, and hence the discovery of sarcoidosis. Of course, many of these cases are easily misdiagnosed as asthma. Other signs that sometime signify sarcoidosis are itchy skin bumps or discolorations that can be seen on the legs, back, arms, scalp or face, or red bumps (erythema nodosum) on the legs. Visual symptoms may also be seen, including seeing spots or other visual changes. Sarcoidosis is poorly understood, but there are potential links to immune and hormonal imbalance. Acute symptoms and signs often resolve spontaneously in 3 years, but recurrence is seen.

Many researchers feel that progressive secondary hyperparathyroidism is a second phase problem of slow bone loss in postmenopausal women due to estrogen deficiency or hormonal imbalance. This slow loss of bone mass, or osteoporosis, is highly associated with progressive secondary hyperparathyroidism, and a high percentage of these cases involve kidney stone formation. This syndrome of hormonal imbalance, sublcinical hypothyroidism and secondary hyperparathyroidism may be a vastly underdiagnosed syndrome, and is similar in scope to metabolic syndrome, or syndrome X, which is acknowledged as the comprehensive disorder that previously was grouped with Diabetes Type 2. A holistic protocol to bring the hormonal system back into balance is needed in these syndromes.

Symptoms and Conditions Secondary to Kidney Stones

Of course, most people realize that acute pain to the back, sides, abdomen, groin or genitals that comes in waves and which is severe and alarming is typical of kidney stones. Nausea and vomiting may occur, as well as chill and fever. Persistent vomiting may dehydrate the patient, and persistent fever may indicate kidney infection, which could result in sepsis and poses grave concern, requiring immediate hospitalization.

Dietary Considerations in Prevention of Kidney Stones:

The five greatest concerns in standard medicine in the formation of kidney stones are: 1) a high level of urinary calcium, usually attributed to poor calcium regulation, or dumping of calcium form calcified tissues in chronic inflammatory conditions; 2) high urinary oxalate, usually attributed to poor liver metabolism, and deficiency of coenzyme A in the conversion of oxalates; 3) high urinary uric acid, usually attributed to high acidity in the urine and body, coupled with high meat consumption, whose digestion and metabolism produces uric acid; 4) insufficient urinary citrate, due to inadequate intake of foods with Vitamin C; and 5) inadequate or inconstant flow of water through the kidneys, which is a product of poor kidney function as much as low consumption of fluids. It is not advisable to consume too many fluids in the belief that this will prevent kidney stones. Physiologists have always found that 5-6 cups of fluid per day is normal intake unless sweating, diarrhea, or blood loss produces increased need. Extreme intake may put undo stress on the kidneys, exacerbating the problem, and leading to potential electrolyte imbalances.

Perhaps the greatest general concern is regulation of acidity in the body by optimal function of the stomach, liver and kidney metabolisms. Protocols in Complimentary Medicine are suited to the individual case, and utilize a combination of acupuncture, herbal formulas, nutrient supplements and changes in dietary habits. A general consideration is the reduction of meat, especially red meat, in the diet, and cereals and simple carbohydrates, both of which can create excess acidity and arachidonic acid. The kidney often struggles with excretion of acid as we age, and it is wise to improve our diets to accomodate aging.

If you produce uric acid stones, reducing the overall meat and protein may also be important. Stopping binge eating and extreme diets is important advice for patients with uric acid stones. Other type of stones may benefit by a reduction of dietary intake of the particular type of stone material, although this subject is still being debated. Metabolism of the various stone materials is of more importance than dietary intake. Of course, if you have inherited a genetic propensity with difficulty digesting and transforming certain food metabolites that conjugate with mineral salts and acids, you must avoid or reduce foods with these types of chemicals.

Sufficient fluid intake is important, but excessive fluid intake does little more than stress kidney function. Six to eight cups of total fluid per day is ideal for most people, and some of this is obtained from the solid foods. If there is excess sweating, diarrhea or bleeding, consume more fluids. Taking of small amounts of fluid throughout the day might help the constancy of flow through the kidney. Certain types of fluid were shown to increase risk in women of stone formation, including grapefruit juice, wine, coffee and tea. These beverages should not be overconsumed. Quality mineral water may be helpful to keep a balance of electrolytes, and use of a quality sea salt may also be helpful.

Very high daily dosage of Vitamin C has shown some correlation to kidney stone formation, as has daily supplementation with calcium pills. On the other hand, dietary calcium and vitamin C has been shown to reduce risk of stone formation. Dark green leafy vegetables are a good souce of healthy calcium, as calcium and magnesium are the backbone of chlorophyll. Berries and citrus are excellent sources of Vitamin C, but if you take a supplement, make sure that it is a quality Vitamin C, so that your kidney and circulation are not hit with a high dose of metabolized Vitamin C at once. The health of the individual may also be important in assessing dietary risks, and for this reason, advice from a professional is recommended.

Basic Chinese Herbal strategies:

Classic Chinese herbal formulas focus on decreasing inflammation and helping to dissolve stones, as well as to promote healthier liver function and to promote passing of stones. These formulas have been used successfully for centuries, and short courses are safe and without ill effects, so that they can be used as preventative measures by taking short courses periodically.

Information Resources

Kidney stone prevention is a complicated subject, and modern medicine has not developed a simple universal public health recommendation due to the wide variety of types of stones and contributing factors to the physiology of kidney stone formation. Nevertheless, the research has produced some simple advice, and both acupuncture and herbal medicine are being researched to prove efficacy in prevention or recurrence.

  1. The Mayo Clinic has an oversimplified but accurate account of the views of prevention in modern medicine:
  2. The New York Times 2008 overview of this subject is a little more informative:
  3. Another interesting site to get a synopsis, or overview, of the kidney stone pathology and simple tips and cures is available here:
  4. The renowned Cleveland Clinic presents thorough information regarding kidney stones, affecting at least 1 in 1000 in the United States, noting that we still do not completely understand some of the pathophysiology related to supersaturation and hormonal imbalance in regulation of minerals such as calcium in the disease. Recommendations to decrease meat consumption and improve the diet, but maintain normal calcium intake and lower sodium in the diet, are foremost in the preventive measures, as well as insuring that a normal amount of fluid is consumed daily (at least 6 cups). In most cases of calcium oxalate or other calcium stones, gastrointestinal health is implicated, with excess absorption occurring, and systemic acidic conditions, as well as inflammatory conditions may contribute greatly:
  5. In 2015, a meta-review of scientific studies for the treatment of kidney and urinary stones, by experts at The Hebrew University, in Jerusalem, Israel, found that, despite evidence of the high rate of recurrence of kidney and urinary stones, that very few randomized controlled human clinical trials have been published concerning standard treatment, and little evidence of efficacy is thus available for pharmaceutical treatment. Among the treatments showing some success in all studies, citrate supplements may increase the pH to prevent some types of stones, allopurinol may be effective if there is a finding of high uric acid in circulation, and several drugs that are widely prescribed have shown efficacy, but not with quality RCTs, and these may produce severe adverse side effects, minimizing their use. In other words, standard medicine has little to offer to prevent kidney and urinary stones:
  6. A large multicenter cohort study of patients in Taiwan with kidney stones found that patients with a prior history of gallstones had a much higher risk of acquiring kidney stones, showing that the standard explanation of these stones has not been accurate, and that a more holistic approach is needed in prevention:
  7. A large 2014 study at the University of Washington School of Medicine, published by the Women's Health Initiative, showed that kidney stones in postmenopausal women can be prevented with increased daily physical activity (not heavy exercise), and attention to diet, with lowered caloric intake and resolution of obesity:
  8. A U.S. Dept. of Human Health and Services database lists the household products with industrial oxalic acid, which one may want to avoid if calcium oxalate stones are experienced or suspected:
  9. A 2009 meta-analysis of scientific research regarding the use of Traditional Chinese Medicine (TCM / acupucture, herbal and nutrient medicine) as an Integrative Medicine to treat or prevent kidney stones was conducted by the University of Minnesota Department of Urologic Surgery, Minneapolis, Minnesota, U.S.A. The conclusion was that TCM holds much promise as a Complementary Medicine in this regard, especially acupuncture:
  10. A 2012 study of the effects of electroacupuncture plus intensive moxibustion therapy in the treatment of kidney stone pathology, found that this therapy significantly improved kidney tissue pathology, such as inflammation of the glomerulus and interstitial tissue, necrotic tissue of the ureter, and helped normalize levels of calcium ions, blood urea nitrogen, and uric acid in circulation. This study utilized moxibustion on needles at the points UB23 on the low back, combined with palpable trigger points (Ashi) and at UB28, SP6, UB52, UB23, with electroacupuncture at UB23, along with moxa applied to these needles:
  11. A 2013 randomized controlled human clinical study of the classic formula to prevent kidney stones in TCM practice, Wu Ling San, at the National Chung Hsing University Medical School Department of Urology, and China Medical University, showed that this formula exerted significant benefits in prevention of calcium oxalate kidney stones over placebo:
  12. A 2007 study of the classic Chinese herbal formula to prevent and treat kidney stones, Wu Ling San, at Changhua Christian Hospital, in Changhua, Taiwan, found that this formula significantly inhibited calcium oxalate nucleation and aggregation:
  13. Published research studies concerning the use of herbal chemicals to aid dissolution of kidney stones is still sparse, but studies are beginning to be published in recent years, such as this study of the Ayurvedic herb Bergenia ciliata (Hairy begonia), found effective in a dose-related fashion to dissolve phosphate stones, and less so to dissolve oxalate stones:
  14. A study of the Chinese herb Pyrrosiae petiolosa (Shi wei) by Lanzhou University, in China, found that this and another Chinese herb, Desmodium styractifolium, significantly reduced blood urate and oxalate, and increased citrate excretion, dilation of ureters, and decrease of malondialdehyde, preventing the return of kidney stones with a number of mechanisms in laboratory studies:
  15. A 2009 study of the Chinese herbal formula Zhu ling tang, long used to prevent recurrence of Kidney stones, showed significant benefit in reduction of calcium oxalate crystal formation in the kidney, as well as other health benefits:
  16. A 2008 study of the Chinese herbal formula Wu ling san, also use to prevent kidney stone recurrence, showed that this formula effectively inhibited calcium oxalate crystal formation in the kidney and lowered the incidence of stones in laboratory animals:
  17. A 2014 controlled study at the Kashan University of Medical Scinces, in Tehran, Iran, found that an alcohol extract of Yarrow (Achillea millefolium) exerts significant preventive and curative effects on kidney stone formation, reducing oxalate concentration as well as citrate concentration:
  18. A 2014 study at the University of Cape Town, Cape Town, South Africa, found that 5 herbal medicines studied and now popular in South Africa to treat and prevent kidney stones were proven effective in decreasing the size of calcium oxalate stones in urine. The trademarked herbal medicine Cystone (Gokshura, Saxifraga ligulata, Didymocarpus pedicellata) worked the best, but Desmodium styracifolium and Orthosiphon stamineus worked well. Desmodium styracifolium, or Guang jin qian cao, commonly called Leaf Tick Clover, is traditionally used to clear kidney stones and treat urinary tract infections. Orthisiphon stamineus, or Java tea, is an herb found in Asia and Australia, long used to treat both Kidney and Gallbladder stones and disease:
  19. A 1993 study of Desmodium styracifolium, or Guang jin qian cao, a Chinese herb long used specifically for Kidney stones, as the herb name indicates, at the Kumamoto University Medical School Department of Urology, in Japan, found that this herb is effective in inhibiting the formation of calcium oxalate stones, and increasing citrate excretion: