No More Kidney Stones E-Book

John S. Rodman

• Herausgeber: John Wiley & Sons
• Kategorie: Ratgeber
• Sprache: Englisch
• Veröffentlichungsjahr: 2010

Seitenzahl: 334

Beschreibung

A Proven Plan to Prevent Painful Kidney Stones At last! Whether you are a chronic kidney stone sufferer or at risk of developing stones, this practical, comprehensive guide will help you take charge of your health and eliminate this painful disease from your life forever. Written by a team of experts in the field, No More Kidney Stones includes the latest information on risk factors, dietary and lifestyle choices, and state-of-the-art treatments. It includes: * Specific, detailed remedies to prevent the formation of the four major types of kidney stones * Prescriptions for creating a diet that works and dietary troublemakers to avoid * Treatment options, including Extracorporeal Shock Wave Lithotripsy (ESWL), cystoscopy, ureteroscopy, percutaneous stone surgery, and open surgery * Case histories showing what types of treatment are appropriate for what specific conditions * Guidance on what to expect before, during, and after treatment * Advice on finding the right specialist

Leseprobe

Table of Contents

Title Page

Copyright Page

PREFACE

Acknowledgments

ABOUT THIS BOOK

PART ONE - WHAT YOU NEED TO KNOW ABOUT KIDNEY STONES

Chapter 1 - THE KIDNEY STONE “BOOM”

What Are Kidney Stones?

Why Do Some People Get Kidney Stones?

The Stone “Boom”

Prevention Is the Cure

The Dietary Prescription

Preventing Kidney Stones

Commitment to Change

Chapter 2 - THE URINARY SYSTEM

The Urinary System and How It Works

The Balance Concept

How Trouble Starts

Chapter 3 - HOW YOUR KIDNEYS BALANCE YOUR BODY

Why Balance Is Important

Elements of Balance

How the Kidneys Keep the Body in Balance

What Happens When the Body Gets Out of Balance

How to Keep Your Sewer System Unclogged

Chapter 4 - NOT ALL KIDNEY STONES ARE CREATED EQUAL

Four Types of Kidney Stones

Calcium-Containing Stones

Uric Acid Stones

Cystine Stones

Struvite Stones

Bladder Stones

Importance of Stone Analysis

Chapter 5 - HOW AND WHY KIDNEY STONES FORM

Genetics

Diet and Lifestyle

What Is a Kidney Stone?

Discouraging Crystal Formation

What Kidney Stones Are Made Of

The Conditions That Favor Crystal Formation

The Best Inhibitor of Kidney Stones

Making a Uric Acid Stone

Chapter 6 - WHY KIDNEY STONES ARE SO PAINFUL

Kinds of Pain

Three Areas Where Stones Hang Up

Secondary Symptoms

Never Make Your Own Diagnosis of a Stone

Treating Pain

When Hospitalization Is Needed

Chapter 7 - HOW MUCH WATER DO I REALLY HAVE TO DRINK?

Causes of Low Urinary Output

How Much Is Enough?

Hard Water, Soft Water

Mineral Water

How to Consume More Water

The Role of Fluids

Chapter 8 - DIETARY TROUBLEMAKERS

How Much You Eat Is Just as Important as What You Eat

Animal Protein Is Animal Protein

Protein and Kidney Stones

The Calcium Controversy

Salt

Oxalate

Vitamins and Kidney Stones

Alcohol

The Dietary Troublemakers

Chapter 9 - MEDICAL CONDITIONS THAT CAN CAUSE KIDNEY STONES

Bowel Disease

Medullary Sponge Kidney (MSK)

Hyperparathyroidism

Milk-Alkali Syndrome and Ulcers

Anatomic Abnormalities

Paralysis and Immobilization

Renal Tubular Acidosis (RTA)

Acquired RTA in Glaucoma Patients

Cystinuria

Oxalosis

Chapter 10 - DIETING YOUR WAY TO A KIDNEY STONE

The Problem with Rapid Weight Loss

Fad Dieting

Fad Health Regimens

Eating Disorders

Laxative Abuse

How Stone Formers Should Diet

Chapter 11 - MEN AND STONES

Why Men Make More Kidney Stones

Pain Patterns

Chapter 12 - WOMEN AND STONES

Why Women Make Kidney Stones

Chapter 13 - THE WORKUP

Risk Assessment

The Workup

Translating Your Workup into a Risk Assessment

Where Are You on the Risk Ladder?

PART TWO - THE PLAN

Chapter 14 - NO MORE KIDNEY STONES

Diet Is Not a Four-Letter Word

The Master Plan

Tips for Staying on the Plan

Chapter 15 - FINDING THE DIET THAT IS RIGHT FOR YOU

Rating Yourself

How Much Do You Have to Change?

Do You Consume Too Many Troublemakers?

How to Know if You Are Eating Too Much Protein

How to Know if You Are Drinking Enough Fluids

Do You Weigh Too Much?

Food Diary

Classic Stone-Forming Profiles

Chapter 16 - LIFESTYLES OF THE KIDNEY STONE FORMER

Bathroom Access

Fluid Loss

Ultraviolet (UV) Light Exposure

Eating Patterns

Change in Lifestyle

Chapter 17 - OPERATION OXALATE

Why Dietary Oxalate Is Important

The Problem with Oxalate Recommendations

Key Issues in Oxalate Control

Oxalates and Seasonal Foods

Chapter 18 - MODIFYING RECIPES AND CONTROLLING PORTIONS

Recipe Modifications

Portion Control

Chapter 19 - HEALTH-FOOD STORE HAZARDS

Supplements

Muscle-Building Protein Supplements

Herbal Teas

Natural Weight-Loss Regimes

Hair Regrowth

Beverages

Vegetarian Burgers

Laxatives

Energy Bars

The Juice Craze

Pastas

Candies and Cookies

Read Labels in the Health-Food Store

Chapter 20 - SPECIAL OCCASIONS

Thanksgiving

Barbecue

Wedding Banquet

Breakfast Buffet

Four Pitfalls of Special Occasions

Chapter 21 - ETHNIC CUISINES

Chinese

Mexican

Greek

French

Japanese

Italian

American

Indian

Chapter 22 - STAYING MOTIVATED

How Far Can You Deviate?

Diluting the Mistake

PART THREE - MEDICINES, SPECIALISTS, AND PROCEDURES

Chapter 23 - CHOOSING A SPECIALIST

Who Does What

How Do You Find Out Whom to See?

Chapter 24 - MEDICATIONS

Who Needs to Take Medications?

What Are the Medications?

Chapter 25 - DECIDING WHO SHOULD BE TREATED

Assessing whether You Need Immediate Intervention

Chapter 26 - PROCEDURES AND TECHNOLOGY

Picking a Procedure

Comparison of ESWL and Ureteroscopy with Laser Lithotripsy

Treating Stones in the Kidney

Open Surgery

Special Situations: Kidney Anomalies

Chapter 27 - WHAT TO EXPECT BEFORE, DURING, AND AFTER TREATMENT

What to Expect before and after Treatment

When to Call the Doctor

What if Treatment Fails?

Asking the Right Questions

Do Not Forget

APPENDIX A - USEFUL TABLES

APPENDIX B - FOOD DIARIES

GLOSSARY

BIBLIOGRAPHY

INDEX

ABOUT THE AUTHORS

Copyright © 2007 by John Rodman, M.D., R. Ernest Sosa, M.D., Cynthia Seidman, M.S., R.D., and Rory Jones. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey Published simultaneously in Canada

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Library of Congress Cataloging-in-Publication Data:

No more kidney stones / John S. Rodman . . . [et al.].—Rev. ed.

p. cm.

Includes bibliographical references (p. ).

ISBN 978-0-471-73929-6 (pbk.)

1. Kidneys—Calculi—Prevention. I. Rodman, John S., 1946-

RC916.R63 2006

616.6’2205—dc22

2006042148

PREFACE

When I started practicing nephrology almost thirty years ago, kidney stones that did not pass, often required open surgery. Dietary advice usually consisted of “drink more water and eliminate all of the dairy products from your diet.” Most of the people I treated for multiple stone episodes were given drugs to reduce their urinary calcium.

Today, most surgery has been replaced by shock wave or laser fragmentation of stones, and we know that reducing calcium is unnecessary for many people and may actually aggravate the problem for a few stone formers. When a prescription is written, it is more likely to be for a naturally occurring substance than for a drug.

As I treated more patients with recurring stone disease, I realized that at least 75 percent of my patients stopped making stones with dietary advice alone. It became apparent that the key to helping people to avoid kidney stones was not going to be the prescription I wrote on a medical pad but the finding of an acceptable way for them to change the way they ate—and in some cases the way they lived. I emphasize the word acceptable because many “ideal” diets represent such a departure from most people’s food habits that they are totally impracticable.

No other disease has a more critical relation to diet. The frequency of stone disease has increased in parallel with the richer Western diet. It is a rare emergency room in an industrialized nation that does not see several patients with colicky pain from kidney stones every week.

As I mapped out diet and fluid recommendations for my patients, many of them wanted something they could refer to when they had questions. They wanted more explanation for oxalate tables, protein control, and fluid guidelines. They asked what they could order in Italian, French, and Chinese restaurants. Family members requested cooking information. The short summary I gave to patients—“Dietary Guidelines for the Stone Former”—became the first notes for this book.

I started to look for patients who might characterize the eating habits of various stone formers, such as the forty-year-old man who began making stones when his weight increased, or the middle-aged woman who drank 2 quarts of iced tea a day. I also saw certain lifestyle patterns that led to the formation of kidney stones. Most sufferers fit one of these patterns. If you can find yourself in this book and make the appropriate changes, you will probably markedly decrease your chance of making stones.

The second reason for writing this book was to find ways for people to stay on the wagon. One of the more difficult aspects of preventing stone disease is keeping people motivated. Frequently, people will follow guidelines religiously for the first three or four months after a stone episode and, when the memory of that awful pain begins to fade, return to the same habits that got them into trouble.

However, I have found that the people who are most successful in eliminating stone episodes from their lives are the ones who understand how and why stones form in the first place. I have therefore tried to explain the “science” in a simple manner that can be used for reference. I hope this book will enable you to understand why your urine makes crystals and how these crystals grow big enough to become kidney stones.

In the eleven years since the first edition of this book was published, many patients have asked me for more information on a number of important topics. In response, this version now includes expanded sections on surgical techniques and procedures as well as the latest scientific information on the role of calcium, vitamins, and various diets on kidney stone formation and treatment.

I am grateful to my patients who have taught me to make my explanations simple enough for the nonscientist to grasp easily. They have also pointed out where my recommendations for diet and lifestyle changes were too ideal or impractical. In turn, I have often had to convince some of them that certain “impractical” changes were necessary if they were to prevent more procedures and more trips to the emergency room. It is from this give-and-take with thousands of patients that the suggestions in this book have evolved.

Nevertheless, there is no substitute for advice from a physician who knows your individual case. You may also need to coordinate a stone prevention program with other aspects of your health. For example, if you have diabetes, your diet will have to be appropriate to that problem as well. Therefore, if you have any questions, you should discuss the information in this book with your own physician. Your doctor can help determine which dietary emphasis is most appropriate for your own care.

John S. Rodman, M.D.

ACKNOWLEDGMENTS

There are many physicians who have taught us what we know about stone disease and assisted us in clinical research. We wish that we could thank all of them. One of them, Dr. Charles Y. C. Pak, former director of the Section of Mineral Metabolism of the University of Texas School of Medicine, whose laboratory has performed the analyses for several of the clinical studies published in this book, deserves special mention. He has been a good friend and mentor.

My collaborators on this book—Ernie Sosa, Cynthia Seidman, and Rory Jones—and I would also like to thank others who have contributed their time, patience, and expertise to our effort:

• Tom Miller, our editor, who has guided the new edition of this book.

• Faith Hamlin, who believed in the concept from the start.

• Richard LaRocco and Thom Graves, who did the illustrations.

My collaborators and I would also like to thank our families for their patience and help over the years. This includes Kathleen, Christopher, and Andrew Sosa; Irwin Iroff; David Jones; and, in particular, Sylvia Rodman. She was the first subject in our pilot study of the safety of calcium supplementation for osteoporosis in women who had previously made stones. Her support, encouragement, and good-humored willingness to try new diets were instrumental in the development and completion of this book.

Finally, we would like to thank the many patients who volunteered to be interviewed so that we could translate their problems, eating patterns, and experiences into the case examples in this book.

ABOUT THIS BOOK

The words in italic throughout the text are common technical terms that you may encounter. They are listed in the glossary for easy reference.

The metric system has been used as the standard for measurement throughout the text. A conversion table is provided in appendix A.

Throughout the text we emphasize the need to consult with your physician for a proper diagnosis and treatment of kidney stones. This is an extra reminder that no medication, procedure, diet, or supplement should be taken or undertaken without consulting a doctor or other qualified professional.

Many people with kidney stones were interviewed for this book. Their names and other details have been changed to protect their privacy.

PART ONE

WHAT YOU NEED TO KNOW ABOUT KIDNEY STONES

May I govern my passions with absolute sway,And grow wiser and better, as strength wears away,Without gout or stone, by a gentle decay.

—WALTER POPE (c. 1630–1714)

1

THE KIDNEY STONE “BOOM”

I drink gallons of milk a day. I love cheese, especially Brie.I love cheeseburgers. I often go out for a big lunch and graba yogurt for dinner. I like raspberry jam on toast and I love peanuts. I’ve always sort of pooh-poohed dietary counseling.Listen, I smoke a pack and a half of cigarettes a day: tellingme not to put raspberry jam on my toast is sort of ridiculousto my way of thinking. But the pain was the type I couldn’tstand. I couldn’t sit and I couldn’t lie down. It came in waves.If I’m good, maybe I won’t get these damn things again.

—SARA, 28

You get different advice from different doctors. It’s confusing.