Kidney Stones
20% Higher Incidence of Stones in PKD
Passing a kidney stone is generally very painful. It can be diagnosed through imaging or if the stone has already passed, the doctor may give you a mesh cup to strain any urine. You might be asked to strain your urine through a filter to catch any possible gravel that can help determine what type of kidney stone you have. Knowledge of the type of kidney stone can aide in the prevention of future stone formation. Nephrolithiasis is another name for kidney stone,
Treatment for Kidney Stones
If your doctor determines that you have a calcium stone (the most common type for PKD'rs) then Shohl's solution or potassium citrate is an old time remedy for these kidney stones. Do not take sodium bicarbonate. With PKD this can increase the chances for kidney stone formation. Pain relief will be given immediately, usually in the form of narcotics. If your urine is too acid you will need to maintain a constant alkaline pH, increase water intake, and eliminate the use of too many proteins.
Urocit K and polycitra syrup are two forms of potassium citrate, a very strong alkalizer. These medications are useful for preventing future kidney stone formation. Taking in a high salt diet increases the amount of calcium excreted in the urine. This can promote the formation of calcium stones. You may also be asked to avoid caffeine. Two separate studies found caffeine and protein to be the primary factor in increasing the chances for developing more kidney stones.
Types of Kidney Stones in PKD
1. Calcium Carbonate Stones
By far and away the most common type of renal stone in PKD Polycystic Kidney Disease.2. Uric Acid Stones
If you have an oxalate stone, your doctor may suggest avoidance of high oxalate foods such as spinach, rhubarb, beets, strawberries, wheat bran, nuts and nut butters. Naturopathically it is recommended that one, alternate freshly squeezed apple juice with freshly squeezed lemon juice each hour. The avoidance of purine rich meats helps prevent uric acid stones. Already with PKD we have a high uric acid level. The primary treatments are to alkalinize (citrate) and dilute the urine (large water intake). The large water intake also shuts down vasopressin which in turn minimizes kidney cyst growth.3. Struvite Stones
Are caused by multiple urinary tract infections. Working with your physician try to eliminate the infection source. Sometimes it can be the angle of your ureter; sometimes it is related to a gel or lubricant; and other times the source of the infection remains hidden. Struvite stone formers are asked to drink cranberry and blueberry juice both acidify the urine preventing bacteria from clinging to bladder walls.4. Cystine Stones
These result from a genetic disorder that causes cystine to leak through the kidneys and into the urine, forming crystals that tend to form kidney stones.
Nephrolithiasis improved with magnesium and potassium citrate
Nephrolithiasis trial with potassium citrate
Potassium Citrate kidney stone trial
Potassium Citrate polycitra- K prescribing information
Potassium Citrate bio of G. Tanner and publications
Citrate Urocit dose chemical structure
Potassium Citrate Urocit contraindications
Potassium Citrate Diminishes Kidney Stone Reoccurrence
Caffeine causes an increase in kidney stone formation
Low Oxalate Diet
A study from Italy was done to determine the correct diet for chronic kidney stone formers. It compared several kidney stone diets. Participants wanted to prevent future kidney stones. Researchers discovered low salt and low protein can prevent kidney stones. Each participant drank 3 liters of water daily. Their daily protein intake was determined by laboratory testing. The hypothesis was would dietary calcium cause an increase in kidney stone formation? It was determined that dietary calcium was not the culprit. It was eating too much protein. It had been previously thought that dietary calcium might precipitate kidney stone formation. Participants using similar guidelines gladly cut back on their protein intake to assure no future development of kidney stones. Authors felt this diet could work in any country, but might prove to be more difficult to institute in the USA where diets contain large amounts of animal proteins.
"In conclusion, our study suggests that a diet characterized by normal calcium, low animal protein, and low salt levels is more effective than the traditional low-calcium diet for the prevention of recurrent stones in men with idiopathic hypercalciuria. We speculate that this type of diet will be of greatest value when it is started early in the course of the disease."
