Table of Contents
Preface xi
Acknowledgments xv
About This Book xvii
Part One What You Need to Know About Kidney Stones
1 The Kidney Stone “Boom” 3
What Are Kidney Stones? 5
Why Do Some People Get Kidney Stones? 5
The Stone “Boom” 5
Prevention Is the Cure 6
The Dietary Prescription 6
Preventing Kidney Stones 6
Commitment to Change 7
2 The Urinary System 9
The Urinary System and How It Works 9
The Balance Concept 12
How Trouble Starts 13
3 How Your Kidneys Balance Your Body 14
Why Balance Is Important 15
Elements of Balance 15
How the Kidneys Keep the Body in Balance 15
What Happens When the Body Gets Out of Balance 18
How to Keep Your Sewer System Unclogged 19
4 Not All Kidney Stones Are Created Equal 20
Four Types of Kidney Stones 20
Calcium-Containing Stones 21
Uric Acid Stones 22
Cystine Stones 25
Struvite Stones 25
Bladder Stones 26
Importance of Stone Analysis 27
5 How and Why Kidney Stones Form 28
Genetics 28
Diet and Lifestyle 28
What Is a Kidney Stone? 29
Discouraging Crystal Formation 30
What Kidney Stones Are Made Of 30
The Conditions That Favor Crystal Formation 31
The Best Inhibitor of Kidney Stones 31
Making a Uric Acid Stone 32
6 Why Kidney Stones Are So Painful 34
Kinds of Pain 34
Three Areas Where Stones Hang Up 38
Secondary Symptoms 39
Never Make Your Own Diagnosis of a Stone 40
Treating Pain 40
When Hospitalization Is Needed 41
7 How Much Water Do I Really Have to Drink? 43
Causes of Low Urinary Output 43
How Much Is Enough? 44
Hard Water, Soft Water 44
Mineral Water 45
How to Consume More Water 45
The Role of Fluids 46
8 Dietary Troublemakers 47
How Much You Eat Is Just as Important as What You Eat 47
Animal Protein Is Animal Protein 48
Protein and Kidney Stones 48
The Calcium Controversy 49
Salt 53
Oxalate 54
Vitamins and Kidney Stones 55
Alcohol 58
The Dietary Troublemakers 59
9 Medical Conditions That Can Cause Kidney Stones 60
Bowel Disease 61
Medullary Sponge Kidney (MSK) 63
Hyperparathyroidism 65
Milk-Alkali Syndrome and Ulcers 65
Anatomic Abnormalities 66
Paralysis and Immobilization 68
Renal Tubular Acidosis (RTA) 69
Acquired RTA in Glaucoma Patients 69
Cystinuria 70
Oxalosis 70
10 Dieting Your Way to a Kidney Stone 72
The Problem with Rapid Weight Loss 72
Fad Dieting 73
Fad Health Regimens 75
Eating Disorders 76
Laxative Abuse 77
How Stone Formers Should Diet 78
11 Men and Stones 79
Why Men Make More Kidney Stones 79
Pain Patterns 82
12 Women and Stones 84
Why Women Make Kidney Stones 84
13 The Workup 89
Risk Assessment 89
The Workup 90
Translating Your Workup into a Risk Assessment 99
Where Are You on the Risk Ladder? 101
Part Two The Plan
14 No More Kidney Stones 105
Diet Is Not a Four-Letter Word 105
The Master Plan 106
Tips for Staying on the Plan 108
15 Finding the Diet That Is Right for You 110
Rating Yourself 110
How Much Do You Have to Change? 111
Do You Consume Too Many Troublemakers? 111
How to Know if You Are Eating Too Much Protein 115
How to Know if You Are Drinking Enough Fluids 117
Do You Weigh Too Much? 119
Food Diary 119
Classic Stone-Forming Profiles 120
16 Lifestyles of the Kidney Stone Former 130
Bathroom Access 130
Fluid Loss 132
Ultraviolet (UV) Light Exposure 132
Eating Patterns 133
Change in Lifestyle 134
17 Operation Oxalate 136
Why Dietary Oxalate Is Important 136
The Problem with Oxalate Recommendations 137
Key Issues in Oxalate Control 138
Oxalates and Seasonal Foods 139
18 Modifying Recipes and Controlling Portions 142
Recipe Modifications 142
Portion Control 146
19 Health-food Store Hazards 147
Supplements 147
Muscle-Building Protein Supplements 149
Herbal Teas 149
Natural Weight-Loss Regimes 150
Hair Regrowth 150
Beverages 150
Vegetarian Burgers 151
Laxatives 151
Energy Bars 152
The Juice Craze 152
Pastas 153
Candies and Cookies 153
Read Labels in the Health-Food Store 153
20 Special Occasions Parties and Other Excuses to Cheat 154
Thanksgiving 154
Barbecue 158
Wedding Banquet 159
Breakfast Buffet 162
Four Pitfalls of Special Occasions 163
21 Ethnic Cuisines 164
Chinese 164
Mexican 167
Greek 168
French 169
Japanese 170
Italian 171
American 173
Indian 175
22 Staying Motivated 178
How Far Can You Deviate? 179
Diluting the Mistake 179
Part Three Medicines, Specialists, and Procedures
23 Choosing a Specialist 183
Who Does What 183
How Do You Find Out Whom to See? 185
24 Medications 186
Who Needs to Take Medications? 187
What Are the Medications? 187
25 Deciding Who Should Be Treated 193
Assessing whether You Need Immediate Intervention 193
26 Procedures and Technology 201
Picking a Procedure 201
Comparison of ESWL and Ureteroscopy with Laser Lithotripsy 208
Treating Stones in the Kidney 210
Open Surgery 211
27 What to Expect Before, During, and After Treatment 214
What to Expect before and after Treatment 214
When to Call the Doctor 219
What if Treatment Fails? 219
Asking the Right Questions 220
Do Not Forget 221
Appendix A: Useful Tables 223
Appendix B: Food Diaries 235
Glossary 241
Bibliography 249
Index 251
About the Authors 269
