Clinical Hub,Patient Education,Health and Nutrition Facts For You,Nutrition

Kidney Stones: Prevention and Management (339)

Kidney Stones: Prevention and Management (339) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition


Prevention and Management

Using diet to prevent kidney stones may mean changing what you eat. Depending on your
individual risk factors and on the type of kidney stones you form, you may need to increase fluid
intake, reduce salt intake, change the kinds of proteins you eat, or increase your intake of
potassium, such as from fruits and vegetables. But not everyone needs to make changes to their
diets to prevent stones. Your dietitian will assess your diet to see if changes can help to reduce
your risk of kidney stones. If so, the dietitian will design and explain a plan to meet your specific

IMPORTANT NOTE: Risk factors for kidney stones vary between individuals. Parts of this
worksheet may not apply to you. Your clinical nutritionist will review and explain those that do.

Check if applicable:

Fluids – Low urine volume makes urine too concentrated
Drinking 3 or more liters (quarts) per day is the best way to lower your risk for forming
new stones. You may have to drink even more than this if you exercise heavily or are in
hot weather for long periods of time. Drink at least 10 (8 ounce) cups of fluids a day. Be
sure to drink all day and during the night. All drinks count toward your fluid intake. This
includes water, lemonade, soda, juices, milks, coffee, and tea. Low-sugar and low-calorie
beverages are recommended for the majority of your fluid intake so that you do not
consume too many calories from beverages. You may need to schedule your fluid intake.
Try dividing the day into equal parts with a goal of drinking a certain amount of fluids in
each part so that it adds up to about 100 ounces per day.

Salt (sodium chloride) – Salt causes too much calcium to be in your urine
Most diets contain too much salt. This may increase the amount of calcium in your urine.
Only about 10% of salt intake comes from the salt shaker. The rest comes from processed
and prepared foods. The amount of salt in your urine in 24 hours is a good estimate of
your intake. Based on your urine study, your intake of sodium is _______ milligrams.
Limit sodium to 3000 milligrams per day or less. High-salt foods:

added salt in cooking added salt at the table canned/bottled tomato sauce
salty, cured meats/deli meats salty snacks cheese (esp. processed)
canned soups/vegetables some salad dressings miso
convenience foods pickles/ olives soy sauce
fast foods/restaurant foods sports beverages frozen entrees
breads, bagels, rolls, and
baked goods
casseroles & other “mixed”
foods (pizza, lasagna)
some breakfast cereals
(read labels)

Check if applicable:

Fruits and Vegetables – Reduce the risk of stone formation
Eating 5 or more servings of a variety of fruits and vegetables daily could decrease your
risk for stone formation by providing potassium, fiber, magnesium, phytate, citric acid,
prebiotics, and antioxidants, all of which reduce various stone risk factors.

Calcium – Avoid getting either too much or too little
Calcium is good for your bones. But it can also lower your risk for forming calcium
oxalate stones, especially when consumed with meals. This table lists calcium needs:
ξ 1000 mg – for men up to age 65 years
ξ 1500 mg – for men 65 years and older
ξ 1000 mg – for women 25-50 years
ξ 1500 mg – for women over 50 years

Choose 3-4 servings of calcium rich foods per day. Dairy foods are rich in calcium, but there are
many non-dairy calcium-rich foods and beverages, too. Try to eat them throughout the day. If
you are at risk for calcium oxalate stones, it is important for you to have something containing
calcium at meal times. Many foods contain calcium; below is a list of foods that you are likely to
be able to work into your daily schedule. Remember to eat or drink these with meals.

Foods containing calcium Amount Calcium
Your plan for including
calcium at meals
NON-DAIRY: calcium-fortified
milks, juices
1 cup 400-450 Breakfast
DAIRY: milk, buttermilk, eggnog 1 cup 300
Kefir (99% lactose free) 1 cup 300 Lunch
Yogurt from cow’s milk or soy ¾ cup 150-300
Cheese & cottage cheese* 1 oz/1 cup 150-200
Other foods may be high in calcium, but you are not likely to eat
these every day with every meal. Examples include:
ξ Broccoli, 1 cup cooked, 200 mg
ξ Dried figs, 1 cup, 300 mg
ξ Tofu, set with calcium, 300-600 mg

*Avoid too much of these foods. They are high in salt and may increase calcium loss in urine.
If you cannot eat dairy, use calcium-fortified beverages and foods. You may use calcium
supplements to help meet your calcium needs, but be sure to take these with meals. Discuss
this with your dietitian.

Animal Tissue (includes all meats, fish, and poultry) may raise urine uric acid
The protein in these foods may raise the uric acid and calcium content of urine. The
amount you eat may have to be adjusted to 1 serving or _______ ounces per day. Notice
that dairy foods are not limited as they do not cause high uric acid.

High Oxalate in the Urine – Several ways to reduce it
Controlling and reducing the amount of oxalate in your urine may have nothing to do
with foods you eat. It may have to do with foods you don’t eat. The major reason for high
urine oxalate is a low calcium intake. Calcium binds with oxalate in the digestive tract
and prevents oxalate from getting absorbed. Because of this, you may be advised to eat or
drink something containing calcium at every meal. Supplemental vitamin C in amounts
of 1000 mg/day or more might cause too much oxalate in your urine, so you might be
advised to stop (food sources of vitamin C are okay). Finally, a few specific high-oxalate
foods might contribute to high urine oxalate, including nuts and nut butters, spinach,
rhubarb, beets, chocolate, potato chips, and french fries. Your urine oxalate may not be
influenced by these foods; your dietitian will advise you.


Teach Back:

What is the most important thing you learned from this handout?

What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions please contact UW Health at one of the
phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s
Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and the Department
of Nursing. HF#339