Citrus Fruits, Liquids Can Prevent Stone Disease

By Dr. Robert J. Irwin, Jr.

(Dr. Irwin is the Harris L. Willets professor of urology at the New Jersey Medical School of the University of Medicine and Dentistry of New Jersey (UMDNJ) and co- medical director of the Stone Center of New Jersey, located on the Newark campus of UMDNJ).

Eating citrus fruits and drinking an eight-ounce glass of orange juice daily may help prevent kidney stones, a painful and unpredictable disease that strikes more than 600,000 Americans each year.

Citrate, an acid found commonly in fruits such as oranges, lemons, limes and grapefruits, seems to help prevent kidney stones from forming. Some people prone to stones have been found with insufficient levels of citrate in their urine. A glass or two of orange juice can help protect against stones by increasing urinary citrate. It also provides the proper daily requirement for vitamin C.

Other elements that contribute to stone disease are heredity and frequent kidney infections. Also, overactive parathyroid glands can release an excess of hormones that cause kidney stones to form in the urinary tract by increasing urinary calcium.

It is essential--especially in the spring and fall--to drink water and other liquids to avoid dehydration during extreme temperature variations. People with a history of kidney stones should consume at least two quarts of liquids daily. If tests reveal excess calcium in patients' urine, they should also avoid products high in calcium, such as milk, cheese and antacids.

A kidney stone is a crystal structure formed by excessive salts in urine. The most common is the calcium stone. A stone will increase in size until it is not passable and becomes lodged in the ureter, the tube that carries urine from the kidneys to the bladder.

Stone symptoms include severe back pain, blood in the urine, strong urine odor and fever. Stones can be detected through a routine urinalysis or through x-rays.

Kidney stones are most common in men aged 40 to 65. For unknown reasons, they strike men three to four times more than women. It is estimated that most men have about a 10 percent chance of experiencing stones in their lifetimes.

The highest concentration of Americans with kidney stones is in what physicians refer to as the "Stone Belt," the Southeastern states. That may be attributable to heat factors in those states that can cause mild dehydration, which contributes to stones.

Stones can occur at any time, at first with few symptoms. Most people develop small, uncomplicated calcium stones that are either passed or easily treated. Larger stones can require multi- ple treatments. Seventy percent of stone sufferers are prone to recurrences.

The good news is that with today's technology, stones are easier to detect and treat. Outpatient clinics across the United States specialize in treating stones, often in a matter of hours and sometimes with one treatment.

In previous decades, surgery was required to treat kidney stones. Today, the universal stone treatment is known as lithotripsy, a precise, non-invasive procedure that often allows patients to return to work the next day.

During lithotripsy, the patient rests comfortably under mild sedation on a bed with a bubble-like projector placed under the back. A sophisticated computer tracks and pinpoints the stone, which is then crushed by a shock wave from the projector into microscopic particles easily passed in urination.

It is impossible to predict when or if a kidney stone attack may confront us in our lifetimes. But eating fruits and consuming lots of liquids may be the best approach to preventing the painful condition. This simple recommendation is inexpensive, nutritionally sound and easily followed by everyone, regardless of whether they have had kidney stones.

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