Dietary and Holistic Treatment of Recurrent Calcium Oxalate Kidney Stones
Laura R. Flagg, MSN, RN, CNP
Having kidney stones can cause morbidity among clients who are vulnerable to this kind of condition. Certain dietary measures were traditionally tested and advised to these clients to prevent recurrence or to decrease risks of developing the condition. These include increase fluid, oxalate, protein, citrate, calcium, and sodium changes in the diet. However, evidence-based practice recommends that only a little evidence confidentiality supports diet modification and fluid intake to affect formation of stones or reduce risks of recurrence of stone formation. The study conducted by Flagg (2007) regarding the dietary and holistic treatment of recurrent calcium oxalate kidney stones provided literature which may be used for evidence-based practice to prevent stone reformation.
A literature review did provide good evidences that having an increased in fluid intake may reduce the rate of stone formation. It is suggests that the urine should me maintained to appear very light yellow in color to clear at all times. With this, the measurement of the water requirement can be easily estimated. This technique can be recommended safe for clients without kidney or heart failure.
Supporting evidences about the regulation of calcium intake to prevent stone formation was also reviewed. Based on previous researches, dietary calcium is safer than intake of supplemental calcium. If the patient is having calcium supplements, it should be considered to take it with meals only.
An increase in meat consumption can also increase the risk of developing kidney stones. Patients should reconsider a choice to have a low-carbohydrate, high-protein diet as a weight loss diet program while taking in consideration the risk of stone formation.
The information on vitamin C intake is contradictory. Supplemental vitamin C use should be undertaken cautiously among stone formers. Lemonade may be a good fluid choice among patients known to have low levels of urinary citrate, rather than grapefruit juice. Future studies should attempt to evaluate the breakdown of ascorbate to oxalate vs. citrate, as the association each has to stone formation is significant.
Patients may find the use of herbal therapies appealing, particularly when traditional Western treatment fails. Clinicians need to inquire about herbal treatments used by patients in their assessments, especially when their stones recur. It is important for the clinician to communicate, through nonjudgmental language, that there is insufficient evidence to support the use of phytotherapeutic agents for kidney stones at this time as the field remains untested.
Laura R. Flagg, MSN, RN, CNP, is a Clinical Nurse at The University Hospital, and a Graduate Student at the University of Cincinnati, Cincinnati, OH.
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Borghi, L., Meschi, T., Amato, F., Briganti, A., Novarini, A., & Giannini, A. (1996). Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: A 5-year randomized prospective study. Journal of Urology, 155, 839-843.
Chai, W., Liebman, M., Kynast-Gales, S., & Massey, L. (2004). Oxalate absorption and endogenous oxalate synthesis from ascorbate in calcium oxalate stone formers and non-stone formers (abstract). American Journal of Kidney Diseases: The official journal of the National Kidney Foundation, 44, 1060-1069.