Monthly Archives: December 2020

Tips for Preventing Calcium Oxalate Kidney Stones

THE PATIENT EDUCATION piece “Tips for Preventing Calcium Oxalate Kidney Stones” was developed as a tool to instruct patients on the recommended nutrition treatment for nephrolithiasis. It is specific for calcium oxalate kidney stones.

Calcium and Oxalate

Oxalate binds to calcium in your stomach and intestines. When this happens, the oxalate won’t be able to get into your kidneys where it can form stones. Therefore, you should consume a moderate amount of calcium to bind the oxalate and help prevent kidney stone formation.

Include 2 or 3 servings of dairy foods every day. It is best to get your calcium from food rather than from supplements. If you do take calcium pills, take them with your meals.

Many foods contain oxalates, but only a few will result in high levels of oxalate in the urine. Avoid these high-oxalate foods:

Nuts and Nut Butters Tea (black and green) Rhubarb
Wheat Bran Chocolate Strawberries
Gelatin Spinach Black Raspberries
Beets and Beet Greens.


Drink More Fluid

You should drink at least 443.60ml of liquid each day.

This will dilute your urine and reduce the concentration of harmful substances that may cause kidney stones to form. At least half of the liquid you drink each day should be water.

Eat Less Salt/Sodium

Limit table salt to no more than ¼ teaspoon a day—measure it!

Omit salt in cooking; add ¼ teaspoon to fresh or prepared food to maximize flavor.

Only occasionally eat foods that are high in salt/sodium. These include the following:

Processed meats like bologna, hot dogs, and sausage; most fast foods; convenience foods; soup mixes, frozen soup, and canned soup; salted snack foods; boxed mixes for entrees or side dishes; high-sodium condiments such as pickles, olives, soy sauce, and steak sauce.

Limit Animal Protein

A high-protein diet can increase the oxalate level of your urine.

59ml serving is about the size of a deck of cards.

Vitamin C

Vitamin C may also be a problem because it can be converted to oxalate.

Do not consume more than 500 mg of vitamin C each day. This includes vitamin C from the foods you eat and from any oral supplement you may take.

Chronic Pelvic Pain

Chronic pelvic pain (CPD) is defined as a pain located in the pelvic area (lower abdomen) of more than 6 months. The painful sensation can be focused in different areas:

  • in the vagina
  • in the perineal area (between the anus and the vagina or between the anus and the scrotum)
  • in the scrotum
  • around the vaginal orifice

The fundamental problem of these patients is that very few urologist in West Delhi think about this syndrome when they come to the consultation. This makes the diagnosis take a long time, usually years, before starting appropriate treatment.

The causes of CPD syndrome are very numerous and varied: vaginal or pelvic surgical procedures, trauma (including repeated small injuries), inflammatory or infectious processes of the pelvis, etc. Usually, the pain is caused by irritation of the pudendal nerve or one of its branches. It is, therefore, what we call “neuropathic pain” against which the usual analgesics do nothing.

It is very characteristic that the pain is triggered or accentuated when the patient sits down and remits when lying down. In addition to pain, urinary symptoms may appear (urgency, frequency, incontinence, stinging, etc.); problems with the deposition; problems or difficulty having sex; erectile dysfunction; alterations of ejaculation, etc. All these associated symptoms are those that mislead the doctor who treats these patients, making the definitive diagnosis difficult.

The necessary study, in these patients, includes the following tests:

  • Physical exploration, locating those points that trigger the painful sensation (trigger points) and assessing the state of the pelvic musculature.
  • Magnetic Nuclear Resonance (NMR) of the pelvis, with special attention to areas where nerve entrapment could most likely occur
  • Neurophysiological study of the pudendal nerve

The PCD syndrome usually requires a long and multiple treatments, including:

  • Pharmacological treatment: As already mentioned, the usual analgesics are not effective in this situation. You must resort to antidepressant medications; state-of-the-art antiseptics; benzodiazepines; etc.
  • Infiltration of painful points with corticosteroids, local anesthetics, etc.
  • Physiotherapy treatments: electrostimulation, massages, etc.
  • Surgical treatment

Once the diagnosis is established, the therapies used are usually very effective and usually eliminate the pain and associated symptoms.

Kidney Stones in Children

Symptoms and diagnosis of kidney stones in children

Kidney stones are said to be able to hurt like childbirth, although at the moment, theirs is that births do not hurt. We are used to seeing them in adults, but in the pediatric age, they can also be seen. We talk about kidney stones. Next, we will reveal some of its characteristics.

Why kidney stones appear in children

Regarding its origin, there are calculations that appear spontaneously, others are secondary to abnormalities in the shape of the urinary tract, infections or metabolic disorders (among them, idiopathic hypercalciuria stands out, an entity that presents with an increase in the excretion of calcium in the urine). Obesity, sedentary lifestyle and heat (especially if the child does not adequately replenish the losses of fluids by sweating with water) favor their appearance.

Up to 50% of cases, there is a family component. That is, some component of the family has had some similar problem.

Symptoms, diagnosis, and treatment of kidney stones in childhood

From a clinical point of view, the most important manifestation is the pain. It is a very intense pain, located on both sides, and radiating to the abdomen. It is described as ‘exasperating’ (the child changes incessantly from a position), and associates with a vegetative procession of vomiting and cold sweat. The movement of the stone produces small erosions on the renal path, so the child bleeds. This bleeding is often evident in the urine.

The diagnosis can be established by the kidney hospital in Palam, West Delhi, and to document it we can resort to a urinalysis (in which we will see an increased number of red blood cells) and an imaging test (ultrasound, abdominal x-ray or tomography).

For kidney stone treatment, it is essential to hydrate the child (orally or intravenously, if he is very nauseous) and provide analgesia. In complex cases, before voluminous calculations, it is necessary to resort to surgery by the urologist in West Delhi. The calculations secondary to specific metabolic diseases require an individualized preventive kidney stone treatment in Uttam Nagar, West Delhi.