No More Kidney Stones

John S. Rodman, M.D., is an internationally recognized expert and researcher on kidney stone disease. He is associate clinical professor of medicine at the Weill Cornell University School of Medicine in New York City and a member of the attending staffs at New York Presbyterian Hospital and Lenox Hill Hospital. He has published extensively in the professional journals and medical textbooks and has lectured worldwide on kidney stone formation and treatment. R. Ernest Sosa, M.D., is a leading urologist in New York City who specializes in surgical techniques for kidney stones. He is associate clinical professor of urology at the Weill Cornell University School of Medicine and attending urologist at New York Presbyterian Hospital. He served for 20 years as director of the Brady Stone Center at the Department of Urology at Weil Cornell–New York Presbyterian Hospital. He has written and lectured on and taught the diagnosis and treatment of stone disease internationally.Cynthia Seidman, M.S., R.D., is director of dietary services at the Rockefeller University Hospital in New York City. She coordinates the design and development of all research diets at Rockefeller and has published in a number of professional journals. She is cochair of the Research Committee of the National GCRC Research Dietitians Association and is a member of the American Dietetic Association.Rory Jones, an award-winning writer and television producer, has done extensive work on health and medical topics. She has developed educational programs as well as interactive multimedia for both adults and children.

• Preface xiAcknowledgments xvAbout This Book xviiPart One What You Need to Know About Kidney Stones1 The Kidney Stone “Boom” 3What Are Kidney Stones? 5Why Do Some People Get Kidney Stones? 5The Stone “Boom” 5Prevention Is the Cure 6The Dietary Prescription 6Preventing Kidney Stones 6Commitment to Change 72 The Urinary System 9The Urinary System and How It Works 9The Balance Concept 12How Trouble Starts 133 How Your Kidneys Balance Your Body 14Why Balance Is Important 15Elements of Balance 15How the Kidneys Keep the Body in Balance 15What Happens When the Body Gets Out of Balance 18How to Keep Your Sewer System Unclogged 194 Not All Kidney Stones Are Created Equal 20Four Types of Kidney Stones 20Calcium-Containing Stones 21Uric Acid Stones 22Cystine Stones 25Struvite Stones 25Bladder Stones 26Importance of Stone Analysis 275 How and Why Kidney Stones Form 28Genetics 28Diet and Lifestyle 28What Is a Kidney Stone? 29Discouraging Crystal Formation 30What Kidney Stones Are Made Of 30The Conditions That Favor Crystal Formation 31The Best Inhibitor of Kidney Stones 31Making a Uric Acid Stone 326 Why Kidney Stones Are So Painful 34Kinds of Pain 34Three Areas Where Stones Hang Up 38Secondary Symptoms 39Never Make Your Own Diagnosis of a Stone 40Treating Pain 40When Hospitalization Is Needed 417 How Much Water Do I Really Have to Drink? 43Causes of Low Urinary Output 43How Much Is Enough? 44Hard Water, Soft Water 44Mineral Water 45How to Consume More Water 45The Role of Fluids 468 Dietary Troublemakers 47How Much You Eat Is Just as Important as What You Eat 47Animal Protein Is Animal Protein 48Protein and Kidney Stones 48The Calcium Controversy 49Salt 53Oxalate 54Vitamins and Kidney Stones 55Alcohol 58The Dietary Troublemakers 599 Medical Conditions That Can Cause Kidney Stones 60Bowel Disease 61Medullary Sponge Kidney (MSK) 63Hyperparathyroidism 65Milk-Alkali Syndrome and Ulcers 65Anatomic Abnormalities 66Paralysis and Immobilization 68Renal Tubular Acidosis (RTA) 69Acquired RTA in Glaucoma Patients 69Cystinuria 70Oxalosis 7010 Dieting Your Way to a Kidney Stone 72The Problem with Rapid Weight Loss 72Fad Dieting 73Fad Health Regimens 75Eating Disorders 76Laxative Abuse 77How Stone Formers Should Diet 7811 Men and Stones 79Why Men Make More Kidney Stones 79Pain Patterns 8212 Women and Stones 84Why Women Make Kidney Stones 8413 The Workup 89Risk Assessment 89The Workup 90Translating Your Workup into a Risk Assessment 99Where Are You on the Risk Ladder? 101Part Two The Plan14 No More Kidney Stones 105Diet Is Not a Four-Letter Word 105The Master Plan 106Tips for Staying on the Plan 10815 Finding the Diet That Is Right for You 110Rating Yourself 110How Much Do You Have to Change? 111Do You Consume Too Many Troublemakers? 111How to Know if You Are Eating Too Much Protein 115How to Know if You Are Drinking Enough Fluids 117Do You Weigh Too Much? 119Food Diary 119Classic Stone-Forming Profiles 12016 Lifestyles of the Kidney Stone Former 130Bathroom Access 130Fluid Loss 132Ultraviolet (UV) Light Exposure 132Eating Patterns 133Change in Lifestyle 13417 Operation Oxalate 136Why Dietary Oxalate Is Important 136The Problem with Oxalate Recommendations 137Key Issues in Oxalate Control 138Oxalates and Seasonal Foods 13918 Modifying Recipes and Controlling Portions 142Recipe Modifications 142Portion Control 14619 Health-food Store Hazards 147Supplements 147Muscle-Building Protein Supplements 149Herbal Teas 149Natural Weight-Loss Regimes 150Hair Regrowth 150Beverages 150Vegetarian Burgers 151Laxatives 151Energy Bars 152The Juice Craze 152Pastas 153Candies and Cookies 153Read Labels in the Health-Food Store 15320 Special Occasions Parties and Other Excuses to Cheat 154Thanksgiving 154Barbecue 158Wedding Banquet 159Breakfast Buffet 162Four Pitfalls of Special Occasions 16321 Ethnic Cuisines 164Chinese 164Mexican 167Greek 168French 169Japanese 170Italian 171American 173Indian 17522 Staying Motivated 178How Far Can You Deviate? 179Diluting the Mistake 179Part Three Medicines, Specialists, and Procedures23 Choosing a Specialist 183Who Does What 183How Do You Find Out Whom to See? 18524 Medications 186Who Needs to Take Medications? 187What Are the Medications? 18725 Deciding Who Should Be Treated 193Assessing whether You Need Immediate Intervention 19326 Procedures and Technology 201Picking a Procedure 201Comparison of ESWL and Ureteroscopy with Laser Lithotripsy 208Treating Stones in the Kidney 210Open Surgery 21127 What to Expect Before, During, and After Treatment 214What to Expect before and after Treatment 214When to Call the Doctor 219What if Treatment Fails? 219Asking the Right Questions 220Do Not Forget 221Appendix A: Useful Tables 223Appendix B: Food Diaries 235Glossary 241Bibliography 249Index 251About the Authors 269