HOw much water is needed to flush kidney stones?

Factual Questions
1

Sure hope someone out there can give me some very needed advice.

I have struggled with kidney stones for years and currently have 2 large stones in my left kidney and 4 or 5 in my right kidney. Last week, my urologist attempted lithotripsy on one of the stones in my left kidney and was unable to break it up because she could not get focus on the stone due to my weight. She said she would not attempt any further lithotripsies, and suggested I wait a month and drink lots of water to try and flush out some of the stones. I was so embarrassed and flustered that I didn’t ask her any questions. I should have.

I am trying very, very hard to lose weight, but I doubt I can lose enough in one month to make much of a difference. In the meantime, I am trying to drink enough water to flush them out.

My question is … How much water is enough? I know we are supposed to drink 8-10 glasses of water for normal health. How much additional water should I drink to flush out my stones? Should the total be 1/2 gallon? 1 gallon? 2 gallons? If I have a target goal, I can fill a container with that much water at the beginning of the day and make sure I drink it all before bedtime.

Thank you all for any advice you can give me.

2

I do not believe there is any solid answer to this. The more the better. In fact, I have never heard of the benefits of drinking excess water for flushing them out, but rather for preventing them in the first place. Depending upon which of the many types of stones you have, drinking water may completely prevent them. I went through my fifth a while back and after extensive testing I was told to “drink more water”. I must say though, I do not envy you having to pass all those stones. In fact, it is possible that some may be too big to pass without the medical procedure.

3

My husband drank about a gallon of cranberry juice and about twice that much water a day when trying to flush his stones. It worked. When drinking that much you must be careful to eat enough salt and such to avoid hyponatremia.

Good luck!

4

I do not know if this question has a factual answer that anybody on this board can provide. Call your urologist to get the answer that is best suited to your medical needs.

That said, here is my personal anecdote (which does not constitute medical advice). I had kidney stones for quite a while and I never really observed a correlation between the volume of fluid intake with stone-flushing. After my kidney transplant, I was advised to drink plenty of liquid to stay hydrated and to keep crystals from re-forming. My doctor at the time advised me to drink 10 liters of fluid daily (about two and a half gallons). Drinking fluid helped keep the crystals in solution (that is, dissolved) so new stones did not accrete.

Your body chemistry will obviously vary, which is why I suggest you ask your urologist for the solution best for you.

Hyponatraemia, as lee suggested, is an abnormal decrease in blood sodium concentration.

5

I had only one, but a pretty good-sized one. I had to drink a lot of fluids, for the same reason - preventing further stones. I still try to stay hydrated - those suckers HURT.

However, when I was trying to pass the stone out of my bladder, doc told me to be exceptionally diligent in the drinking, to cause frequent urination and give it more chances to pop out.

6

As I understand it, stones are made up of calcium oxalate…calcium from dairy and oxalate from tea/iced tea.

Maybe you’d want to cut them out of your diet.

7

Over 40 stones, here, up to 13 mm.

I don’t think there’s a specific goal in water, just drink much more than you did before.

Get advice from your urologist. The advice here about getting enough sodium etc also sounds good; ask about that too.

In my understanding, drinking extra water when you have a stone to pass helps get it moving and keep it moving. It also increases the liklihood of passing it sooner before it’s even bigger.

Also, drinking extra water all the time to keep stones from forming helps to keep the little crystals separated. If you form calcium oxylate stones, as I do and as most stone formers do, you aren’t keeping it in solution, it’s neglibly soluble in water. In fact last I heard nobody knew for sure how it was transported in urine, but the leading theory was that it formed little solid crystals that the body then coated with something to keep them from agglomerating. The theory is that many stone formers lack the coating mechanism, or at least it’s weak. Supposedly, excess vitamin C can also interfere with this mechanism. Other reasons one can form calcium oxylate stones include your digestive system for some reason being too efficient at gathering one of these compounds, or a diet too rich in them.

You know what a low calcium diet looks like, no doubt. I try to avoid it, as many stone patients do.

You don’t want a low oxylate diet. You’ll be eating baloney on white bread with mayo for every damn meal. Well, if that’s what it takes…

If you are too big, you may have to have a good old fashioned lithotomy. I had one and was in hospital 10 days. On the up side, it’s only your side that hurts, not your soft nether regions.

You might ask about taking Polycitra or some similar citrate ion supplement. My current urologist put me on it right away and in the several years since I’ve apparently only formed a tiny stone or two. I haven’t had surgery in something like 4 years now. He told me a month or two ago that for some reason urologists are generally much better at yanking the stones out than they are at prescribing preventative medications, but his personal preference is to work harder on this latter.

In addition to losing weight and taking lotsa water, you could start saving stones for a necklace - that’s what I’m doing.

Good luck.

8

Some stones are made of uric acid, not calcium and besides according to this study a diet rich in calcium my reduce stone formation. Yes, that is counterintuitive, but that is what they found. Read the article and consult with your doctor specifically about this study beofre increasing your chances of brittle bones but cutting down calcium. If you don’t feel comfortable bringing that article or discussing what is causing your stones with your doctor, find another.

My husband takes allopurinol for his gout. as well as a stickign to gout prevention diet. Gout is the accumulation of uric acid in the extemities. The gout medicine seems to prevent his stones. Once when his doctor stupidy halved his dose for no reason within a couple of weeks he had stones again.* Not all people form stones for the same reasons. No one set of advice will fit for all.

*He no longer sees that doctor. The doctor had written the Rx so sloppily the pharmacy could not read it. He then did not look up the numbers whenthey called and just agreed with what the pharmacy guessed what the numbers were. When we asked why he was suddenly reducing the dose, he said we should not question his orders and besides depending on medicine was bad for you. HE then disappeared and we could not contact him at all. Hubby was sick within the week and passing stones within another. When we talked to another doctor the best they could figure is that he was lazy and distracted. He was finishing his residency that week and that is why he dissapeared.

9

Before you go altering your diet to reduce the risk of kidney stones, talk to your doctor!. Much depends on what type of stone you have, and whether you have abnormal levels of calcium or uric acid in your blood, just for a start.

Here’s an old thread with some hints on what to do depending on what type of stone you have, combined with the results of blood and urine testing: http://boards.straightdope.com/sdmb/showthread.php?t=246401

10

BTW, it’s recommended you get at least 2.5 liters of fluid a day to minimize the risk of further stone formation, just on general principles. You should try to produce at least 2 liters of urine a day. And it’s important to try to get at least 400-500 ml at bedtime, as nighttime dehydration can really contribute to stone formation.

QtM, MD

11

The Bible does not offer advice in passing the stones. However, once you are without stones, you may cast the first sin.

Wait a minute. That sounds a little bent. :dubious:

12

I’d agree with what Qadgop said. Especially about talking to your doctor before changing your diet – changing calcium and eating less tea and spinach doesn;t help most people.

When the urologist said “wait a month” and “lose weight”, the doctor meant take steps to gradually reduce your weight over time by exercising slightly more, substuting the most unhealthy items in your diet, eating more fish and skinless chicken and less high fat meats and baked goods and eating more fruits, fibre and vegetables. I very much doubt the implication was to lose a lot of weight in one month, which is not healthy for most people (as this weight tends to be water loss) and which is decidely unhealthy for “stoners”.

13

This sounds like a recommendation only for those who have or have had stones… is that true?
As for avoiding hyponatraemia: are sports drinks likely to cause problems with stones? I have heard ( though not really believed) that sports drinks put more stress on the kidneys for those who are not ‘working out’, especially when one is dehydrated. Does drinking a sports drink count as drinking extra water for us sedentary types?

14

This, of course, would depend on what type of stones you have. The minerals, salts, etc. in sports drinks could exacerbate the formation of stones. But, bottom line for all kinds of stones, the salts in sports drinks will keep your kidneys from being completely flushed, and that’s not good. The idea is to drink ample fluids to flush your kidneys. My doc recommends: water, coffee, tea, cranberry or grape juice, and beer. The water and beer keep stuff flowing, and the acidity in the other beverages supposedly helps break down the stones. I aim for a gallon of fluid a day, and try to make sure that at least half that is water.

Incidentally, if your doctor couldn’t get the stone with lithotripsy, ask him if he could get it with a scope (it has to be fairly close to the bladder for this to work). It still usually requires general anasthesia (although I’ve also had it done with a spinal block), but is much less invasive than other methods of removal.

15

Yes, this is a recommendation for people with recurrent, problematic stones. Not a blanket recommendation for fluid intake for healthy people.

16

I’d drink water til my eyeballs floated. The only positive thing about my one (and hopefully only) experience with stones was the dilaudid.

17

I had one a few months ago, and guzzling all the water and cranberry juice I could swallow did nothing to dislodge it. It was oddly-shaped and stuck in my ureter about halfway between my kidney and bladder.

My urologist broke it up with what serious medical professionals refer to as a “vibrating dohickey.” Worked like a charm, although I was off work for a couple days and my first piss aferward was blood red.

Good luck.

18

Thanks for all the input!

I will call my doctor on Monday and ask her for specific details on how much water she wants me to drink, but as far as changing my diet is concerned, I did ask her about that and the “Drink more water” comment was her only reply.

I am new to this city and to this doctor, and she has done no testing on my stones, so I don’t know what kind they are. The only stone I have captured lately is small, and it looks like a lot of little bubbles stuck together.

Regardless of what kind of stones my misguided body is producing, lots and lots of water sounds like a good idea.

So does Napier’s suggestion about the necklace. :wink: