Kidney stones

All good advice above.

The number one cause of kidney stones, by far, is not drinking enough. WLS does not contribute to kidney stones. But not drinking enough after WLS does.

Drink.

Hello everyone!

Thank you for all the replies....

First I want to begin by addressing fluids ...

I drink 3 litres of water daily, plus 1 litre of decaffienated teas, I also still drink 700 ml of Premiere Protein shakes... I thought that was enough!

I am not sure how I could increase water intake without compromising food intake...

The Emergency room physician told me that they see a lot of WLS patients that have had a quick weight loss in a short period of time with kidney stones.

I have my 12 week follow up with Weight Management clinic Monday morning.

I will address my concerns then...

Thsnks again

I remember being told that kidney stones can be a result of rapid weight loss, just as gall stones can be the result of rapid weight loss. It makes sense that lots of fluid would help them move along more quickly (before they become big stones), but sounds like you are drinking plenty.

Sorry you are experiencing this. Hopefully your clinic can give you good advice.

This an article from someone who comes in here , although, I haven't seen her since I came back a few days ago. Hopefully she wont mind me sharing. The reason I have this is because 2 years ago I had a 9mm stone stuck in the ureter (which is 5mm), needless to say, it was lodged in so tight they had to surgically go in a blast it to smithereens . I was in bed for months that experience, so try very hard not to get in that predicament. Drink plenty of fluids!

************************************************************ Recently, I have been doing some research on kidney stones, diet, and RNY since I currently have several large uric acid stones and because this is my third round of stones (the only stone captured previously was a calcium stone) since my RNY six years ago (and I never had any stones in the 45 years prior to my RNY). Those who have had RNY definitely develop kidney stones more frequently than the general population, and now I understand why. Here is a summary of what I have found so far.

First, some general info about kidney stones. There are several types and, in terms of dietary causes (there are also physiological causes), the various kinds can be due to 1) "excessive" protein consumption, particularly animal proteins 2) too few carbohydrates 3) high oxalate consumption 4) calcium carbonate supplements.

High protein consumption is hard on the kidneys, but there is no medical consensus on exactly how much is too much. There does seem to be general agreement, however, that protein consumption should account for less than 30% of total calories. The protein goal most frequently given by RNY surgeons is 60g per day (for women), so RNYers who eat 60g are eating around the amount of protein recommended by the NIH (.36g per pound of body weight, which would be 54g for a 150 pound woman and 45g for a 125 pound woman) once you take some possible malabsorption into account. RNYers who are eating 100g (or more) of protein per day, however, would be eating two to three times what the NIH recommends and may be increasing their chance of kidney stones. The type of protein also matters. Too much animal protein (including fish and eggs) can contribute to uric acid stones.

Too few carbohydrates and too little fiber can also contribute to formation of kidney stones. According to The Cleveland Clinic (published in "High Protein Low Carbohydrate Diets", Department of Nutrition Therapy at The Cleveland Clinic. Edited by Cynthia Haines, MD, WebMD, October 2005... cited because I know this is going to raise some eyebrows on the carbophobes here), diets that include less than 100g of carbohydrates per day can cause your body to stay in a state of ketosis (even if you are not losing any weight), wherein your body produces ketones which can result in kidney stones (and, if too many ketones are present for too long a period of time, can result in kidney failure).

Excessive oxalate consumption (in soy products, nuts, whole wheat bread (I have seen this cited several places but don't understand why), berries, kiwi, carrots, celery, eggplant, kale, spinach, leeks, sweet potatoes, and chocolate) can produce calcium oxalate stones. This is the type of stone that is most commonly seen in people who have had RNY and the DS. One of the effects of bypassing part of the intestine is that we have higher oxalate levels in our bodies. Part of the reason that we are instructed to drink so much water is to help decrease the oxalate levels in the urine (by diluting it). So, with higher oxalate levels because of the bypass and the potential dietary contributors of high oxalate foods and often not enough fluid intake, it makes sense that RNYers get these stones more frequently than non WLS folks. (I wish my surgeon had told me that this is part of the reason for the additional fluids. I have never been a big drinker, but have also never been dehydrated (except after an illness with diarrhea), so I have been pretty lax about my fluid intake. My current stones are uric acid stones, but I still need to make an effort to get more fluids on a regular basis now that I know this.)

For folks like RNYers who do not absorb calcium carbonate well, taking calcium carbonate supplements can cause calcium stone formation. The good news is that calcium citrate, which is what we DO absorb, helps prevent calcium stones, as do dairy products (because the calcium binds with the oxalate before it enters the kidneys) and foods/drinks that are high in citric acid (lemonade and orange juice seem to be particularly effective).

Finally, "excessive" Vitamin D supplementation can also contribute to the two calcium types of kidney stones, so while we want our D to be at a good level (around 80), if it is significantly higher, it may contribute to stone formation.

Hopefully that helps explain why we are more at risk for kidney stones (of all kinds except the rare ones) both because of our surgery and because of our post-op diets.^^^^^^^^^^^^^^^^^

Thank you so much for the research article!

Sincerely!

Sandra

Mahalo

Hello everyone

Just a quick update....

I went in to see my Weight Management Team last Monday.... The nurse practitioner was new to the team and had no idea if RNY patients are at higher risk for kidney stones.

I must say that the article posted here informative and interesting.

I have since followed up with a urologist! CT Scan showed I actually had (3) stones... The first one was 8mm, 4mm & 3mm. What the heck ? I have no idea what kind of stones they are as Emergency care was poor.

I am hoping that was the first and only episode.

I will continue with my 2 litres of water, 1 litre of tea & liquid protein.

I can't ever imagine going through that again.

How do you prevent something that you have no control over or any idea how it started.

I will persevere and move forward!

Thanks for all the input!

Sandra

Mahalo