The People's Perspective on Medicine

Show 1148: What Can You Do About Kidney Stones?

Kidney stones are relatively common and extremely painful. The biomineralization processes that create them have a lot in common with coral reef building.
Calcium oxalate kidney stone; photograph Bruce Fouke, PhD
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What Can You Do About Kidney Stones?

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Kidney stones afflict an estimated three million Americans each year, resulting in at least half a million trips to the emergency department. But what are they and what can you do about them? How do they form and how might you prevent them?

We hear from a listener who has first-hand experience of the pain of kidney stones. Then we get a primer in this condition from urologist Glenn Preminger of Duke University Medical Center. Find out what types of kidney stones there are, which kinds are most common, and how they are diagnosed. Dr. Preminger also describes treatments including lithotripsy, medical expulsive therapy with tamsulosin and percutaneous nephrolithotomy (a form of minimally invasive surgery).

What Are Kidney Stones?

These tiny rock-like deposits form in the kidneys by substances precipitating out of the urine. The trouble comes once they get into the ureters to be flushed out of the body. Especially where the tube is tiny, even small kidney stones can cause irritation and cramping pain called renal colic. Doctors often use CT scans to make the definitive diagnosis of kidney stones. When a patient passes a stone, he or she can ask the doctor to have it analyzed. That will reveal what type of stone it was and may offer clues for prevention.

Geology and Kidney Stones:

You may be wondering what geology has to do with kidney stones. After all, don’t these little things form inside a human body? They do indeed, but they are far more like real rocks than you might imagine. We talk with Dr. Bruce Fouke about the common biomineralization processes involved in creating rocks in Yellowstone National Park, coral skeletons in the ocean and kidney stones in the body. Dr. Fouke’s research has produced the stunning photograph of a kidney stone at the top of the page.

This Week’s Guests:

Sue Wasiolek works in Student Affairs at Duke University.

Glenn M. Preminger, MD, is the James F. Glenn Professor of Urology and Chief of the Division of Urologic Surgery at Duke University Medical Center. He is also Director of the Duke Comprehensive Kidney Stone Center.

Bruce Fouke, PhD, is a professor of Geology, Microbiology and Genomic Biology at the University of Illinois at Urbana-Champaign. He also serves as Director of the Illinois Roy J. Carver Biotechnology Center. The Center performs genomic, proteomic, metabolomic and bio-informatic analyses for laboratories around the world. Dr. Fouke conducts geobiology research on coral reefs, hot springs, energy exploration, Roman aqueducts and human kidney stones. He is co-author of The Art of Yellowstone Science: Mammoth Hot Springs as a Window on the Universe.

NY Times: Geobiology Reveals How Kidney Stones Dissolve In Vivo

NASA: The Art of Yellowstone Science – Mammoth Hot Springs as a Window on the Universe

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The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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A few of things I didn’t notice mention of during this interview:

*There is research indicating that if calcium-containing foods and oxalate-containing foods are eaten together, stone formation is lower than if the oxalate-containing foods are eaten alone.* My understanding of the mechanism is: If calcium and oxalate are traveling together in the gut, they are likely to bind in the gut, forming calcium oxalate before reaching the kidneys – allowing the oxalate to be carried through the kidneys and out of the body. If oxalate is eaten alone, calcium eaten later forms calcium oxalate with oxalate present in the kidneys, and forms stones.

*There is research indicating that “taking calcium supplements increases stone formation,” for people who are known to form stones.* It is well-understood that consuming citrate inhibits oxalate stone formation. (Lemon juice is a common source of citrate.) It occurred to me that the supplement used in the supplement research was likely to be calcium carbonate. Calcium Citrate is also available as a supplement, though is more expensive. I did some digging into the supplement research. The first few studies I was able to access all used calcium carbonate. It seems to me that there are a few good reasons to do some supplement trials with calcium citrate. It might actually be a very helpful supplement for stone-formers, whether or not they have other reasons to supplement their calcium intake. Calcium citrate consumed with oxalate-containing foods might *inhibit* the calcium from combining with the oxalate in the kidneys.

I have used black radish root pills & they turned my kidney stones to a soft jelly-bean consistency & I can urinate them out with no pain.

My husband was plagued by kidney stones for years and we finally found a remedy (the same info) in two older natural healing books. Since We started using it daily, he has not ever had stones form until he decides I’m giving him too many supplements and he stops taking them. About 6 months later, he will have a stone painfully trying to pass. As long as he stays on the following daily, he does not even have stones form.

There are a number of different forms of Magnesium, and the only one recommended for preventing stones from forming is Magnesium Oxide. He takes 400 mg of the Twinlab brand. You must also add 30 mg B6 for best results. His multiple vitamin only has 10 mg B6 in it, so we add a separate 25 mg. B6 tablet.

I think it is far more advantageous to prevent stones from forming than waiting until one is trying painfully to pass, but I do understand some posted their remedies for what to do during the passing for those who already have stones.

Goodmorning! My nephew had the same problem with kidney stones. He first went to the emergency room and was told “Drink water to flush it out!” That cost him $2,000.00. He then drank 2 liters of Coke and ate asparagus. Passed the stones. Now, he takes Chanca Piedra and swears by it. Just food for thought. Thankyou for your time.

62 years ago I had a terrible bout of severe pain and vomiting from passing handfuls of kidney stones. Later I did a lot of studying since I didn’t want to repeat that experience. To this day I still take 200gms of magnesium everyday with my calcium supplement. I have been totally free of stones. My father also suffered from repeated bouts of stones but he wanted no part of my solution since it didn’t come from his doctor. Thus a lifelong problem for him. And thankfully I have been problem free.

My husband: with his last attack, CT showed a 5 mm stone ‘stuck’ at the end of the ureter where it meets the bladder. The stone was removed via surgery going through the urethra and a stent was put in to prevent prolapse of the ureter. The stent was removed abt 2 weeks later. In a sense, it’s good that he had enough pain to head to the ER, or the situation could have been much complicated/worse.

His Urologist has him drink ¼ cup grapefruit juice after meals. HOWEVER, he had to have dosage of other meds adjusted due to INTERACTION with the grapefruit juice. If you try this, do it under MEDICAL SUPERVISION so adjustments can be made, if necessary to other meds you’re taking.
So far, this regimen is working for him.

I have a long history of calcium oxylate stones. Went through one lithotripsy in my 20’s. Other trips to emergency room, passing stones in extreme pain. About 5 years ago I began taking 250mg of magnesium every other day. I still get stones but they are tiny and pass with minor discomfort.

This remedy comes from the Cherokee Indians. Most stones are calcium. Hydrangea root dissolves, and Marshmallow root eases the way out. This has worked for me, several family members and acquaints. Other supplements work on other stones. An herbalist can suggest what to try.

I passed my first kidney stone when I was 19 years old (I’m now 72). Over the next 50 years I passed 4-6 stones per year and have probably seen 20 doctors with regard to my stones. Five years ago, after suffering a heart attack, I adopted a ketogenic lifestyle and began taking several supplements. I am also type-2 diabetic. My diet is 75% fats, 20% protein, and less than 20gm of carbs per day. Supplements include: Vitamin K2, Ubiquinol, D3, curcumin, kelp (iodine), fish oil, Vitamin C, B complex. Over the past 5 years I have only passed 1 stone, and that was 3 months after I began the ketogenic diet. A recent ultrasound shows no stones.

I don’t know which of these caused my body to stop producing the stones but it has worked for me, even though the kidney stones were not a consideration when I began. Heart health, blood sugar control, and weight loss were my objectives, all of which were achieved.
Hope this helps some other chronic sufferers.

Here is a “home remedy” that was passed on to me by two different chiropractors years ago. I don’t normally drink Coke but I elected to give it a try to see if I could avoid the expense of seeing a doctor about the pain I was experiencing in one of my kidneys. You simply drink one liter of regular, full sugar Coke and eat one pound of asparagus within a 24 hour period.
I prefer to eat the asparagus raw, but was told that it could be cooked as well. There are elements in both that work synergistically to produce the softening that allow the stones to pass without pain.

It has worked for me at least four times over the last 25 years. Hope this may help someone else. And a huge ‘thank you’ for your incredible show. We love it and often pass on the info. to others.

My husband gets large kidney stones. He’s had them blasted and a stent put in. We know that peanuts give him stones. A home remedy that has worked every time is one tablespoon of raw apple cider vinegar in 8oz of pineapple juice 3-4 times a day. It really does dissolve the stones to make them small enough to pass, and usually only takes one day.

I didn’t hear anyone talk about the “kidney stone belts” of the US. The higher incidence of Kidney stones often occur along the vertical longitudinal lines of the the mountain ranges of the U.S.: in the Sierras, Rockies, Ozarks and Appalachian chains. That’s where the urologists concentrate as well. It could be affected by the mineral concentrations of the mountain water. I recommend distilled water for drinking and cooking to the frequent formers of stones. A pinch (1/8 of tsp) of sea salt occasionally can help with keeping traces minerals available in a reasonable concentration.

Years ago I was diagnosed with producing high-normal amounts of both compounds that can cause kidney stones.

At that point the urologist prescribed the lowest strength of a high blood pressure medicine “because it was the cheapest way to treat” my problem.

I was given a very long print-out of things to know about that specific medicine and one that stood out was that I could develop an allergy to sunlight! Being male and living in an area that is known for hot, humid summers, going around in a burka was out of the question!

So I went to an alternate remedy encyclopedia that said for one compound to take magnesium oxide and for the other to take B-6.

I tried that but mixing powdered magnesium oxide was awkward.

I then found Solgar manufactures a table that contains both and to this day whenever I feel the approach of renal colic, I pop one along with a good extra swig of water and within a few minutes all is back to normal.

I have had 2 bouts of kidney stones. Medicine seems to be not sure about them at first. The pain is in the lower left abdomen and it does get your attention. Mine are of the smaller variety and the trick is to get them to pass. They gave me muscle relaxant that did help, but wouldn’t give it a 2nd time. The docs want to measure urine for days and try to catch the stone to examine it. No luck there.

The most important thing you can do to help is to hydrate well. After that there are a bunch of other home remedies and herbs/drugs I have not tried yet.

I take 3 oz/day lemon juice which is supposed to help with oxilate stones. (the most common stone 70%) not sure if this is successful yet, but am giving it a chance.

So far lots of good information about kidney stones. One other reason people get them has not been mentioned: a condition called hyperparathyroidism. When the parathyroid glands – which are meant to keep calcium in the blood in a good range, get a growth (adenoma) or become enlarged (hyperplasia) they begin to pull calcium from bones and put it into the bloodstream. This can cause lots of symptoms such as brain fog, aching throughout the body, GERD, heart arrhythmia, high blood pressure, digestive issues, fatigue, kidney stones and more as excess calcium flows and collects throughout the body. Something to be checked out by having a group of blood tests from the same draw – Calcium, Parathyroid Hormone, and Vitamin D. Especially if the person has some of the symptoms and/or has kidney stones when they didn’t have them before. I had this happen to me 4 years ago. Once the stone passed, had surgery and found that the parathyroids were enlarged. Two were removed, 2 were cut down in size. I feel so much better!! (And no more kidney stones)

Fascinating show: your last interview, with Dr. Fouke, was by far the most interesting segment, and I wish you would consider bringing him back for a full show. The very fact that he found similarities between the microbiome involved in both kidney stones and dental plaque suggests that this is a new cutting edge arena for study and discussion. Thank you for giving us so much to think about! I am going to buy Dr. Fouke’s book: I love it when disparate fields of science (geology, biology, medicine) collaborate to become more than the sum of their parts! His segment of your show gets five stars!

I liked the similarity with rock formation; makes so much sense!
The diet causes and preventions were very helpful.

Went to the emergency room with my first kidney stone attack. The receptionist said: “Sounds like you have a kidney stone.” Then on to the Triage nurse who said: “Sound like you have a kidney stone.” Then on to my room where the attending nurse said: “Sounds like you have a kidney stone.” Then the doctor who said: “Sounds like you have a kidney stone.” Then the technician who said I had to have a CTSCAN to see “……..if you really have a kidney stone.”

In fact they did two scans to see if I had a stone in my other kidney which I did. Well the pain meds were great but a month later I got the bill for $5500! Most of that was for the CT SCANs. This was done because they said an ultrasound could not see a smaller than 5 mm stone which turned out not to be true. The other stone was 3.5 mm and was diagnosed by using ultrasound.

So before you submit to the CT SCAN and the expenses and radiation associated with it ask for the ultrasound instead.

By the way passing a kidney stone hurts like #$%*@$%##…………………

My husband had a large kidney stone (age 62, first time), and it was so bad he almost passed out. We had to call an ambulance, not knowing what was wrong. He had gone to dr. earlier that afternoon with a diagnosis of “probably a groin pull from something during his sleep” – yeah, right!!! His dr. was not in, so this was another one filling in. Long story short: he had an ultrasound which showed nothing, and they finally did a CT scan hours later but, thankfully, they had finally put him on morphine, as pain was unbearable. We received a bill for almost $8,000.

My husband, and I, don’t get kidney stones anymore since we went on a low-oxalate diet two years ago.

I have had many kidney stones over the years since 1975 when i had an operation to lose weight. This operation has caused me to get kidney stones but not the small ones, mine are the size of large Marbles, but do to their size I have not really felt pain as they cannot move out of the kidney. The last time I had 4 of them sitting on top of my right Kidney and had to be shattered to break them up, well the doctor went through my side and broke them up except for 1. Doc said that he broke 6 probes doing it but the one that was left I had to come back next week, I told him to make sure he had enough Probes as I dont want to come back a week later. Well he finally broke the last one and since taking this liquid medication that a new doc gave me I have been stone free. I still have the Xray showing the stones and the Doc said he has never seen anything like that before. Too bad my old Doc didnt give me this medication from the beginning, would have saved me a lot of grief. My doc is a young man and he has kept up the new treatments, my old doc didnt do so. Oh well.

What is the medication your doctor gives you to prevent the kidney stones?

I have had a lifetime history of calcium oxalate stones. After the difficulty I had two years ago, I now take potassium citrate 2x a day to help prevent this from happening again. I am 71 years old. Unfortunately, I think my stomach cannot handle the potassium. I have also tried lemon juice with the same stomach issues. It seems as if I am in a Catch-22 situation. Any suggestions?

After two calcium oxalate stones and a consultation with an endocrinologist I now follow a low oxalate diet and eat one citrus fruit per day. When I told the doctor that most pills don’t agree with my stomach he opted for food based citrus rather than a potassium citrate pill.

I had kidney stones 15 years ago and went the medical route ( meds, etc) . I watched my diet and did not have kidney stones again until last year. I felt it coming on and this time my insurance was not great so I went herbal. I bought “Stone Breaker” and “Herbabuprofen” and it passed within 3 days and I never missed work.

Mary. How does these herbs work? Where do you get them?

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