Prevention

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Drinking adequate amounts of water is key to a healthy urinary system. The urinary system regulates concentrations of substances such as potassium and sodium. When you don't drink enough water, your body responds by retaining water to maintain the proper concentration.

A good rule of thumb is to drink enough water and other fluids (at least eight glasses a day) to keep the urine clear or straw colored. The fluids also help clear bacteria from the urinary tract. Cranberry juice may help prevent repeat urinary tract infections, but you may want to avoid the beverage during an infection since it contains acid that can exacerbate the painful urination associated with the condition.

Limit your intake of soda because carbonated drinks can make some kidney conditions worse. High levels of calcium and oxalate (a substance found in colas, cranberry supplements, teas and leafy green vegetables) can contribute to kidney stones in susceptible people.

Carbonated drinks, coffee and spicy or acidic foods or drinks can cause bladder irritation for some people. Avoiding such foods and drinks can prevent the problem.

Medications, poisons and trauma-related blood loss can also harm the kidneys. In particular, combining over-the-counter painkillers such as aspirin, acetaminophen and ibuprofen can be toxic. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can also damage the kidneys. Ask your health care professional or pharmacist about adverse effects of any medications you are taking, including over-the-counter drugs.

High blood pressure can lead to kidney dysfunction. Smoking also elevates bladder cancer risk, and chronic coughing associated with the habit can worsen incontinence.

Preventing kidney stones

If you have had more than one kidney stone, your risk of developing another is high. Fortunately, there are strategies for preventing the recurrence of stones. A good place to start is a medical assessment to determine if you have a known stone-forming condition. Blood and urine tests may be required, and you may be asked to provide urine samples after the initiation of treatment to assess whether the treatment is working.

Medications may also be used to prevent stones, including:

• Allopurinol (Aloprim) for some cases of hypercalciuria and hyperuricosuria

• Diuretics such as hydrochlorothiazide (Aldoril, Dyazide) to control hypercalciuria by reducing levels of urinary calcium

• Sodium cellulose phosphate (Calcibind), which binds to calcium in the intestines (keeping it out of the urine)

• Tiopronin (Thiola), which reduces the amount of cystine in the urine

• Potassium citrate (Urocit-K), which helps make the urine less acidic, reducing formation of kidney stones

• Acetohydroxamic acid (Lithostat) for infection stones (struvite stones) that cannot be removed. Acetohydroxamic acid is used with long-term antibiotic drugs to prevent the infection that provokes stone growth

You can also make lifestyle changes to reduce your risk:

• Drink more liquids, especially water. Your total daily urine output should be two to three quarts.

• Eat foods high in calcium. In the past, susceptible people were told to avoid such foods, but new studies show that high-calcium foods actually help prevent stones. Calcium pills, however, may increase the risk or stones, so try to get your daily intake from food sources.

• Based on the results of lab tests, you may be advised to avoid foods with added vitamin D as well as antacids with a calcium base. If your urine is highly acidic, you may be advised to lower your intake of meat, fish and poultry (all of which boost urinary acid concentration).

• If you tend to form calcium oxalate stones, you may be asked to cut back on the following foods: beets, chocolate, coffee, cola, nuts, rhubarb, spinach, strawberries, tea and wheat bran.