Diagnosis: Low Urine Ph
Citrate supplements, such as potassium citrate, will raise the pH of your urine, making stones, such as those composed of uric acid, less likely to form. If your blood potassium level is high, your doctor may prescribe sodium bicarbonate or Bicitra.
Lower protein intake
A diet high in protein will reduce urinary pH. As a general recommendation, limit your daily protein intake to 12 ounces per day of beef, poultry, fish and pork. Twelve ounces is equivalent in size to about three decks of cards. This will be plenty of protein to meet your bodys needs.
Increase fluid intake
No matter what your diagnosis, you should drink enough water to produce at least 2 liters of urine per day.
Related Resources For Kidney Stones
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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
It’s Not One And Done
Passing a kidney stone is often described as one of the most painful experiences a person can have, but unfortunately, it’s not always a one-time event. Studies have shown that having even one stone greatly increases your chances of having another. “Most people will want to do anything they can to ensure it doesn’t happen again,” said Dr. Jhagroo. “Unfortunately, it doesn’t seem to be the case that people make the changes they need to after their first stone event.”
Research conducted by Dr. Jhagroo shows that those with kidney stones do not always heed the advice of their nephrologists and urinary specialists. About 15% of kidney stone patients didn’t take prescribed medications and 41% did not follow the nutritional advice that would keep stones from recurring. Without the right medications and diet adjustments, stones can come back, and recurring kidney stones also could be an indicator of other problems, including kidney disease.
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Furosemide May Interact With Other Medications
Furosemide oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. To find out how this drug might interact with something else youre taking, talk with your doctor or pharmacist.
Examples of drugs that can cause interactions with furosemide are listed below.
Medicines That Can Cause Kidney Stones
While certain medications are necessary for treating or managing serious health conditions, they can sometimes create unintended negative consequences. And, in some cases, these consequences involve the increased risk of kidney stone formation.
Not every medication on the market is a prospective culprit, of course. However, research has found that there are some that have a greater tendency to lead to stone formation than others. Additionally, certain medications can raise your risk of certain types of stones.
For example, taking loop diuretics can sometimes lead to calcium kidney stones. Loop diuretics are a powerful type of diuretic that work by reducing, if not completely eliminating, your bodys ability to reabsorb sodium, chloride, and potassium. This results in an increase in your urine output. So, even though it does help your body in some regards, it also puts it in a state more prone to calcium stone formation.
Other medications that can result in calcium-based stones include glucocorticoids , theophylline , and even some antacids. Even over-the-counter vitamins can raise your risk of calcium stones. Vitamin C and D are the biggest culprits, so keep this in mind if you take either of these.
Then there are the medications that have a tendency to support the formation of uric acid stones. Aspirin is probably the most well-known, but medicines taken for gout, laxatives , and thiazides can have the same negative effects.
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Causes Of Struvite Stones
Struvite stones are almost always caused by urinary tract infections. Certain bacteria produce urease, which breaks down urate and raises the concentration of ammonia in the urine. Ammonia makes up the crystals that form struvite stones. The bacteria that promote stone formation are most often Proteus, but they may also include Ureaplasma urealyticum, as well as Pseudomonas, Klebsiella, Providencia, Serratia, and Staphylococcus species. Women are twice as likely to have struvite stones as men.
The Need To Monitor Kidney Function With Certain Drugs
Experts have suggested that after the initial assessment of kidney function, physicians should consider regular monitoring after starting or increasing the dosage of drugs associated with nephrotoxicity, especially those used chronically in patients with multiple risk factors for impaired kidney function, Dr. Naughton noted. If there is any sign of kidney harm, the provider should review the medications you are taking in order to identify which one is causing the problem.
If multiple medications are present and the patient is clinically stable, physicians should start by discontinuing the drug most recently added to the patients medication regimen. Once that has been taken care of, further harm to the kidneys may be minimized by keeping blood pressure stable, staying hydrated, and temporarily avoiding the use of other medications that may cause nephrotoxicity.
These safety tips can ensure you get the care you need while keeping your kidneys safe. That way, they can tend to essential functions like keeping things flowing .Originally published May 11, 2017
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Types Of Kidney Stones
The different types of stones are made of different types of substances. It’s important to know the type of stone you have, so you can know what may have caused it and how to prevent it.
If you pass a kidney stone, you should take it to your doctor so they can send it to the lab and find out what kind it is:
Calcium stones. Most kidney stones are made from calcium, in the form of calcium oxalate. There are two kinds of calcium stones:
Calcium oxalate. Oxalate is a substance made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, are high in it. Your body absorbs the substance when you eat these foods. Other things that can make the concentration of calcium or oxalate in your urine to rise are taking high doses of vitamin D, intestinal bypass surgery and certain metabolic disorders.
Calcium phosphate. This type of stone happens more often in people with metabolic conditions, like renal tubular acidosis or with people who take medications to treat migraines or seizures.
Struvite stones. These can form from a urinary tract infection . The bacteria that cause the infection make ammonia build up in your urine. This leads to formation of the stones. The stones can get large very quickly.
Uric acid stones. These form in people who lose too much fluid because of chronic diarrhea or malabsorption eating a high-protein diet or having diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.
Water Pills That Don’t Adversely Affect The Kidneys
Also known as diuretics, water pills are medications that encourage fluid loss in the body. They are frequently prescribed when your body is not properly regulating its own fluids, such as when you have high blood pressure, body swelling or glaucoma. Each of three chief types of diuretic acts on a different part of the kidneys to remove water from your body. To avoid adversely affecting the kidneys, you must use the right diuretic type and refrain from abusing the limitations of a water pill.
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Can A Large Kidney Stone Cause An Injury
Your risk of injury from a kidney stone can go up based on the size and location of the stone. A larger stone could get stuck in a ureter, causing pressure to build up. This can lead to renal failure and, in the worst-case scenario, you could lose your kidney. The chance of passing a 1 cm stone is less than 10%, and stones larger than 1 cm typically dont pass.
What Is The Best Medication For Kidney Stones
Medication will depend on the type of kidney stone and the underlying condition that has caused stone formation. Few drugs actually treat kidney stones, but instead either aid the passing of stones or prevent their recurrence.
|Best medication for kidney stones
|8, 250 mg capsules per day
|Abdominal pain, loss of taste, diarrhea
The standard dosages above are from the U.S. Food and Drug Administration and the National Institute of Health . Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight. Other possible side effects exist.
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Thiazide Type Diuretics Reduce Stone Formation
The common thiazide type drugs in use today are hydrochlorothiazide, chlorthalidone, and indapamide. All three have been used in stone prevention trials and shown to have beneficial effects. A nice recent review is also the source for the drug structures pictured above.
I have obtained and studied nine trials. In all nine trials, there was a comparison untreated group. This spreadsheet contains links to the trial documents, but you will find it not easy to obtain the original publications unless you have access to a university library system. For this reason I have copied out the key data. Briefly, there were 330 controls, of which 149 relapsed , and 314 treated subjects of whom 72 relapsed , a savings of about half . That is the bottom line for this class of drugs.
Here is a picture of the 9 studies. For each study the left panel has a bar whose height is how many control red, and treated blue subjects it had. The right panel shows how many of the red and blue people made new stones.
It is obvious that there were no differences in new stones between control and treated people in studies 1 and 6. These were both brief . In the others, the treated blue bars were lower than the red controls. Trial 9 had no relapses in the treated group. .
A simple X2 test using the four numbers from the bottom line of the spreadsheet: Treated, 72 relapse 242 no relapse untreated 149 relapse, 181 no relapse gives a X2 of 35.2, p< 0.001 .
Diuretics For Weight Loss
Although diuretics can cause you to lose a lot of weight rapidly, they are limited in their ability to function as an agent for long-term weight loss. Diuretics do not cause you to burn extra calories or lose fat instead, the weight loss they cause is entirely water. When you stop taking the diuretics, your body will regain this lost water by replenishing its water reserves. For sustainable weight loss, follow a healthy diet and exercise regularly.
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Fda Warning: Dehydration Risk
- This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients to drug effects that may be dangerous.
- Furosemide is a strong diuretic that helps your body get rid of excess water. It does this by increasing the amount of urine your body makes. If you take too much of this drug, it can lead to very low amounts of water and electrolytes in your body. This can cause dehydration. Your doctor will monitor your fluid levels and may change your dosage based on those levels.
- Low blood pressure warning: This drug can cause low blood pressure. Symptoms include feeling dizzy and faint after standing up. If this occurs, move slowly when changing positions after sitting or lying down. If this problem continues, call your doctor.
- Low potassium levels warning: This drug can cause low potassium levels. Symptoms include tiredness, muscle weakness, and nausea or vomiting. Call your doctor if you have these symptoms.
- Low thyroid levels warning: High doses of furosemide can cause low levels of thyroid hormones. If youre taking high doses of this drug and have symptoms of thyroid problems, call your doctor. These symptoms can include:
More Common Side Effects
The more common side effects that can occur with furosemide include:
- nausea or vomiting
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.
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Passing The Stone Naturally
For a small stone, the treatment is to let it pass naturally through the urinary tract. The patient will be asked to drink plenty of water and take pain relievers. The healthcare professional may also prescribe medications that relax the ureter muscles, making it wider so that the stone passes more quickly.
Why Are Potassium Citrate Pills An Alkali Load
In the citric acid cycle citrate is metabolized as citric acid, meaning that 3 protons are taken up from blood with each molecule. Removing protons is identical to adding alkali. Typical dosing is about 20 40 mEq of potassium salt daily, but the amount can vary widely.
Commercial potassium citrate contains 1080 mg of the compound in a 10 mEq pill. Typically the potassium citrate salts have a potassium on each of the three anion sites on the citrate molecule. The MW of citrate anion is 189.1. Urocit K, a common commercial version, is a crystalline monohydrate salt so it has a MW of 3×39 + 189.1 + 18 for the one water molecule, or 324.1 in all. Given 324.1 for 3 mEq of base, the 10 mEq tablet contains 10/3 x 324.1 or 1080 mg.
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Whats The Outlook For Kidney Stones
The outlook for kidney stones is very positive, although there is a risk of recurrence . Many kidney stones pass on their own over time without needing treatment. Medications and surgical treatments to remove larger kidney stones are generally very successful and involve little recovery time.
Its possible to get kidney stones multiple times throughout your life. If you keep developing kidney stones, your healthcare provider may work with you to discover why the stones happen. Once the cause is found, you may be able to make dietary changes to prevent future stones.
What Are The Drug Interactions Of Diuretics
Thiazide diuretics given concurrently with antidiabetic drugs causes a decreased blood level of antidiabetic drugs, hence doses of antidiabetic drugs may need to be increased.
Among patients taking digoxin, low levels of potassium caused by concurrent digoxin and diuretics may cause weakness, cramps, and irregular heartbeats.
Potassium-sparing diuretics given with angiotensin converting enzyme inhibitors or nonsteroidal anti-inflammatory drugs have been associated with severely elevated levels of potassium . Severe hyperkalemia may present as muscle weakness, fatigue and slow heart rate. It is important to monitor potassium blood levels and to have an electrocardiogram performed.
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Inclusion And Exclusion Criteria
The inclusion and exclusion criteria for the studies were determined prior to data extraction. The inclusion criteria included the following: RCTs with thiazide diuretic administration as the intervention and placebo or no medication as the control condition patients with renal calculi or hypercalciuria as the study subjects and test indicators including at least one of the following: number of patients with new stones, 24-h urinary calcium level, 24-h urinary oxalate level, and serum calcium level. Conversely, the exclusion criteria included the following: non-RCTs RCTs without a treatment group or placebo group trials with incomplete or no data available and other study types, e.g., abstract, case report, and review.
Why Is This Medication Prescribed
Hydrochlorothiazide is used alone or in combination with other medications to treat high blood pressure. Hydrochlorothiazide is used to treat edema caused by various medical problems, including heart, kidney, and liver disease and to treat edema caused by using certain medications including estrogen and corticosteroids. Hydrochlorothiazide is in a class of medications called diuretics . It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.
High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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