Iced tea kidney stones

Apr 23, 2015 9:00 AM

Author: Office of Public Affairs

Drinking tea is good for your health. It may lower the risk of cancer, it can encourage weight loss, and recent studies have shown tea can help lower blood pressure.

But one Arkansas man discovered there can be too much of a good thing.

In May 2014, a 56-year-old man arrived at Central Arkansas Veterans Healthcare System, complaining of weakness, fatigue and body aches. Doctors discovered that his kidneys were failing. He was placed on dialysis. After questioning the patient, they learned that he drank 16 8-ounce glasses of iced tea daily, which is about 1 gallon.

“Iced tea is full of oxalic acid, which, when taken in excess, deposits in your kidneys and mucks up the work of removing waste from the blood,” says Scott Youngquist, MD, an emergency physician at University of Utah Health. “This patient was drinking 16 8-ounce glasses of iced tea per day for an unknown period of time. This created a load of oxalic acid that his kidneys couldn’t handle, leading to renal failure.”

Black tea is rich in oxalate, a compound found naturally in many foods. Too much of it can also lead to kidney stones. The man likely consumed 1,500 milligrams of the compound daily. As a comparison, the average person ingests between 150 and 500 milligrams of oxalate each day.

“This kind of kidney failure has also been reported due to excessive consumption of star fruit, cucumber fruit, rhubarb and peanuts,” Youngquist says.

Like tea, these foods are known for their health benefits. But as Youngquist says, “Anything consumed to excess can be toxic—including water!”

Contents

Thomas Rhett to perform at BB&T Pavilion

The world is full of questions we all want answers to but are either too embarrassed, time-crunched or intimidated to actually ask. In the spirit of that shared experience, we’ve embarked on a journey to answer all of the questions that burn in the minds of Philadelphians — everything from universal curiosities (Why do disposable coffee cups still leak?) to Philly-specific musings (How does one clean the Liberty Bell?).

Tea drinkers have long feared the answer to the question of whether their hydration method of choice is actually detrimental to their kidney health. Eager to set the record straight, we reached out to Dr. Pooja Singh, a clinical assistant professor in nephrology (kidney studies) at Jefferson University Hospital.

Getting to the chase, can drinking too much tea really cause kidney stones?

The answer to that is ‘Yes,’ but only if it is done in an excess amount. And the reason for that is because tea, specifically black tea, which is how we drink tea in America, is very rich in a mineral called oxalates. These are present not only in black tea, but chocolates, spinach, beets and peanuts. So if you have susceptibility for stones – you and I, if we are not susceptible to kidney stones, we can perhaps drink a lot more and not have a problem …

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So only if you’re susceptible, which means some sort of genetic predisposition or a family history of stones — your mom or dad or siblings had it, or you have a personal history of stones or had symptoms from it. Those are patients more likely to develop stones. And more so if they drink too much black tea, and that’s because of the fact kidney stones are made up most commonly of calcium oxalate and the oxalate is quite high in black tea.

Is oxalate present in other teas, too?

Yes, that’s an interesting question. So, in the U.S., most of the black tea’s consumed as iced tea, and you don’t add milk to it. But for example, in Southeast Asia, in India and Pakistan and other southeast countries, you drink tea but you add milk to it. And the milk has calcium in it. So some of that oxalate I’m talking about gets bound to the calcium and the amount that gets absorbed when you drink that tea is a lot less than what would be absorbed if you just drink iced tea or black tea. The amount of oxalate is what will kidney stones if you are predisposed to it.

Black tea has the most oxalate in it but green tea has a lot less oxalate. If I had to choose one, I’d choose green tea. Green tea has a lot less. Herbal teas have, in general, a lot less oxalate in the tea, but black tea has the maximum amount. If you add milk to it, you’re a little less susceptible, but it all depends how much you drink it. I’m a kidney doctor and we have read cases where in the summer months when you get dehydrated – not drinking as much – you get a little dehydrated and you drink 19 cups of tea. And if you do it on a consistent basis, you could have patients come in with kidney as the result of the oxalate getting deposited in the kidney of the patient developing the kidney stones.

Specifically if they have a history, not to drink so much black tea. And it also goes with other things like the chocolate and the spinach and other things I mentioned.

How do you know you’re susceptible?

The way kidney stones advance is you have symptoms from it. Flank pain going into your groin area, or back pain or you notice blood in the urine. In general in America, about a few decades ago, prevalence was about 5 percent for kidney stones. There’s a little bit of a rise in the last decade, so I’d say it’s more like 8 percent now, and men are a little more susceptible than women .

And if you have a family history — a genetic predisposition, that would be one way to look at it. Or if you have certain kidney conditions, you’d be more predisposed to it. And most patients would know about it if it runs in their history. But otherwise, the way to diagnose it is either you get symptoms and go to the ER and they’ll do a CAT scan or ultrasound of the kidney — some sort of imaging study — and they will pick it up, or you go for unrelated reasons because you’re getting some studies done, some surgery done, and a CAT scan or radiologic study gets done and incidentally kidney stones are picked up. So in those cases, we will tell patients, ‘By the way, you don’t have symptoms from it, but you have a kidney stone.’ There’s something we’ll tell any patient with a kidney stone, which is to drink lots and lots of fluids. That’s the No. 1 protective mechanism to prevent kidney stones. Especially if you’re predisposed to it. And when I say ‘Lots and lots of fluid,’ it’s like you have to make at least two liters of urine a day …

We give them instructions about how much they should drink — water is the best drink — and tell them to avoid high oxalate foods. Sodium restriction is very important, having a heart-healthy diet is important and cutting down proteins is important – proteins also predispose you to kidney stones. And adding citrus fruits like orange and lemonade is good because that supplies what is called citrate .

How much tea is too much tea?

If you’re going to drink 10 glasses, it’s too much I’d say. This is only visible to people who have that predisposition. So I’ll give you an example. The recommendations on how much oxalate we should take in, whether it is with tea, chocolate, spinach or food we eat, is on average you should not have more than 100 milligrams of oxalate per day. And if you’re going to drink tea, based on the type of tea you’re drinking, you can have anywhere from – with black tea if you drink about three ounces, that could have about 50 milligrams of oxalate. If you’re going to drink two or three glasses, I think it’s OK. Even four or five, it might be fine.

On top of that, the reason kidney stones form is — it’s not the oxalate, but the urine gets saturated with the oxalate. So if you’re going to drink a lot of water with it, you may not even notice there’s a problem and may never get kidney stones. But think of that scenario where all you drink is iced tea, and that’s your main source of hydration during summer months and you’re not drinking any water with it, and that oxalate gets really concentrated in the urine and once the concentration goes really high and the calcium is there and the calcium and oxalate get together that’s when kidney stones form. And the stones form over a period of time.

If you can keep the concentration low by flushing down with the water, you will never have a problem. So it’s more an exception that you will get stones. But based on what you eat and how much you’re drinking, a few glasses may be problematic or many glasses with lots of water may not be a problem. It’s relative to the patient.

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I have heard this one million times from patients in my practice. Make stones? Drink water. Water, water, and more water. Drink it all day long, all night long. Just drink water.

What about other fluids? Are they safe? Are they high in oxalate? Will they count toward your daily intake? Is caffeine a problem?

Your Physician Prescribes How Much

I will be offering as much variety as I can, and encouraging you to drink, but the volume you need comes from your physician. This applies especially to my two day long examples. I made them to provide very large amounts of fluids for those who need them. If your physician prescribes less, just scale my recommendations back. Under no circumstances should you follow a fluid prescription in this post unless it fits with your physician’s specific recommendations for you.

Some Beverages Raise Stone Risk

Understanding what you can and can’t drink for stone prevention can be exhausting. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.

What Did People Who Developed Stones Drink?

Perhaps the most useful study of this matter is by Ferraro and colleagues. Two large groups of nurses and one group of physicians have been followed for many years to ascertain habits and diets that appear healthy or unhealthy.

Some of the people in each group developed kidney stones. Most, as expected, did not. Because diet habits were closely monitored by well established questionnaires over the years, the scientists could determine which beverages, my particular concern here, were associated with a higher or lower risk of becoming a stone former.

The amounts are important to keep in mind. For coffee and tea it was 8 ounce servings. For juices, a small glass. For carbonated drinks and beer a glass, bottle or can. For wine a 5 ounce glass. Servings were graded from less than 1 weekly, over the range of 1, 2-4, 5-6 weekly, and more than 1 serving a day. A significant effect meant that as the amounts increased, the risk of new stones increased or decreased in rough proportion – there was a ‘dose’ effect.

Winners and losers

Sugar sweetened colas and non-cola drinks were associated with development of kidney stones. Punch was also associated with more stones. But drinks with sugar in them were not all bad. Apple juice, grapefruit juice, and tomato juice did not raise or lower risk of stones.

Coffee, decaffeinated coffee, tea, red wine, white wine, orange juice, and beer were the winners. People who used more had a lower risk of new stones.

No Special Effect on Stones

We already mentioned apple, grapefruit and tomato juices. Add to them liquor, artificially sweetened sodas – cola and non-cola (clear sodas), whole and skim milk, and water itself.

Water Is Not Your Only Option

Nothing is totally off limits when it comes to increasing fluids. The main point is that you do, indeed, increase them. If having a soda here and there helps you maintain your ultimate daily fluid goal, then by all means, treat yourself once in a while.

I am certainly not advising you to have as many Coke’s as you would like, nor am I advocating that you drink very large amounts of coffee all day long, even if coffee drinking lowers risk of stones. What I am saying is that all fluids count and water is NOT your only option. Other beverages help provide variety but my principle is to use them in moderation.

This post will help you decide which other beverages you might incorporate into your diet to help raise your total daily fluid intake. Keep in mind that you need to take into consideration other medical conditions you may have that will contraindicate some of these choices. Review your version of my plan with your physician to be sure.

Pucker Up!

Lemonade is an excellent way to increase your total daily fluid intake and raise your urine citrate level. Citrate is a molecule that binds to calcium so that calcium does not have the chance to bind with phosphate or oxalate. It also slows the formation of stone crystals. Both actions decrease your risk of forming new kidney stones. Lemonade use was not part of the large beverage study I have already quoted, but is thought to be beneficial for stone prevention, or at least not a specific risk like sugared drinks.

The Best Tasting Ones

The Huffington Post polled people on the best store bought lemonades The winner was Whole Foods brand 365 Pasteurized Lemonade. The next two best were Simply Lemonade and another Whole Foods product, brand 365 Organic Lemonade. Read the whole article and let us know which ones you like.

Unfortunately, all three winners have extra sugar added to them. Simply Lemonade seems free of extra sugar, but comments to a review of the product document added cane and beet sugars.

Sugar in any form can raise kidney stone risk, and sugared drinks raise risk of stones – as I have already pointed out. Of course sugared drinks promote weight gain, and raise blood glucose and insulin. But if you follow my moderation principle some of these tasty treats are fine. ‘Some’ means some.

My Favorite for You

I recommend Crystal Lite™ lemonade for my patients, as it is a no calorie alternative. The other reason I love this for you is its convenience. Here is a link for “on the go” packets. Another out that those who need potassium citrate treatment can use this beverage in place of some of their pills.

Make Your Own

You can also just squeeze some fresh lemons to add to your water. If you don’t have time to always buy, cut up, and squeeze fresh lemons, here is an excellent, convenient, alternative: Pre-made concentrate. I get it at Whole Foods, but you can find it at Walmart and Amazon as well. In order to increase your citrate level with a recipe that has been tested in a research experiment, you need to add one half cup of RealLemon© to 7 1/2 cups of water. The Whole Foods concentrate may work as well, but has not been tested.

Got Milk?

Adding low fat, skim or 2% milk is a great way to increase your daily fluid intake and also help you to increase your diet calcium intake. For those of us who are lactose intolerant, here are lactose free alternatives.

Lots of Calcium and Protein

Getting normal amounts of calcium into your diet (about 1000 mg/day) is necessary for your bone health. An 8 ounce glass of milk contains about 305 mg of calcium. Two percent contains 295 mg. You can check the amounts for all milks . There is a lot of protein (8 grams) and other nutrients, too. The protein content is the same whether for fat free or whole milk.

Not So Many Calories As You Might Think

Milk is a calorie bargain. An 8 ounce glass of 2% has only 120 calories, and 1% 105 calories.

Soda Pop

The Skinny on Diet Sodas

Having a diet soda a few times a week will add to your overall fluid intake and, as I have already pointed out, does not increase risk of forming kidney stones to a significant extent. But, unlike milk and lemonade, most sodas offer you no health benefits.

There May be Real Risks

There may indeed be drawbacks. For example, in one study, risk of hip fracture seemed related to diet soda intake in women.

There is Risk By Association

Among diabetic young men, use of diet, but not sugared, sodas was associated with higher average blood glucose. This was ascribed not so much to the beverages as to the generally unhealthy life style of those who consumed larger amounts of such beverages. Likewise, in another study, diet sodas were associated with new onset of type 2 diabetes in men. But with full adjustment for other factors that might predispose to diabetes, the effect of diet soda disappeared. It seems as if men who were trying to lose weight, or compensate for high diabetic risk, preferentially used diet sodas.

Cola vs Uncola

Given that there are drawbacks to sugared sodas and no benefits to diet sodas, what about the clear sodas – the non-cola drinks, as a special case?

The clear sodas have citric acid instead of phosphoric acid. We have already presented the chart of citrate levels in clear soda and you can read it over yourself: Higher is better. Likewise, in the same post, this site has presented the case for the use of beverages as a source of citrate in place of expensive potassium citrate pills.

7UP and Sprite have no caffeine which may be an advantage for some people.

The Final Verdict

Think of diet sodas as a treat, probably not a good protection against stones. The higher urine volume is offset by what else is in the soda. It is not something to have all the time. Diet soda may increase hip fracture risk in older women. Sugared sodas raise risk of stones, so just avoid them except for a special treat once in a while.

Given the high price of potassium citrate pills, many patients may need to use high citrate beverages, which are clear sodas, as a supplement. For those who do not need supplemental citrate, and there are very many stone formers in this category, the clear sodas serve no special purpose except for variety and taste.

Unless you are using high citrate beverages to replace potassium citrate pills, limit how many times a week you are choosing soda as an alternative to water. I would recommend no more than 3 cans a week. If you’re somebody who drinks it every day, start weaning yourself off of it.

Try substituting a LaCroix for each can of soda. It is carbonated and flavored, but without the calories, sugar, and yucky stuff that soda has in it.

Wake Up and Sip The Coffee

I drink one cup of coffee every morning. Not the 72 ounce cup you can get at Dunkin’ Doughnuts, just one true cup. I need it, I love it, and I will not do without it. There is no doubt that coffee can contain considerable oxalate. Instant coffee has even more oxalate per gram than the regular coffees. The question is whether drinking coffee increases urine oxalate, which has not been determined.

I suspect it does not because coffee drinkers have a lower, not a higher kidney stone risk. In the same prospective study I quoted for sodas, caffeinated coffee drinkers had a 26% statistical reduction in new stone onset compared to people who did not drink coffee and there was a graded reduction in risk as the amount increased from none, through 1 cup per week, up to 1 cup or more every day. The decaf drinkers had a 16% reduction.

These coffee drinkers were not using coffee as a form of stone prevention. I presume they used it as a pleasurable beverage. So there is something about coffee drinking that offered a protection.

The issue is therefore not about kidney stone risk but about how much coffee people should drink every day. That is something you need to discuss with your physician. But, I cannot imagine anyone will use coffee, even iced coffee, as more than a small fraction of the many liters of fluid needed daily for stone prevention.

Terrible Teas?

Every patient I have worked with (thousands at this point) has told me that they have been told NEVER, EVER, to drink tea. Tea is known to be high in oxalate. It is true that tea is a higher oxalate beverage, but if you drink it in moderation, a cup here and there will not increase your risk of forming new stones and does add to your total daily fluid intake. In support of what I just said, in the same study I have already quoted in the prior paragraph, tea drinkers had an 11% reduction in stones.

Even though a cup or more of tea every day appears to decrease stone risk, tea, and iced tea, are not a reasonable source for the majority of the large quantities of fluid used in stone prevention. Tea is like coffee: A source of some fluids and variety.

Lovely Libations

The very important epidemiological study on beverages which I have been quoting offers perhaps a little surprise: Wine drinkers (5 ounce glass between 1 per week and 1 or more a day) had a progressive reduction in stones of 31% to 33%. Beer drinkers (1 can between 1/week and 1 or more daily) had an even higher reduction of 41%.

None of these quantities are like the scale of water drinking, or even milk drinking. These are like coffee and tea: Pleasure drinks.

Overall, your alcohol intake is between you and your physician; drinking in excess is never advisable. One glass of wine, or one can of beer a day may confer real benefits for stone reduction.

In between rounds, remember to raise a glass to your old friend water. Your body will thank you the next day.

Sport Drinks

I have not encountered very many patients who use sport drinks in important quantities. Maybe I travel in the wrong circles. Sweetened sport drinks all have the obvious disadvantages of their sugar in relation to stones, and, of course, for weight control. None were remarkable sources for citrate. They are like the sodas: Occasional treats to break up monotony.

Juicy News

If you want risk reduction specific to a juice, orange juice, 1 or more small glasses a day, was effective (12% reduction). Apple, grapefruit, and tomato juices had no effect.

But the lack of an effect is not critical here. The study refers to a small glass daily and did not test larger volumes for urine dilution. Given that none of the juices increased risk, I see no reason larger volumes cannot be used as part of the day’s fluids, apart from the problem of calories – from sugar.

Although cranberry juice may help in protecting you from recurrent UTI’s, no studies have shown it reduces kidney stone risk.

A Day In The Life

How do these suggestions play out in normal day life? Let’s take a look at an example weekday and weekend day. For those of you who are trying to increase urine citrate, we have a whole post to help you.

These are Examples; Your Physician Sets The Amounts

I have already said this and say it again. These examples are for very large volumes of fluid. They show you how you can achieve such large volumes with variety. Your physician will tell you how much to drink. Scale back these examples to match what you are told.

Perfection Is Not a Realistic Goal

You may notice that depending on your day you may drink less than your goal. You may not reach your intended goal every day. It is OK. You are not going to be perfect every single day. Try your best on most days, and if you have a really bad one, just make up for it on the following day.

Monday – A Weekday Fluid Plan That Provides 120 ounces (~1 gallon)

Here is a weekday example for your sunny, early riser with a job and a lot to do. The plan provides 120 ounces – one gallon – of fluids a day and aims for modest front loading so you do not have to get up at night. It includes a treat – diet coke – which could be any diet drink. It does not favor milk because many people do not like it or cannot tolerate it. If you can, milk can substitute for water whenever you wish.

Wake Up – 6 am

1 cup of coffee or tea (5 ounces).

5 ounces of milk with cereal

One 8 oz glass of water with lemon

Mid-morning

Three 8 oz glasses of water

Lunch

One 8 ounce glass of fresh lemonade or diet lemonade beverage

One 8 ounce glass of water

Mid Afternoon

Two 8 ounce glasses of water

One (5 ounce) cup of tea

Dinner

One 8 ounce glass of water before dinner

One 8 ounce glass of water during dinner

One can of diet soda — 12 ounces toward the end

After dinner / before bed

One 8 ounce glass of water

One cup (5 ounces) of herbal mint tea

Saturday – A weekend plan that provides 148 ounces

No work for most of us but a lot of chores. Weekends may be a time to up the ante and go over a gallon. Even if you fall short on the weekdays a bit, and likewise on the weekends, these plans are large enough to give you some margin. But it would be ideal to stay on the high side more days than not. You are buying insurance by the day, after all.

Wake Up – 8 am

1 cup of coffee or tea (5 ounces)

One 8 oz glass of water with lemon

5 ounces of orange juice

Three 8 ounce glasses of water

12 ounces of iced tea

8 ounces of water

One liter of water with workout at gym (about 34 ounces)

5 ounces of green tea

Two 8 ounce glasses of water

Dinner

Two 8 ounce glasses of water

Two 5 ounce glasses of red wine

One 5 ounce decaf

The Wrap Up

My intention was to convey that water does not have to be the only thing you choose when calculating your daily fluid intake. All fluids DO count toward the total.

I think this is important to note, as many patients tell me they hate drinking so much water everyday and then wind up not drinking at all. You can safely add items like diet soda, fruit juices, tea, and alcohol if you do it sparingly throughout the week along with your best friend: water.

Personally, I choose water most of the time. It is free, without any calories, supposedly good for my skin, and does a great job of quenching my thirst during the day and after exercise. As a middle-aged woman, it checks all my boxes.

Need more support getting in fluids or changing your diet?

I have recently put together a private FB page called THE Kidney Stone Diet. It is a group that helps educate you on your physician prescribed treatment plans. I moderate it to keep it clinically sound. Come on over and join the discussion!

Return to Walking Tour about Supersaturation

Understanding what you can and can’t drink for stone prevention can be exhausting. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.

Drink a Lot of Iced Tea? Watch Out for Kidney Stones

FRIDAY, August 3, 2012 — Refreshing, inexpensive, and low in calories, a cold glass of iced tea makes an ideal summertime sip. But before you guzzle glass after sweating glass of the brewed stuff, beware of one not-so-sweet risk: kidney stones.

Kidney stones are solid masses of salts and minerals in the urine that form in the kidneys and can pass through the urinary tract, causing great pain. While the most common cause of kidney stones is simply not drinking enough water, tea contains oxalates, chemicals that also play a role in kidney stone formation. During the summer, when you’re more likely to refill your iced tea glass than your water bottle and more likely to get dehydrated from sweating, those risk factors merge to make double trouble for people susceptible to kidney stones.

Who’s at Risk for Kidney Stones?

The prevalence of kidney stones in the United States is growing — from 5.2 percent in the mid-1990s to 8.8 percent in 2010, according to data from a nationwide survey presented in May at the American Urological Association meeting — but experts can’t explain why.

Similar data suggests men are more prone to kidney stones than women — especially after age 40 — and kidney stone prevalence among women peaks in their fifties, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC).

People who’ve had kidney stones once are more likely to get them again, and those whose family members have a history of kidney stones also face a higher risk.

Food and drink, like iced tea, can facilitate formation of kidney stones in susceptible individuals, but scientists don’t believe it does so in people who are not susceptible, according to the NKUDIC.

What Makes Iced Tea Different for People at Risk?

The ease with which people can drink iced tea, consuming more of it, makes it riskier than hot tea, says John Milner, MD, from the Department of Urology at Loyola University Chicago Stritch School of Medicine in Maywood, Ill. “It’s hard to drink enough to cause kidney stones,” he said in a Loyola release. Roughly 85 percent of tea consumed in the United States is iced, according to the Tea Association of the USA. That’s a lot of iced tea!

Other foods high in oxalates include chocolate, spinach, beets, and peanuts. Interestingly enough, coffee doesn’t make the list.

To protect against kidney stones, Dr. Milner’s advice includes eating less salt, more calcium — which can reduce the amount of oxalates the body absorbs — and drinking plenty of water. The citrate found in lemons also helps prevent the unpleasant pebbles from forming.

If you do have kidney stones, you might not feel any pain until they start traveling from the kidneys to the bladder. You might feel the pain in your side your side, belly, or groin, and your urine might look pink or red. If you feel any of these symptoms, call a doctor who can give you medicine to help the stone pass on its own. If medication and drinking lots of water aren’t enough to help the stone pass, you might need additional treatment.

News and Events

Four Myths About Kidney Stones

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You’re Probably Doing Kidney Stone Diets All Wrong

If you’ve ever had a run-in with kidney stones, then you’ve also had a run-in with a relative/neighbor/obnoxious over-sharer who has the home remedy that fixed them right up. And while unsolicited after-dinner medical advice may sometimes sound reasonable, there’s a lot you need to know about your own kidney stones before you start adjusting your diet based on Aunt Alice’s latest stone story.

“You don’t want calcium because that’s what stones are made of, so ditch the milk.”

“Oxalates are bad, so stop eating foods like chocolate, beer, soy, nuts, spinach and coffee.”

“And if you feel a stone coming on, start drinking lots of cranberry juice to get rid of it.”

You’ve probably gathered lots of advice and home remedies in your battle against kidney stones (and you probably even asked for some of it). But many of grandma’s homemade fixes may actually do more harm than good when it comes to the specific composition of your kidney stones and the reasons why you are forming them.

What are kidney stones? They’re crystal-like formations of the excess minerals in your urine. This simple answer leads to simplified—and problematic—responses. The logic: Identify what you’re consuming, and reduce whatever the stone is made of.

Four Main Kinds of Kidney Stones

There are four main kinds of kidney stones:

  • Calcium oxalate stones, by far the most common type of kidney stone
  • Calcium phosphate stones, also very common
  • Uric acid stones, often associated with diabetes
  • Struvite stones, often caused by an active infection

The two most common kidney stones include ‘calcium’ in their names, so does that mean you should cut out milk and other calcium-rich foods?

Educational Event:
Kidney Stone Update

Join Dr. Stephen Nakada and Kristina Penniston, PhD, for a free educational event on the latest treatments and research into the prevention of kidney stones.

June 28, 2016
6:30-7:30pm
Register for the event

Kidney Stone Myths

MYTH: Kick Calcium to the Curb

“This is a big myth-buster here,” says Kristina Penniston, PhD, registered dietician and researcher in the University of Wisconsin-Madison Department of Urology. “Sometimes we actually need to increase a person’s calcium intake. People that form calcium stones will say, ‘Whaaaat? I’ve been told to avoid dairy all my life!’ To that I say, ‘Yeah, and you’ve continued to form stones, right?!’ “

Many people fear calcium because they hear stones are made of calcium, but the truth of the matter is if your calcium intake is too low, you’re at risk for over-absorbing oxalate, a common compound we eat in many foods. Over-absorbing oxalate can lead to extra oxalate in your urine and that can lead to calcium oxalate stones

MYTH: Axe the Oxalate!

In some people who form calcium oxalate stones, if there’s no other reason (there usually are other reasons!) for that stone formation, then it might be time to try to reduce oxalate intake. After making sure calcium intake is appropriate, then a lower intake of a couple of the most oxalate-rich foods might be recommended. But here’s the caveat, says Penniston:

“The foods that are highest in oxalate are also high in fiber, magnesium, potassium, and phytate. These are actually stone inhibitors. Moreover, studies show that when you reduce oxalate, you reduce your fiber intake. That can lead to constipation and other bowel issues. In general, we’re trying to help people eat a healthy, balanced diet.”

MYTH: Surrendering the Salt Shaker Is a Sure Thing

Sometimes patients are asked to reduce their salt intake, but if their salt intake is already low, then no amount of salt reduction will prevent stones from forming. But how low is it, really?

“If salt intake is high and if you’re forming calcium stones in particular, then we may recommend reducing salt intake,” said Penniston. “That’s a big problem because people have so many contributors to salt in their diet and they don’t even realize it. The salt shaker accounts for about 10 percent of a person’s salt intake, so it’s really a matter of educating patients.”

MYTH: The Internet Knows All

All four major categories of stone have subcategories within them, so looking at nutritional contributors of stones gets very individualized. There’s never going to be a one-size-fits-all stone prevention diet.

“Every time I finish a talk or meet with a patient, that’s the main message: It’s not about going to the internet and picking out a diet,” said Penniston. “Everyone has slightly different stone risk profiles and health needs, and people have different dietary habits on top of that. We can make stone prevention work; it’s just a matter of giving it individualized attention.”

Ways to Prevent Kidney Stones

ALL THAT SAID, there are some always-good-for-you options that can also help prevent stones. Here’s a short list of recommendations to consider.

  • Fluids of all types are safe because they increase urine output and that’s a big goal. Dilute urine is your best friend in preventing stones, so drink up.
  • There are benefits to balance, so eat more fruits and vegetables. “I can’t think of a reason why they wouldn’t be safe for anybody,” said Penniston. “A variety of fruits and vegetables can provide stone prevention benefits for most people. There are some foods like fruits and vegetables that, if we eat more of them, can reduce some of the major risk factors of most types of stones.”
  • Bacteria Can Be a Good Thing. The gut microbiome is the hottest new topic when it comes to nutrition. And it turns out that the bacteria that live in our GI tract probably do have a lot more to do with our overall health than we think.

“Some of the therapy that we do is aimed at optimizing the gut microbiome, and to do that you have to eat foods that will sustain a healthy colonization of bacteria, like fiber and fruits and vegetables,” said Penniston. “Cultured foods like yogurt, and kefir or fermented foods aid the microbiome directly by introducing more bacteria into the digestive tract.”

Ultimately, if you are experiencing stones, see your urologist. They can not only help you in the short-term, but they can provide you with information about your stones. Additionally, a registered dietitian can set you up with an individualized diet plan.

“Patients come in and they’ve been told various things by doctors or nurses or neighbors, and a lot of what we do is redirecting what people have heard “We want to get people to eat what they want to eat while still preventing stones,” said Penniston. “Everybody is different with different underlying health conditions like diabetes, high blood pressure, heart disease and so on, and many conditions have their own diet recommendations. We try to integrate a stone prevention diet into existing diet recommendations, so it’s about finding what you can eat and making that work for you.”

Read More About Kidney Health

  • Tips to Keep Your Kidneys Healthy

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Date Published: 05/19/2016
News tag(s): wellness, healthy bodies, urology

TUESDAY, Aug. 7 (HealthDay News) — People who drink iced tea may be putting themselves at greater risk for developing painful kidney stones, a new study indicates.

Researchers from Loyola University Medical Center explained that the popular summertime drink contains high levels of oxalate, a chemical that leads to the formation of small crystals made of minerals and salt found in urine. Although these crystals are usually harmless, the researchers cautioned they can grow large enough to become lodged in the small tubes that drain urine from the kidney to the bladder.

“For people who have a tendency to form the most common type of kidney stones, iced tea is one of the worst things to drink,” Dr. John Milner, an assistant professor in the department of urology at the Loyola University Chicago Stritch School of Medicine, said in a news release. “Like many people, I enjoy drinking iced tea in the summer, but don’t overdo it. As with so many things involving a healthy lifestyle, moderation is key.”

Being dehydrated is the most common cause of kidney stones, the study authors pointed out. Drinking iced tea, however, can increase people’s risk for the condition.

“People are told that in the summertime they should drink more fluids,” Milner said. “A lot of people choose to drink more iced tea, because it is low in calories and tastes better than water. However, in terms of kidney stones, they might be doing themselves a disservice.”

Men are four times more likely to develop kidney stones than women. That risk jumps significantly for men over the age of 40. The researchers noted, however, that postmenopausal women with low estrogen levels and those who have had their ovaries removed are also at greater risk.

To reduce the risk of kidney stones, the researchers advised people to stay hydrated. Although drinking water is best, they noted real lemonade is another good option. “Lemons are high in citrates, which inhibit the growth of kidney stones,” explained Milner.

The study authors also advised that people at risk for kidney stones should take the following steps:

  • Avoid foods with high levels of oxalates, including spinach, chocolate, rhubarb and nuts.
  • Reduce salt intake.
  • Eat less meat.
  • Get enough calcium, which reduces the amount of oxalate absorbed by the body.

Although hot tea also contains oxalates, the researchers noted it’s hard to drink enough to cause kidney stones. They added that people who do develop kidney stones that drink iced tea should have their doctor check to see if they are producing too many oxalates.

— Mary Elizabeth Dallas

Copyright © 2012 HealthDay. All rights reserved.

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Here are a few FAQs about kidney stones and tea:

Yes, green tea prevents the formation of kidney stones.

Can tea cause kidney stones?

Not all teas cause kidney stones. The ability for tea to cause kidney stones depend on the type of tea and the level of oxalate it contains.

Does iced tea cause kidney stones?

The answer is yes and it’s time to limit your consumption. Drinking too much of tea can cause kidney stones and even damage your liver because of its high concentration of oxalate.

What kind of tea causes kidney stones?

Mostly iced tea causes kidney stones because of its high concentration of oxalate.

Can you drink tea when you have kidney stones?

Tea should be avoided when suffering from kidney stones. While the most common cause of kidney stones is simply not drinking enough water, tea contains oxalates, the key chemical that also play a role in the formation of kidney stones.

Black tea and Kidney stones

Just like iced tea, even the consumption of too much black tea can increase your risk of developing kidney stones.

What is the ingredient in tea that causes kidney stones?

Oxalate is one of the key chemicals present in tea that leads to the formation of kidney stones.

Is tea bad for your kidneys?

While drinking too much of iced tea may damage your kidney, there are a few healthy teas that can work as kidney cleansing teas. Here are a few best teas for kidneys:

  • Dandelion tea
  • Nettle tea.
  • Ginger and turmeric tea
  • Green tea.

Drinking herbal tea for kidneys is also a good idea when you’re looking to detox your kidney.

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6 Easy Ways to Prevent Kidney Stones

Instead: Take action! 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.

  • When Life Hands You Kidney Stones… don’t fret. And as the saying goes, “make lemonade.” It’s important to consider dietary remedies alongside prescription medications. While it may seem easier to just take a pill to fix a medical problem, consider what lifestyle changes will also make a big impact on your health.
    Instead: Next time you drive past a lemonade (or limeade) stand, consider your kidneys. Chronic kidney stones are often treated with potassium citrate, but studies have shown that limeade, lemonade and other fruits and juices high in natural citrate offers the same stone-preventing benefits. Beware of the sugar, though, because it can increase kidney stone risk. Instead, buy sugar-free lemonade, or make your own by mixing lime or lemon juice with water and using a sugar substitute if needed. “We believe that citrate in the urine may prevent the calcium from binding with other constituents that lead to stones,” said Dr. Jhagroo. “Also, some evidence suggests that citrate may prevent crystals that are already present from binding with each other, thus preventing them from getting bigger.”
  • Not All Stones are Created Equal. In addition to calcium oxalate stones, another common type of kidney stones is uric acid stones. Red meat, organ meats, and shellfish have high concentrations of a natural chemical compound known as purines. “High purine intake leads to a higher production of uric acid and produces a larger acid load for the kidneys to excrete,” said Dr. Jhagroo. Higher uric acid excretion leads to lower overall urine pH, which means the urine is more acidic. The high acid concentration of the urine makes it easier for uric acid stones to form.
    Instead: To prevent uric acid stones, cut down on high-purine foods such as red meat, organ meats, and shellfish, and follow a healthy diet that contains mostly vegetables and fruits, whole grains, and low fat dairy products. Limit sugar-sweetened foods and drinks, especially those that contain high fructose corn syrup. Limit alcohol because it can increase uric acid levels in the blood and avoid crash diets for the same reason..Eating less animal-based protein and eating more fruits and vegetables will help decrease urine acidity and this will help reduce the chance for stone formation.
  • See also in this A-Z guide:

    Diet and Kidney Stones
    Kidney Stones
    Kidney Stone Treatment: Ureteroscopy
    Kidney Stone Treatment: Shock Wave Lithotripsy

    If you would like more information, please contact us.

    I’m an avid tea drinker. I love tea, especially green tea, and all of the benefits it can offer. For example, green tea improves health and promotes weight loss. And mint tea can help with stomach aches. One thing I’m wondering is if tea can cause kidney stones. My friend posed this question to me a few weeks ago, and ever since then, that question has been swirling around my head— especially if I’m drinking a cup of tea.

    According to EverydayHealth.com, an article they published stated that drinking iced tea may cause kidney stones. The article notes that because tea consists of oxalates, kidney stones have an increased chance of forming in the kidneys. An oxalate is a common chemical that causes kidney stones to form. The article also points out that iced tea has a greater chance of creating kidney stones than hot tea. And while tea may contain oxalate, does correlation equal causation?

    For example, while oxalates may be correlated with creating kidney stones, this does not necessarily mean it is the cause. Many other factors can attribute to causing kidney stones. These factors, confounding variables, could be the solution to this question of whether tea causes kidney stones or not. Some possible third variables may include genetics, gender, exercise, diet and age. And of course, chance could always be the answer to the hypothesis.

    According to DiscoverTea.com, an article they published stated that different types of tea contains different levels of oxalates. The article further notes that a Japanese study concluded that green tea can even help prevent the formation of kidney stones. Additionally, the article points out that all of the studies used tea bags, and not loose tea.

    I would probably conduct my own experiment and compare my results and data to determine if iced tea can cause the formation of kidney stones. I would perform a meta-analysis and gather two groups of people. One group would drink iced tea, and the other group would not. I would then compare both groups and determine how many people formed kidney stones. I’m interested to find out what the results would be, but I assume the group who drank the iced tea would have an increased number of kidney stones formed versus the non-tea drinking group.

    While tea may have a lot of benefits, certain teas, especially of the iced variant, may cause kidney stones. But don’t fret, because some teas, like green tea, can have the opposite effect and actually prevent kidney stones. Be aware of what kinds of tea you’re drinking, but don’t be too concerned. Kidney stones are not a major health hazard, and they pass naturally through the body.

    Unless you’re Joey from Friends, and it’s an unbearable experience all around.

    What to know about kidney pain after drinking alcohol

    Moderate alcohol consumption should not cause kidney pain. However, excess alcohol consumption may injure the kidneys or increase the risk of chronic kidney disease.

    Kidney pain after drinking alcohol may be a sign of these conditions.

    Acute kidney injury

    Share on PinterestExcessive alcohol consumption can injure the kidneys.

    Binge drinking, or drinking numerous drinks in just a few hours, can cause an acute kidney injury.

    An acute kidney injury can occur when waste accumulates in the blood at a faster rate than the kidneys can filter it out.

    In addition to kidney pain, a person with an acute kidney injury may also notice the following symptoms:

    • decreased urination
    • exhaustion
    • swollen legs, ankles, or face
    • difficulty breathing or shortness of breath
    • nausea or vomiting
    • confusion
    • chest pressure or pain

    Without treatment, a person with an acute kidney injury may have a seizure or go into a coma.

    Urinary tract infection

    Alcohol may indirectly increase the risk of developing a urinary tract infection (UTI). UTIs that spread to the bladder may cause kidney pain.

    Alcohol increases the acidity of urine and can irritate the lining of the bladder. A person who drinks alcohol can become dehydrated, increasing the risk of a UTI.

    In addition to kidney pain, some symptoms of a UTI include:

    • pain when urinating
    • a strong urge to urinate, even when little urine comes out
    • dark or smelly urine
    • blood in the urine
    • stomach or back pain
    • a fever
    • a frequent urge to urinate

    Chronic kidney disease

    Over time, drinking may also increase the risk of kidney disease by forcing the kidneys to work harder and damaging the liver.

    Over time, drinking too much can cause kidney pain and other symptoms of kidney dysfunction, such as high blood pressure.

    Chronic kidney disease is a serious and potentially life threatening condition that requires ongoing treatment. Some people with kidney disease may need dialysis or a kidney transplant.

    Kidney issues unrelated to alcohol

    Drinking does not cause all types of kidney pain. The timing of the pain could be a coincidence, or the alcohol could have intensified an existing problem.

    Kidney stones are another possible cause of pain. A person may feel intense back pain or pain in their genitals or stomach as the body attempts to pass the stone. Some people also develop a fever. If the body does not pass the stone, a person can develop a severe infection or blockage.

    Sustaining a physical injury to the kidneys, such as by falling from a height, may also cause kidney pain.

    It is important to see a doctor for any and all kidney pain, whether it is related to alcohol consumption or not.

    Interested in learning how that sip of alcohol affects the kidneys? Keep reading to find out more about the effects of alcohol on kidney health. The intoxicant not only affects the cognitive function of the body but also damages the vital organ. Excess consumption has been a significant contributor to various kidney diseases, some of them can be cured by simply decreasing the amount of ethanol consumed, the other ones put the life of an alcoholic at risk.

    How Alcohol Affects Kidneys

    Is alcohol bad for your kidneys? The answer is yes, although the damage is not always noticed at once.

    Kidneys serve as a body filter, removing the harmful substances from the system. Alcohol is one of such toxic elements and is mainly excreted through kidneys and liver – thus, these organs suffer the most. Alcohol negatively affects the body part in the following ways.

    Alcohol dehydrates the body which affects the ability of kidneys to function properly

    Excessive liquor consumption can have a short-term effect on the kidneys, which is dehydration. This affects the ability of the organ to regulate the acid-base, body’s fluids, and also the electrolyte balance. This is because liquor selectively increases renal perfusion and basal metabolic rates of renal tubes hence causing an increase in diuresis, leading to massive dehydration. Dehydrated kidneys are unable to function properly, and the subsequent consumption of the next portion of ethanol makes this situation even worse, which eventually leads to the malfunction of the organ.

    Alcohol causes high blood pressure, which is harmful to kidneys

    The effects of alcohol on blood pressure cannot be ignored. It affects medicines that are used to treat high blood pressure, thus rendering them inefficient in treating the disease. High consumption of ethanol also adds up as a risk factor for kidney diseases.

    Alcohol affects the liver which makes kidneys work harder to filter blood

    A liver is a major organ which can be affected by excess alcohol consumption. When the liver is affected and unable to handle the amount of ethanol consumed, the kidneys take over some part of its work. The rate of blood flow to the part of the body is kept at a constant level for it to filter blood. When the liver is impaired, the balancing act is affected, hence overworking the organ, which leads to its dysfunction.

    Alcohol may cause type 2 diabetes which also affects kidneys

    Diabetes has proven to be a severe condition which affects many people worldwide. It is a condition which affects the blood sugar, by either spiking it or decreasing it.
    Can alcohol cause type 2 diabetes? If that is you’re your question, the answer is yes. Type 2 diabetes can be as a result of the effects of alcohol on the body, especially when consumed excessively. Alcoholic drinks, especially beer, are usually rich in carbohydrates, which can raise blood sugar levels, leading to type 2 diabetes.
    The intoxicant increases the risks of developing type 2 diabetes by excessive amounts of calories and carbohydrates. Drinking heavily also makes the body less sensitive to insulin. Liquor can also lead to type 2 diabetes by stimulating appetite, leading one to eat more than normal. It also affects food choices.

    Alcohol may affect the acid-base balance

    Kidneys play an essential role in determining the rate at which metabolic reactions take place by regulating acidity. This is because substantial metabolic reactions that are important in life are sensitive to the acidity of the surrounding fluid.
    The bodies’ metabolic balance interferes with the use of liquor, which changes the regulation of acidity.

    Can Alcohol Cause Kidney Stones?

    Kidney stones are crystals that form from some of the materials in urine. While liquor does not directly cause them, it can contribute to the increased risk for the formation of the stones. This is because the intoxicant has a high purine count. Purines are the chemical compounds that result in uric acid kidney stones. The presence of excessive amounts of purines can lead to the accumulation of uric acid, hence resulting in a kidney stone.
    Dehydration generally can lead to the formation of the stones. With ethanol being a dehydrating agent, calcium oxalate stones can form as a result.

    Is Beer Good or Bad for Your Kidneys?

    Despite the risks associated with alcohol consumption, there are some benefits associated with taking a beer. Several research studies show that drinking beer can be beneficial for kidney stones because beer causes frequent urination, thus preventing their formation.
    Beer also develops the volume of liquid in the patient’s body and forces the kidney stones to pass in the urine. Hence, some amount of beer can help in the expulsion of small sized stones.
    This, however, does not outweigh the dangers associated with the drink as the consumption of beer can cause kidney stones through the dehydrating effect. Moreover, beer consumption does not allow to control the stone expulsion speed which can cause urinal trauma, especially if the concretes are big. It is therefore not advisable to treat these stones with beer.

    How Much is Too Much?

    According to research, a lady should have less than three drinks in a day to keep the kidneys healthy, which translates to less than seven drinks per week. For a man, less than four drinks in a day and less than fourteen in a week is considered to be an amount that will not hurt. Excessive drinking overworks the organ, thus increasing the risk of kidney diseases.
    Blood alcohol levels can also shoot to a dangerous level through binge drinking. This results in a quick kidney malfunction for which dialysis is administered to return the kidneys to normal function.
    It is important to always consult the health provider on the amount that one can take, without compromising their health. This depends not only on the personal health conditions but also on medications prescribed. Many medications can seriously harm kidneys when combined with alcohol. It is important to always drink in moderation.

    Why Kidneys Hurt After Taking Alcohol

    Does alcohol damage the kidneys? After indulging in drinking, some people may complain of pain in the upper or lower back or between the buttocks and lower ribs. This is because of the effects of alcohol on back pain, which is an effect of alcohol poisoning. The pain may be accompanied by painful urination, fever, vomiting, loss of appetite and fatigue. This pain can also be caused by several conditions such as liver disease, kidney disease or infection, dehydration and hydronephrosis. Most of these conditions are as a result of the diuretic effect of the drink, hence the importance of limiting its consumption. It is important to seek medical care if kidneys hurt after drinking alcohol.

    Treatment for Alcohol-Induced Kidney Diseases

    In conclusion, the effects of alcohol on the kidneys cannot be ignored. Excessive consumption of alcohol can be detrimental to the overall health. Therefore, moderate consumption or total abstinence is preferred. Kidney problems experienced after consumption of spirits are a red flag to seek medical attention in case of any symptoms of kidney diseases. To prevent kidney damage in adolescents, teenagers drinking should not be allowed by their parents.

    In the case of alcohol dependency, patients need professional counseling and also rehabilitation services to receive guidance through detoxification and other types of treatment depending on the condition.

    In case of alcohol addiction and failure to stop drinking or start drinking moderately, there are many professional rehabilitation consultation providers that will assist in choosing the right treatment approach among the dozens of alcohol abuse programs to treat alcoholism. The easiest way to get the professional assistance of the medical representatives is to call one of the hundreds of alcohol treatment facilities available.

    Author

    Marixie Ann Manarang-Obsioma

    Content Writer

    Marixie Ann Manarang-Obsioma is a licensed Medical Technologist (Medical Laboratory Science) and an undergraduate of Doctor of Medicine (MD). She took her Bachelor’s Degree in Medical Technology at Angeles University Foundation and graduated with flying colors.
    The combination of having a good medical background, being a mom, and wanting to help people, especially the elderly has cultivated her passion for working in remote areas with love and compassion.
    Marixie likes to travel, read, and watch movies.

    Medical review by Brian Obodeze

    Discomfort after drinking a lot of fluids

    MEN’S HEALTH MATTERS:Obstruction in kidney may require surgical intervention

    Q I am 25 years old and recently started getting pains in my left loin area. The discomfort is not there at all times, but is certainly made worse if I have a few beers or just drink a lot of fluids. My general practitioner organised a scan of my abdomen and kidneys, which showed that my left kidney was “blown up” and the radiologist mentioned that it could be due to an obstruction to the tube draining my kidney, calling it a PUJ obstruction. My GP has referred me to a urologist. What is this condition and how is it treated?

    AWhat you may have is a condition called pelvi-ureteric junction (PUJ) obstruction, but further tests will need to be done to clarify the situation. This condition is due to a narrowing of the junction between the renal pelvis (part of the kidney) and the ureter (tube that links the kidney and bladder).

    PUJ obstruction is more common in males and tends to affect the left kidney more often than the right, with less than 5 per cent of people having a significant problem in both kidneys. It is often present from birth, but usually does not become apparent until adolescence or early adult life.

    Pain or discomfort in the side or flank is the most common feature and this is often made worse by a high fluid intake, particularly after drinking alcohol. The amount of pain experienced is often dependent upon the degree of blockage.

    Blood in the urine or a kidney infection with temperatures are not uncommon presenting features of this condition. Left untreated, PUJ obstruction may cause a number of problems, including diminution of function in the affected kidney over time. It may also be a precipitating cause for the formation of kidney stones.

    Assessment of any patient with PUJ obstruction will firstly involve the taking of a full history followed by a physical examination, which may reveal some swelling or tenderness in the flank. Investigations may include an ultrasound or CT scan, which may show an enlargement of the affected kidney as a result of the obstruction.

    An intravenous urogram (IVU), which involves using a special dye injected into a vein in your arm, was routinely performed in the past, but is used less often these days. A nuclear medicine scan called a renogram is generally performed to diagnose a PUJ obstruction. This scan or study is a simple outpatient test that involves administering small amounts of radioactive substances, called tracers, into the body and then imaging the kidneys and bladder with a special camera.

    The images obtained can help in the diagnosis of PUJ obstruction and will also give an estimation of the function of both kidneys. Some patients with findings on ultrasound scanning such as in your case may not have any obstruction as determined by renogram.

    The need for treatment depends on the effect of the obstruction on the kidney, the presence of complications and the severity of your symptoms.

    Surgery is reserved for those patients in which the condition is becoming increasingly painful or where the obstruction is causing damage to the kidney with decreasing function. It may also be necessary if the obstruction is causing kidney stones to develop.

    Surgery is not always necessary. Many people live with the condition by controlling symptoms with painkillers and antibiotics. Patients not requiring surgery may be managed with careful follow-up.

    The most common surgical technique involves removing the obstructed area and joining the ureter back to the kidney, which is called a pyeloplasty. Surgery to relieve the obstruction has success rates of up to 95 per cent. The method of choice is by laparoscopic (keyhole) surgery, using several small incisions, and open surgery is rarely indicated.

    Laparoscopic surgery has significant benefits with quicker recovery, reduced pain relief, shorter hospital stays, and the obvious benefit of not having a large surgical incision.

    If you need to have an operation, it generally necessitates no more than a couple of days in hospital. A small plastic tube is often left inside to help with the healing process and this is generally removed after six weeks using a small telescope passed through the water passage under local anaesthetic.

    Occasionally, the kidney will be found to have very little function and in these circumstances it is best to remove it rather than attempt a repair job. The kidney can be removed using keyhole surgery and rarely open surgery is indicated. It is possible to lead a completely normal life with one normal functioning kidney.

    • This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James’s Hospital, Dublin, with a contribution from Dr James Forde, urology registrar, St James’s Hospital, Dublin

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