Kidney Stones (Nephrolithiasis): Therapy

Inpatient admission is required if the patient is unable to drink or has concomitant fever and/or pain requiring i.v. administration of analgesics (pain relievers). The following measures are essentially for urinary stone prophylaxis:

General measures

  • Consistent fluid intake of 2.5 to 3 liters. In case of great heat or sweaty physical exertion, the drinking quantity must be more than 2 l in any case!
    • Drinking urine pH neutral drinks.
    • In order not to develop a “thirsty period” during the sleep phase, drinking should also be done before going to bed. Nighttime urination is thus normal for urinary patients.
    • The volume of urine should be 2.0-2.5 l / day.
  • Urine pH measurement of urine for diagnostics (including to exclude renal tubular acidosis, RTA) and during metaphylaxis (urinary stone prophylaxis) – see below “Daily profile of urine pH (measurement protocol)”.
  • Nicotine restriction (refrain from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
  • Adequate physical exercise!
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • Review of permanent medication (eg laxatives / laxatives) due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Chronic stress

Conventional non-surgical therapy methods

  • Antibiotic therapy for recurrent (recurring) urinary tract infections.

Regular check-ups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis required!
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
  • Observance of the following special dietary recommendations:
    • Mediterranean diet – can reduce the risk of urolithiasis (urinary stone disease) by 40%.
    • Avoidance of:
      • Dehydration -(dehydration of the body) – due to fluid loss or lack of fluid intake (drinking amount)Note: Increased drinking amount of at least 2.5-3 l/day reduces the probability of stone recurrence (recurrence of a urinary stone) by about 50%.
      • Malnutrition
      • High-protein (high-protein) diet (animal protein).
      • High intake of oxalic acid-containing foods (chard, cocoa powder, spinach, rhubarb).
      • High intake of calcium (calcium intake no more than 1-1.2 g/day).
      • High purine intake (offal, herring, mackerel).
      • High consumption of table salt (eg, canned and convenience foods) (table salt intake < 6 g /day).
      • Fructose-containing beverages lead to an increase in uric acid serum levels in approximately 5% of patients – due to the presence of a gene variant of the fructose transporter gene SLC2A9 – this leads to disruption of renal excretion of uric acid
    • Alkaline-rich, alkalizing diet with potatoes, vegetables, salads, legumes, and fruits; alkaline minerals for the following types of urinary stones:

      If necessary, supportive intake of a dietary supplement with alkalizing (basic) mineral compounds potassium citrate, magnesium citrate and calcium citrate, as well as vitamin D and zinc (zinc contributes to normal acid-base balance).

    • Protein intake: 0.8-1.0 g/kg bw
  • Selection of appropriate food based on the nutritional analysis.
  • See also under “Therapy with micronutrients (vital substances)”.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

Psychotherapy