Before doing a 24-hour urine collection for kidney stone prevention, there are three important things to know. First, you should eat like you did when you were forming kidney stones to see how those foods affected your urine chemistry. Second, stop taking vitamins that have not been prescribed by a doctor three to five days before the collection, as some vitamins can interfere with the test. Third, make sure to follow the instructions for the urine collection and submit it on time. It is also important to do follow-up tests and address any high urine calcium levels to prevent osteoporosis.
Takeaways
- Eat like you did when you were forming kidney stones to see how those foods affected your urine chemistry.
- Stop taking vitamins that have not been prescribed by a doctor three to five days before the urine collection.
- Follow the instructions for the urine collection and submit it on time.
- Do follow-up tests and address any high urine calcium levels to prevent osteoporosis.
Sound Bites
- “You know you need a 24 hour urine collection, but these are three things you need to know before doing the 24 hour urine collection.”
- “The first thing you should be aware of before you do a 24 hour urine collection is you’re supposed to eat like you did when you were forming kidney stones.”
- “Stop taking vitamins that have not been prescribed by a doctor three to five days before you do a urine collection.”
Chapters
- 00:00 Introduction to 24-hour Urine Collection
- 01:13 Eating Habits and Urine Chemistry
- 07:19 Following Instructions and Timely Submission
- 11:06 Addressing High Urine Calcium Levels
You know you need a 24 hour urine collection, but these are three things you need to know before doing the 24 hour urine collection.
Welcome back to the Kidney Stone Diet podcast. The show about reducing your kidney stone risk and living your best life. I’m your host and fellow student, Jeff Sarris. And I am Jill Harris, your kidney stone prevention nurse.
Hi guys. And we are back. Another week. Another big anchor kind of point of the Kidney Stone Diet, the 24 hour urine collection. And this has been something that’s so key just to anyone who’s trying to make the change and sort of to live the better life. Yes. You this is I mean, Jeff and Amara.
in the background here must be so sick of hearing me talk about this but it would be like I don’t know any you you have to be tested with any medical condition to see why you have that medical condition you must why do we just drop this with kidney stone prevention “Jill, my doctor says I don’t need it,” why would the doctor say you don’t need a test to find out why you have a medical condition you need to push back so there’s that I’m done
I’ll probably say it again during this, but I’m just warning you. I get so mad about this because, because well, I’ll tell you later. So the first thing. I’ll tell you later. The first thing you should be aware of before you do a 24 hour urine collection is you’re supposed to eat like you did when you were forming kidney stones. Jill, there’s no way I’m going to eat spinach again. No way. I know.
I know you’re not going to. So it’s obvious that you’re going to give up the highest oxalate foods. But the gold standard of doing a urine collection is to eat exactly how you did. So if you were eating jujubees all day and corn chips, that’s what you’re supposed to do. Maybe drinking Miller High Life all day long. I don’t know what the hell you were doing to make your stone, but whatever you are, you should do it on the day of your collection so you can see how those foods bothered your urine chemistry.
Now, because I’ve talked to all of you for 25 years, I know you’re not going to eat spinach and almond products during your urine collection. Hell no to that almond milk, Jill. I threw that out after that stent. So I get it. But, so I’ll let you do that one. But I would prefer it if you just drank normally, how you did, how you did when you made your kidney stone. If you want to give up your spinach and almonds because people freak out so much about those, fine.
But that’s not what you’re supposed to do. But, but, but I know you probably will.
Go out to eat if you go out to eat all the time. Again, if you don’t drink that much water, don’t drink that much water. We want to see why you made that stone. We wanna see how the sodium and added sugar affected your urine collection. Here’s what I hear. Listen to this. Jill, there’s no way. I’m going to do it eating like a nun and drinking like super person.
Okay, that’s what I’m gonna do. Okay, so here’s the scenario, what happens. That patient does the urine collection like a nun. They go get their results with the doctor. The doctor’s like, I don’t know why the hell I’m ordering these urine collections. They’re stupid. I don’t know why you’re making stones. Your diet’s fine. Meanwhile, the patient doesn’t say, well, doc, I changed it. I didn’t eat almonds. I didn’t eat spinach. And then the doctor’s telling me, Jill, stop hollering about these urine collections. It’s not diet.
These people, they’re eating fine and there’s just nothing. Well, doctor, they’re not telling you that they ate cotton for the urine collection and drank a gallon of water. That’s not what they did before. okay. Because sometimes patients, I don’t know, they feel more at ease telling me what really went down or I know to pull it out of them. The doctor’s not sitting in the office pulling a police detective inquiry on you.
So they’re just take what your word for it. So they don’t understand that you changed your diet before the urine collection was done. So don’t do that. Please don’t do that. We want to see how your eating affected those values. That’s number one. How many am I supposed to do? Three of them. Okay. Yeah, I feel like that’s almost like flossing when you go to the dentist. It’s like, do you floss? It’s like, yeah.
Floss like the bowl is filled with blood when they tell you to spit. She hasn’t flossed since 1962. I mean, look, we as patients, I’m a patient too with stuff. So I’m like, yeah, no, no. I now have learned my lesson. I tell the truth. Hell no. I do not do that or I do do that. So they can tell me why I should. And then when I don’t at home, I’m a little nervous when I don’t do it and go, I know I better because of this.
So like when I go over urine collections with patients, I tell them, here’s your value, here’s where we wanted to prevent kidney stones, and here’s why. So when you know the why, you’re more apt to do it. Holy brajole, Jill said if I don’t drink water, this is what’s going on in my body. Hell no to that, makes me a little scared. Mabel, get me the water. This is what should be happening. So we’re a little bit afraid when we don’t do what we’re supposed to do.
But we humans, we’re human. Lots of times we need a knock knock before we make a change. All right, so that’s one. The other thing is, what is it? I have my notes here, because I wrote a blog on this. I just haven’t put it on. So eat how you’re supposed to eat. There is a really important one. Hold on. I want to remind you, you’re not going to make a kidney stone in 24 hours.
So people will say, I’m so afraid of making a stone, Jill. I don’t want to go back to my old way of eating. Please do, because nobody makes a stone in 24 hours. It takes years to make a stone in some cases. Sometimes months, sometimes months, depending on what type of stone former you are. But I promise you, the other thing that you should know before you do a urine collection is you should be stopping vitamins that have not been prescribed by a doctor three to five days before you do a urine collection.
Look at the instructions on your urine collection paperwork. Please look at them. It will give that advice typically. Some of the vitamins like vitamin C can convert over to oxalate in the urine collection. Some of the vitamins you may be taking could just mess up the test. So please ask your doctor about that.
If the doctor doesn’t know, please ask the laboratory that’s doing your urine collection. That’s super important. You want to be off unprescribed vitamins. If a doctor has told you to take a vitamin, please take it. But things like calcium supplements, Tums, vitamin C, you should not be taking those during a urine collection. That’s super important. And speaking of the lab, how do you get connected with that?
Is that something the doctor sets you up with or how does that work? That’s a great question. So the doctor is plugged into whatever lab they use to do urine collections. You could say, I want a little link test doctor. And the doctor will say no, because the doctor is contracted to work with somebody like Quest. So the doctors in a lot of offices are contracted and must work with whatever lab they’re with.
Sometimes doctors, but a lot of doctors are with Litholink and that’s my preferred lab. I used to work there so I know about their quality. But whatever lab you get asked to use, please use it and make sure your insurance company will cover the bill. You don’t want to have that scary thing too. So just because your doctor may say use Quest or Litholink, make sure that your insurance company will cover it. That’s really important too. Coming from a patient who has had
I don’t know, up to a million dollars in over a million dollars in medical bills. You know, I had good I have good insurance, obviously. So it pays a lot of it. But I was on the phone with insurance companies a lot. So make sure testing is covered and that’s for cancer portion. Yeah, my stuff is for cancer. But you do just patient to patient. You want to make sure. OK, so there’s that. The other thing that’s really important during urine collections is
Make sure that you’re going to get your urine collection in on time. Lots of them are time sensitive. So I guess what I’m going to say again is please read the instructions. Litholink has really great instructions. I know because I wrote them. I put we put pictures in them so they’re very explicit. There are other laboratories that they’re not as explicit. So if you don’t understand something that your instructions are saying, please reach out to the lab, their customer service number, because the worst thing to do is to have to redo a urine collection.
Some people will write on my Facebook group, you know, my lab says to refrigerate it. And then somebody will say, well, my lab didn’t say that. And everybody gets confused. You must pay attention to your instructions. Every laboratory will do a urine collection differently. So
Pay attention to your instructions. If you’ve done a urine collection with one lab and then you were ordered to do it with another lab, don’t assume it’s done the same way because it’s not. Some of that urine is put in the refrigerator. It shouldn’t be, that’s old school. Some, and a lot of them, you don’t have to put in the refrigerator. So read your instructions. It’s very, very important. I think really that’s about it.
I mean, you have to know to do follow -ups too. You have to get annuals done. Lots of times the doctors don’t remind you to do that. It’s very, very, very, very important to do a follow -up test. After you’ve done a urine collection, the first one, you go through it with your doctor. Hopefully the doctor gave you a treatment plan and then you need to do a follow -up a couple months later to see how that follow -up plan is working for you. If it’s not, you may need to re -tweak things and or go on a medication.
Some of you, a lot of you may need medications to help. You’ll still have to do the diet. That’s not getting you out of it, but you will also need a medication. So that’s super important to know too. I think that about wraps it up. And if, listen, if I’ve missed something, write it in the comments. Hey Jill, you should have said this, this, this. I’m always open to that. So please, and then I’ll answer you in the comments. Yeah, but yeah, the testing is just so important. my God, yes. Because if you have some sort of ailment, why would you not?
You have to test because you have to figure out why this is happening and there’s things on the urine collection Here’s what I was saving for later. See I forgot but here it is the urine calcium in so many of you of higher than 50% of the urine collections I look at on a yearly basis the patients have high urine calcium due to high salt high added sugar. Too much meat protein too much like carnivore diet.
Or genetically you have high urine calcium. You would never know you have that unless you did a urine collection. And guess what’s happening to your bones, folks? You’re losing this calcium from your bone. So it’s so important you get the urine collection if for nothing else to see if you have high urine calcium. Because if you do not get that fixed, you will continue to be a stone maker.
And you will eventually have a very high risk. I don’t diagnose anybody as a nurse, but I will say you will have a very high risk of having osteoporosis going forward. I can’t tell you how many of my patients, they come to me, I explain their urine collection values, I tell them here’s how to have the conversation with the doctor based upon these values, and please ask the doctor about the high urine calcium, and then also ask your doctor if they’ll get you a DEXA scan because they’ve been I say that because they’re 40s, 50s, they’re young, but they’ve been making stones for decades for the last 20 years.
The high urine calcium keeps coming back. Nobody’s doing anything about it. And I’m worried they may have bone disease. So the patient will say, well, what the hell, Jill? I’m only 45. I know, Sammy, but this urine collection has been showing for the last five years this high urine calcium. So you should get a baseline now. Please ask the doctor if they can take care of that for you.
And then the patient writes me and they say, yes, I have osteopenia too. So look, I’m just telling you what I know. I know like three things in my life. I know love, I know that. I know kidney stone stuff and you know, that’s about it. Maybe, I don’t even know, exercise, I know that too. So, but that’s it. And what else do I need to know? Health, exercise, love. There’s nothing else, okay? But I do know this. Follow what I’m saying.
All free of charge for you. Please listen to what I’m saying. Get the urine collection done. Don’t fudge it up, okay? And then when you do the follow -up, by the way, I want you to do it how you should be doing it. Change your diet, change it the way the doctor wants you to do. Follow the Kidney Stone Diet and see how remarkable the follow -up will be. It’s really important that you do that. And that’s how you know it works. Like that’s why you know you know what? I forgot something. This is really important.
Okay, so there’s some people that will say, Jill, I’m eating this. But when I was making stones and I’m like, well, it’s not that high in oxalate. They’re like, I’m just gonna give it up anyway, because I’m just afraid. I can’t tell you how many people give up food that they don’t have to. And so I say to them, do this. Listen, Henry, eat that food. Eat it.
When you do your urine collection so you can see that your urine oxalate is not going to be high. Get your calcium needs met that day, eat that sweet potato, have half of it, and see your urine oxalate will be low, I promise. The patient eats that food that they’re so afraid of, they love it, they’re afraid of it, they eat it, the follow -up comes back, they’re like, my god, look at this, it’s beautiful, it’s my oxalate’s low, Jill, I’m going to incorporate them back. Of course, I warn.
Don’t eat sweet potatoes all day long. I give them, you know, everything within portion, but you can’t eat so many things. So if you have a food that you’re like a little trepidatious about having, eat it during the urine collection so you can see what it does. All right. I promise you it’s going to be okay. I so promise you that really is it. Yeah. So that’s what you need to know before your urine collection. And if you do want help reviewing your urine analysis, you can find that on kidneystonediet.com where you can work with Jill. But I think that’s it for this week. Thanks for tuning in. We’ll see you next time. Bye guys.
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