46 Reasons You’re Still Making Kidney Stones.

I spent much of my week helping patients understand their urine collection results so they can have more informed and productive office visits with their physician. When we patients are educated, we typically will get better treatment plans from our physicians regardless of what disease we’re battling.

Also this week, I had a number of patients tell me that when they had their first urine collection result office visit, the doctor said everything “looked fine.” Yet, the patient is calling me because they have a new stone. So what happened? Why are they still making kidney stones?

Much of the time, it’s because the reference range on your urine collection results are far too generous and the doctor doesn’t know where the range should be for kidney stone formers. 

For example, many labs will say that sodium references ranges are ok if your result falls within a range of 1,000mg – 5,000mg of sodium per day. You kidney stone formers know that our goal is around 1,500mg. You can clearly see that if your value falls within the generic reference range on your lab result, it could be misleading and result in another stone.

Remember, more sodium in the urine often means more calcium in the urine, and when we have more calcium in the urine that increases our kidney stone risk (and bone loss btw).

Here are some other common reasons why you continue to make kidney stones. It’s a long list, but I want you to see that kidney stone occurrence has little to do with oxalate consumption once you take away the highest oxalate foods and get your calcium needs met.

1. Dehydration: Not drinking enough water, especially in warm climates or after exercise.
2. High Sodium Intake: Excess salt can increase calcium in urine, contributing to stone formation.
3. High Oxalate Foods: Eating a lot of foods high in oxalates, like spinach, beets, and almonds, without balancing with calcium.
4. Low Calcium Intake: Not consuming enough calcium, which is needed to bind oxalate in the digestive tract.
5. High Animal Protein Diet: Consuming excessive meat (anything that swims, runs, or flies), which can raise uric acid levels.
6. Sugary Beverages: Drinking sodas or sugary drinks, especially colas, can increase stone risk.
7. Obesity: Higher body weight can alter urine composition, leading to stones.
8. Lack of Exercise: A sedentary lifestyle can be a contributing factor, as exercise helps with overall kidney health.
9. Family History: Genetics can play a role; if family members have kidney stones, others may be more likely to develop them.
10. Frequent Use of Laxatives: Overuse can lead to dehydration and mineral imbalances.
11. High Vitamin C Intake: Large doses of vitamin C can increase oxalate levels in urine.
12. Certain Medications: Some drugs, like antiseizure med (Topamax), antacids, or calcium-based supplements, can contribute to stone formation.
13. Gout: This condition can increase uric acid levels, leading to stones.
14. Metabolic Disorders: Conditions like hyperparathyroidism or renal tubular acidosis can increase the risk.
15. Too Much Dairy: While calcium is essential, overconsumption, particularly of supplements, can lead to stones.
16. Chronic Urinary Tract Infections (UTIs): UTIs can cause struvite stones, especially in women.
17. Low Magnesium Intake: Magnesium helps prevent the formation of stones by binding with oxalate.
18. Excessive Alcohol Consumption: Can lead to dehydration and alter urine composition.
19. Frequent Fasting or Skipping Meals: This can concentrate urine, raising the risk of stone formation.
20. Imbalanced pH Levels: Diets that affect urine pH, making it either too acidic or too alkaline, can increase stone risk
21. Overuse of Calcium-Based Antacids: Consistent use can contribute to elevated calcium in the urine.
22. High Sugar Diets: Excessive sugar, particularly fructose, can increase the risk of calcium oxalate stones.
23. Not Eating Enough Fiber: Fiber helps balance the minerals in the digestive system and can reduce stone risk.
24. High Intake of Purine-Rich Foods: Foods like shellfish, organ meats, and certain types of fish raise uric acid levels.
25. Overuse of Vitamin D Supplements: Excess vitamin D can raise calcium levels in the urine.
26. Not enough Vitamin D: Too little can also raise urine calcium. Get yourschecked (blood test).
27. Digestive Disorders: Conditions like Crohn’s or ulcerative colitis can impact mineral absorption, leading to stones.
28. Bariatric Surgery: Procedures affecting the digestive tract can increase oxalate absorption.
29. Chronic Diarrhea: This condition can cause dehydration and mineral imbalances.
30. Rapid Weight Loss: Quick weight reduction can affect urine chemistry, leading to a higher risk of stones.
31. Low Citrate Levels in Urine: Citrate helps prevent stone formation by binding with calcium, so low levels can increase risk.
32. Consuming High-Phosphate Foods: Too much phosphate, found in processed foods, can disrupt calcium balance.
33. Low Potassium Intake: Potassium helps balance minerals, and low levels can contribute to stone risk.
34. Low Intake of Fresh Fruits: Fruits are a natural source of citrate, which helps prevent stones.
35. Prolonged Bed Rest or Immobilization: This can lead to bone calcium being released into the bloodstream.
36. Recurrent Kidney Infections: Infections can alter urine composition and lead to stone formation.
37. Poor Gut Health: Gut imbalances can affect how the body absorbs and processes oxalates.
38. High-Temperature Work Environments: People in these environments may get dehydrated more often, increasing stone risk.
39. Consumption of Processed Foods: High in additives, preservatives, sugar and salt, these foods can alter mineral balance.
40. Frequent Exposure to Heat: Living in a hot climate or prolonged exposure to heat can lead to dehydration.
41. Parathyroid Gland Problems: Overactive glands can cause an increase in calcium levels in the blood and urine.
42. Excessive Coffee Consumption: Coffee acts as a diuretic, which can lead to dehydration if water intake isn’t balanced.
43. Poor Sleep Quality: Disrupted sleep can affect overall metabolism and kidney health. It also keeps us from activity and eating well the next day.
44. High Altitude Living: The body needs more fluids in high-altitude environments, so inadequate hydration can lead to stones.
45. Not Urinating Frequently Enough: Holding urine for long periods concentrates it, increasing the likelihood of stone formation.
46. Unbalanced Vegan or Plant-Based Diets: High in oxalate foods without balancing with calcium can lead to stones.

So as you can see, kidney stone disease is complicated and difficult to manage if you’re not getting the proper guidance. It’s NEVER one thing—there are usually many reasons you’re still making kidney stones despite the fact that you gave up spinach and almond products and your doc says everything “looks fine.”

You know where to find me if you need me!

Your friend and advocate,

Jill