Start Here: After Your First Kidney Stone

If You Just Had Your First Kidney Stone

If you are reading this after your first kidney stone, there is a good chance you have just been through some of the worst pain of your life.

You may also be scared.

Scared that it will happen again. Scared to eat the wrong thing. Scared because you do not understand why this happened in the first place. And if you went home and started searching online, you may now be even more overwhelmed than you were before.

You do not have to figure everything out today. You do not have to eliminate half your diet. And you do not have to spend the rest of your life afraid of another stone.

You are going to understand this, and you are not going to feel lost forever. I promise.

Jill Harris, LPN, CHC

Unfortunately, kidney stone patients often start searching and become more confused, not less.

One website tells you to stop eating calcium. Another tells you calcium is important. You find three oxalate lists, each with a completely different number for the same food. Someone tells you to drink lemon water. Someone else tells you to stop eating meat. Before long, you are looking at your dinner wondering what on earth you are allowed to eat.

Your confusion can end here. You do not need to learn everything about kidney stones today, and you certainly do not need to overhaul your entire diet tonight. You need a clear starting point, reliable information, and a way to figure out what is actually contributing to your kidney stone risk.

Make sure to bookmark this page so you can access it in the future!

Step 1: Find Out What Kind of Stone You Made, If You Can

If you passed a stone or your doctor removed one, ask whether it was sent to the laboratory for stone analysis. Knowing what your stone is made of can give your medical team another important piece of information when planning prevention.

If your first stone was not collected or analyzed, do not worry. This happens all the time, and it does not prevent you from moving forward with prevention. Your 24-hour urine collection can still tell us a tremendous amount about why you are forming stones.

Going forward, however, I recommend asking that every stone you pass or have removed be analyzed. Stone composition can change over time, so even if you already know what kind of stone you formed in the past, a future stone is worth checking.

There are several types of kidney stones, including calcium oxalate, calcium phosphate, uric acid, struvite, and cystine stones. Calcium oxalate stones are by far the most common, but the type of stone is only one part of your prevention story. Your 24-hour urine results help us understand why that stone may have formed.

These are the most common kidney stone types:

• Calcium Oxalate Stones
• Calcium Phosphate Stones
• Uric Acid Stones
• Struvite Stones

And if you do not know your stone type yet, that is okay. Keep going. The next step is one of the most useful tools we have in kidney stone prevention.

Step 2: Ask Your Doctor About a 24-Hour Urine Collection

This is one of the most important things I want every new kidney stone former to understand.

A 24-hour urine collection tells your kidney stone story. And each of you will have a different one.

One person may have very high urine calcium. Another may not be making enough urine. Someone else may have low citrate, elevated oxalate, high sodium intake, an unfavorable urine pH, or several risk factors at once.

That is why the Kidney Stone Diet^® goals remain the same, but your 24-hour urine results tell us which of those goals need the most attention in your particular case.

A 24-hour urine collection measures many factors that influence stone formation, including urine volume, calcium, oxalate, citrate, sodium, uric acid, pH, and other important factors.

Why does this matter?

Because without those numbers, you may spend months worrying about the wrong thing, trying internet folklore remedies instead of addressing the actual reason you are forming stones, and you may wind up making another one. Believe me, I have heard that story far too many times over the decades.

Your stone may have the same name as someone else’s, but the reason you made it may be completely different.

Sometimes patients tell me their doctor wants to wait until they make a second stone before ordering a 24-hour urine collection. I have never understood why kidney stone disease should be treated that way.

Imagine having a heart attack and being told, “Let’s wait until you have another one before we figure out why this happened and talk seriously about prevention.” Of course, a kidney stone is not a heart attack, but the prevention principle is the same. If we have testing that can help uncover risk factors and potentially lower the chance of another event, why wait for another one before using it?

Anyone who has experienced kidney stone pain knows how awful it can be. No one should have to go through that pain again if there are things we can identify and change to lower the risk.

Once you have the results, treatment can begin. I recommend using diet first whenever appropriate, then repeating the 24-hour urine to see what actually changed. If an important risk remains despite your best dietary efforts, medication may sometimes be necessary.

That is prevention: test, treat, retest, and adjust.

• Everything You Need to Know About the 24-Hour Urine CollectionWhy it matters, what to ask for, and how to do it.
• How to Eat During a 24-Hour Urine Collection

Step 3: Learn the Kidney Stone Diet^® Goals

The Kidney Stone Diet^® is not a giant list of foods you can and cannot eat. It is a set of prevention goals built around the major dietary factors that influence kidney stone risk.

Those goals include water, sodium, calcium, added sugar, meat protein, and oxalate.

Want help with all six? In All Access, a new meal plan every week puts the goals on your plate, and my video course teaches each one step by step.

The important word here is goals.

At its core, the Kidney Stone Diet^® is a healthy way of eating, one that addresses the major dietary risks for kidney stones. There is nothing strange or extreme about it. We work on drinking enough water, reducing sodium and added sugar, eating appropriate portions of meat, getting enough calcium, and being thoughtful, not fearful, about oxalate.

And those changes often benefit much more than your kidneys.

Over the years, many of my patients have also lost excess weight, improved their A1C, lowered their blood pressure, and adopted eating habits that support better bone health. The same changes we work on for kidney stone prevention often fit beautifully with recommendations for diabetes, cardiovascular health, hypertension, osteoporosis, and osteopenia.

We are not trying to make you healthy only from the kidneys down.

The Kidney Stone Diet^® gives you goals rather than endless lists of forbidden foods, because prevention has to work in your real life, with family, restaurants, travel, holidays, favorite foods, and everything else that comes with being human.

• What Is the Kidney Stone Diet^®?The six goals, and why each one matters.

Before You Change Everything You Eat, Let’s Clear Up Some Myths

Kidney stone advice has been passed around for years, and unfortunately some of it is outdated, oversimplified, or simply wrong.

New patients often arrive believing they need to stop eating calcium, eliminate every food containing oxalate, drink gallons of water, give up meat, or live on a tiny list of “safe” foods. You may also have heard that lemon water alone will prevent stones or that once you make one stone, you are destined to keep making them.

This misinformation creates an enormous amount of unnecessary fear.

For example, calcium in food is not the enemy for most calcium oxalate stone formers. Getting enough calcium is an important part of prevention. And simply knowing that your stone contains oxalate does not mean your urine oxalate is high.

I have written several articles specifically about the myths I hear from patients over and over:

• Kidney Stone Prevention Myths
• More Kidney Stone Myths

When kidney stone advice sounds extreme, especially when it tells you to eliminate long lists of otherwise healthy foods, learn more before making major changes.

Good kidney stone prevention should give you more confidence around food, not less.

Jill Harris, LPN, CHC

Now, About Oxalate

If you made a calcium oxalate stone, oxalate was probably one of the first things you searched.

Then you found a list. And another list. And another one. Suddenly the same food has three different oxalate values depending on where you look.

This is one of the most confusing parts of kidney stone prevention, which is why I want you to start with reliable information rather than chasing numbers all over the internet.

I use the Harvard oxalate food list in my teaching. I have also written extensively about why oxalate numbers vary, how to use those numbers without becoming obsessive, and what to do when Harvard has not tested a particular food.

Oxalate matters for patients who need to lower it, but it is one part of the Kidney Stone Diet^®, not the entire prevention plan.

Start here to understand oxalate

If you are brand new to this, begin with these:

• Harvard Oxalate Food List
• Why Do Oxalate Lists Have Different Numbers?
• Low-Oxalate Diet Mistakes
• Removing Oxalate Won’t Prevent Kidney Stones

These will give you the foundation you need before you decide which foods to change.

The goal is to understand oxalate, not become afraid of it.

Before You Make Big Changes

If you have not yet completed your first 24-hour urine collection, ask your doctor whether they want you to do it before making any drastic changes to your normal eating and drinking. That first collection can provide valuable information about the conditions under which you formed your stone.

And please do not make ten major dietary changes at once because you are scared. You want to know which changes actually matter for you and whether they are working.

First understand the problem. Then treat the problem.

Jill Harris, LPN, CHC

Questions to Ask Your Doctor

You do not need to become an expert before your next appointment, but knowing what to ask can make that visit much more productive:

1. What type of kidney stone did I make?
2. Was my stone sent for analysis?
3. Can we order a 24-hour urine collection?
4. Do I need blood testing related to my kidney stone risk?
5. Do I currently have stones remaining in my kidneys, and will they pass?
6. When should I have repeat imaging?
7. Based on my testing, what do you think is contributing to my stones?
8. When should we repeat my 24-hour urine to see whether treatment is working?
9. If my numbers remain abnormal after dietary changes, are there medications that may help?

Write your questions down before your visit. It is very easy to forget them once you are sitting in that exam room.

Use My Free Resources

I have spent years creating free educational resources because I want kidney stone patients to have a reliable place to turn when questions come up.

On the Kidney Stone Diet^® website, you will find articles about water, sodium, calcium, oxalate, added sugar, meat protein, 24-hour urine testing, eating out, grocery shopping, recipes, and the everyday questions that come with trying to prevent another stone.

You can also take me for a walk with you and listen to the Kidney Stone Diet^® Podcast on Apple Podcasts, Spotify, Audible, or wherever you listen to podcasts. I talk about kidney stone prevention, diet, 24-hour urine testing, common mistakes, myths, oxalate, and the real questions I hear from patients every day. On YouTube, I answer the questions kidney stone patients ask me every day in easy-to-understand videos.

• The Kidney Stone Diet^® PodcastEvery episode, with a transcript.
• Apple Podcasts
• Spotify
• Audible
• The Kidney Stone Diet^® YouTube Channel

You are also welcome to join the private Kidney Stone Diet^® Facebook community, where you will find other people working through many of the same questions. I am the admin and active in the group as well.

And don’t forget the Kidney Stone Diet^® newsletter! Each week, I share practical kidney stone prevention tips, answers to common patient questions, recipes, and real-life ways to make the Kidney Stone Diet^® easier to follow.

• Private Facebook Community
• Harvard Oxalate Food ListThe list I use in my teaching.
• The Kidney Stone Diet^® NewsletterSign up here.

If You Want More Personalized Help

Many people can use my free resources and work through the Kidney Stone Diet^® goals on their own. Others want more structure or individual guidance. I offer both.

Wondering what you can actually eat? Start with the meal plan.

One of the first questions I hear from newly diagnosed patients is, “What am I supposed to eat now?”

My answer is: plenty.

Kidney stone prevention should not leave you afraid to open your refrigerator. The Kidney Stone Diet^® Meal Plan shows you what this way of eating looks like in real life, with breakfast, lunch, dinner, snacks, recipes, and practical meal ideas built around the Kidney Stone Diet^® goals.

Instead of judging individual foods as “good” or “bad,” you begin to see how normal, enjoyable meals can fit into your prevention plan.

• Kidney Stone Diet^® Meal Plan

Private consultations with me

If you want individual help, I also work privately with kidney stone patients.

A private consultation lets us look at your situation: your medical history, stone history, 24-hour urine results, current diet, other health concerns, and the areas of prevention that need the most attention.

This is also where one of my specialties becomes especially helpful: melding kidney stone prevention with the other diets you may already need to follow.

I do not want to hand you a generic sheet of instructions. I want you to understand what matters most for you, why it matters, and how to make it work in your actual life.

• Private Consultations

So, Where Should You Start?

If you have just been diagnosed, do not feel that you have to tackle this entire page today. Bookmark it and come back as questions arise.

For now, focus on the basics: find out what kind of stone you made if possible, ask about 24-hour urine testing, and learn the Kidney Stone Diet^® goals before you start unnecessarily restricting your food.

Then use the resources on this page to learn more about the areas that actually apply to you.

You do not need a perfect diet. You do not need to memorize the science. And you certainly do not need to spend the rest of your life afraid that every bite of food is making another kidney stone.

You need to understand why you are forming stones, what you can do to lower your risk, and how to make those changes sustainable.

That is what I have been helping kidney stone patients do since 1998.

You are definitely in the right place.

Your friend,
Nurse Jill

Go Deeper

• How Kidney Stones FormHow a stone forms long before the pain starts.
• 28 Most Common Kidney Stone MythsThe myths I’ve heard in 25 years, and the facts.
• Ten Common Mistakes That Increase Your Stone RiskEasy-to-miss mistakes that sound perfectly reasonable.
• What Most People Get WrongWhy oxalate matters least once you stop a few foods and meet your calcium needs.
• Kidney Stone Diet, Where to StartFitting the diet into the life you already have.
• Kidney Stones in PregnancyWhy they can happen, and how to lower your risk.
• The Stone Is Gone. The Fear Isn’t.When the worry stays after the stone is out.