Kidney Stones: Why It's Hard For Some People To Follow A Simple Means Of Prevention
Researchers are launching clinical trials into prevention and treatment of kidney stones — hard deposits of minerals and salts that can block the flow of urine — as more Americans are contracting them and enduring their painful symptoms.
UT Southwestern Medical Center will participate in the clinical trials The first involves finding ways to get patients to drink more water; dehydration is a common cause of kidney stones. Dr. Naim Maalouf, an associate professor specializing in mineral metabolism, explains why that’s easier said than done.
On the increase in kidney stone disease: We know that there are probably several reasons. One is that kidney stones are associated with obesity and diabetes, and with the rise in the prevalence of those two conditions, there is an increase of kidney stones. Our diet has changed to include more sodium and more protein and that predisposes. We’re doing more imaging studies and that can detect asymptomatic kidney stones, but that does not seem to be a major contributor.
On the clinical trials: There are many ways to prevent kidney stones, but one of the more important ones is to maintain a high fluid intake...What we have noticed, though, is many patients are not able to maintain high fluid intake. There are many reasons: They tend to forget, or they’re in occupations that prevent them from taking bathroom breaks. One trial we are launching is to find out whether we can change behavior to improve fluid intake.
We’re looking at three strategies:
- Meeting with a health coach to identify barriers to increase fluid intake.
- Using "smart" water bottles and smartphone applications. We have a smart bottle that can track fluid intake and can give feedback to the patients through messages on their cell phone.
- Using, for a short period of time, modest financial rewards to change or establish new behavior.
On appropriate water intake: It depends on each patient, but it’s close to 100 ounces of water a day. That’s has been shown to prevent kidney stone recurrence. Not everyone needs to drink that much water, but those people with kidney stones and low urine volume to start with are the ones who would benefit.
For more information on kidney stones:
- Mayo Clinic: Kidney Stones (Symptoms & Causes
- MedlinePlus (U.S. National Library of Medicine): Kidney Stones
- National Institute of Diabetes and Digestive and Kidney Diseases
How to enroll in the clinical trials:
- To enroll an adolescent, call 214-456-0279
- To enroll an adult, call 214-645-8787
- For more information, go to www.usdrn.org
This interview has been edited for clarity and length.