Diet taboos for high uric acid kidney stones

Prioritize to avoid foods high in purine, high in fructose, and high in oxalate, which can easily aggravate uric acid metabolism disorders and promote the formation of stones. At the same time, avoid common misunderstandings such as "blindly quitting calcium" and "replacing water with drinks", and avoid excessive dieting that may lead to nutritional imbalances.

Xiao Zhou, a 28-year-old game operator who was admitted to the emergency room in the middle of the night last time, came in sweating in pain and holding on to the wall. The uric acid test was 592 μmol/L. There was a 3mm uric acid stone in the left kidney and it was stuck in the upper ureter. I asked him what he usually eats and said he was in a hurry. My goal is to eat 3 cans of iced Coke a day as a base. When I meet up with friends after get off work, I will show off the spicy crayfish with ice beer. Last week, I heard someone said that green leafy vegetables are high in acidity, so I don’t even dare to touch green vegetables. I eat big bones with sauce and white rice every day. This is not to say that I have stepped on all the traps.

Many people immediately give up all meat as soon as they are diagnosed with high uric acid and stones. In fact, it is really unnecessary. The high-purine foods we are talking about that should be strictly avoided are those with a purine content of more than 150mg per 100g, such as animal offal, shelled seafood, thick broth, and hot pot soup base. Regardless of whether you are in the period of uric acid attack or stable period, you should not touch these foods without touching them. If you take one bite, the purine level will explode. The uric acid level will increase by dozens in a day, and it can easily induce stone formation and pain. Of course, there are now two different opinions. Doctors in the Department of Rheumatology and Immunology generally require that the daily purine intake be controlled within 100 mg in the acute phase, and can be relaxed to 300 mg in the remission phase. Purine-rich foods such as lean pork, chicken, and freshwater fish are perfectly fine as long as you eat about one or two each time. However, eating a vegetarian diet can easily lead to malnutrition, leading to metabolic disorders in the body, and uric acid cannot be lowered. ； The urology doctor may be more strict and believe that as long as there are stones, you should touch them as little as possible to avoid rapid rise in uric acid and stimulate the growth of stones. You can adjust according to your own attack frequency and stone size, and you do not need to stick to a certain standard.

Many people say that if I don’t drink alcohol or eat seafood, why do I still develop stones due to high uric acid levels? Look at what you usually drink. Fructose is the most deeply hidden uric acid bomb. Whether it is the fructose syrup in Coke and Sprite, or the syrup in freshly squeezed juice, honey, milk tea that you think is healthy, or even the crystallized fructose added to some snacks labeled "sucrose-free", after entering the body, it will promote the production of uric acid and inhibit the excretion of uric acid by the renal tubules. It is equivalent to storing water in the uric acid pool and blocking the drainage outlet. It is strange that the uric acid is not high. I previously treated a 62-year-old aunt who was afraid that eating sweet foods would raise her blood sugar. She squeezed orange juice and drank three glasses a day. After three months, her uric acid increased by 230 μmol/L. She also found sediment-like kidney stones. She couldn’t believe it.

After talking about purines and fructose, let’s talk about the most controversial issue of oxalic acid. When many people hear that they have kidney stones, they immediately blacklist all green leafy vegetables. In fact, they really don’t need to. First of all, you have to figure out the type of stone you have. If it is a pure uric acid stone, it has nothing to do with oxalic acid. As long as the uric acid is well controlled, there is no need to specifically limit oxalic acid. ； But if it is a stone composed of uric acid mixed with calcium oxalate, you need to be more careful. There are now two opinions on the control of oxalic acid. One group believes that high-oxalate foods such as spinach, amaranth, purslane, and bamboo shoots should be completely eliminated to save trouble. The other group of nutritionists believe that such high-oxalate vegetables can be removed by boiling them in boiling water for one minute in advance. More than 70% oxalic acid can be eaten normally. After all, the dietary fiber and B vitamins in green leafy vegetables can also help promote the excretion of uric acid, which has many more benefits than not eating it at all. I prefer the latter. After all, you can't even skip vitamin supplements in order to control oxalic acid, right?

There is another pitfall that many people step on, that is, they are afraid of eating calcium-containing foods for fear of stones. This is really a huge misunderstanding. Many people think that eating too much calcium will combine with oxalic acid to form stones, so they dare not drink milk or touch tofu. In fact, it is just the opposite. As long as you eat natural calcium-containing foods, such as low-fat pure milk and brine tofu, the calcium in these foods will combine with the oxalic acid you eat in the intestines and turn into unabsorbed calcium oxalate and be excreted in the feces. On the contrary, it can reduce the oxalic acid content in the blood and reduce the risk of kidney stones. I once had a patient who didn't dare to touch any dairy products for three years. He was eventually diagnosed with osteoporosis and his stones grew from 2mm to 4mm. It was really not worth the gain. Oh, by the way, I want to mention here, don’t rely on taking calcium tablets to supplement calcium. Extra large doses of calcium tablets may increase the risk of stones. Food supplements are enough.

Finally, one thing that is more important than what you eat is drinking water. Don’t think that drinking water does not count as a diet. For people with high uric acid and stones, drinking the right water is more effective than taking any supplements. Drink at least 2000ml of warm boiled water every day. Do not use soft drinks, strong tea, or milk tea instead. The more you drink these things, the higher your uric acid will be, and the faster stones will grow. If you forget to drink water when you are busy at work, buy a large cup with a graduation and place it at your work station. Take a few sips when you have nothing to do. Don't wait until you are thirsty. You can drink about 100ml of warm water before going to bed at night, which can reduce the concentration of urine at night and reduce the probability of stone precipitation. If you are prone to getting up at night, don't drink it. Poor sleep will affect uric acid metabolism, which is not worth the gain.

In fact, there really aren’t that many rules about what you can’t eat and what you can’t eat. You don’t need to use a food scale every day to calculate the purine content of each bite. The core is to avoid eating foods high in sugar and oil, drink more boiled water, and check uric acid and urinary system B-ultrasound regularly every six months. This is better than anything else. If you are really greedy, it’s okay to eat two or three crayfish occasionally to satisfy your craving. Don’t just show off three to five kilograms in one meal and drink cold beer. After all, you can’t live a life without losing all the fun because of taboos, right?