Kidney stones & diet

[AJ1171]

I had my first kidney stone send me to the ER in April (5mm). I don't know if it actually passed because there was no evidence, but the pain did stop after 2 weeks. Through testing in June, I know that I have 5 small stones in my left kidney and the kidney has hydroneph... can't remember the word at the moment, but it means enlarged/swollen. My uric acid (1480) and oxaclic acid levels were high. I am now on allopurinol (sp? the bottle is not with me).  I was told to change my diet to avoid purines and oxalic acid. I got a very short list from the doctor and was told to do some research on the internet. Well, the internet hasn't been too helpful because different websites contridict each other on the content levels. Where can I get good info? Also, add into the mix that I am hypoglycemic. This is really stressful in figuring out what exactly is okay to eat. Any advice?

[Stephen Liroff, MD]

Your history concerns me in that you are not sure that the obstructing stone has passed. The stone may still be there yet not cause any symptoms. It can even result in kidney damage without giving you any additional pain. I think that you need to have a test (CAT Scan of abdomen and pelvis) or IVP to demonstrate the absence of the obstruction/stone.
It sounds as though you have had a work-up with 24 hour urine collections to look for the amount of substances that you excrete in your urine that may cause or inhibit stone formation. Now, what to do with the information. Hospitals have dietitians as do major nephrology departments. These individuals can help plan a reasonable dietary approach to your problem. You will need a request   from your physician when contacting these individuals. You should have your urinary excretion checked after you have been on your diet for a few months to make sure that you are achieving what you want. There is an article that I just ran across in investigating this answer that makes a lot of sense: www.khaleejtimes.com/.../weekend/2008/June/weekend_June5.xml§ion=weekend&col= -
It points out that moderation is the key.
Good luck!
S.A.Liroff, M.D.
This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.

[AJ1171]

Today, I had a follow up to look at the enlarged kidney. They did x-rays with contrast. No results as of yet. It will be a week if they find anything before I would see a urologist to get any obstruction taken care of. Seems like this whole process is kinda slow considering, like you said, damage can be done even without pain. Thank you for the article and advice. If you can think of any reliable websites or books with Oxalate & Purine levels in foods, I would be greatful ---- it seems like there are wide disparities in the amounts depending on the source.