The American College of Physicians has issued new recommendations for people who have urolithiasis and seek to reduce the risk of stone formation in the future.
One of the main recommendations of doctors is to drink so much liquid that the amount of urine released per day (diuresis daily) reached 2 liters.
The new edition says that if an increase in the norm of the liquid does not prevent the formation of stones, patients can additionally be recommended thiazide diuretics, citrate or allopurinol.
More information on this can be found on the pages of the American edition of Annals of Internal Medicine.
"Increasing fluid intake during the day can reduce the risk of stone formation by at least 2 times with virtually no side effects. But these recommendations do not apply to people who already drink a lot of fluids, as well as those to whom such volumes of fluid are contraindicated, "writes Dr. David Fleming, president of the American College of Physicians.
It is believed that 13% of men and 7% of women in the US at some point in their lives will have kidney stones. These concretions are formed as a result of the accumulation and bonding of salt crystals, which are metabolic products.
Urolithiasis is associated with such serious consequences as bleeding, infection and decreased kidney function. Studies show that, without preventive measures, there is a 35-50% chance that within 5 years a cured patient will again have stones.
Most often doctors recommend drug treatment and a special diet, but scientists know too little about the effectiveness of these activities. It is accepted to send the extracted stones for analysis to determine their chemical composition - it is considered that this is necessary to develop a further strategy. But the American College of Physicians say that the benefits of even such activities are not completely clear.
To arrive at new recommendations, the RSA conducted its own review of scientific data collected from 1948 to 2014. Experts took into account the benefits and risks of various drug and nutritional strategies for the prevention of stone formation.
Less cola and protein foods.
The authors of the survey found some evidence that a decrease in cola consumption prevents the formation of stones in the future. As for other liquids, they did not find any difference in the preventive effect of tap water and various brands of soft drinks. The main thing is to maintain a daily diuresis at a level of 2 liters.
There is evidence of the effectiveness of thiazide diuretics, citrates and allopurinol for the prevention of stone formation. This is especially true of stones consisting of calcium salts - the most common type of stones.
In their article, the ACP experts draw attention to the fact that "the quality of the analyzed studies varies, and adequate studies that compare the effectiveness of several prevention methods have not been carried out sufficiently".
Researchers say that in the US patients are getting old recommendations from their doctors.
They are told about the need for additional liquid intake and the restriction of certain products: spinach, nuts, chocolate, strawberries, rhubarb, tea, wheat bran. The new guide indicates that patients should limit the use of animal proteins and purines (substances that split up to uric acid), as well as the rate of calcium.
In September 2014, the American Journal of Kidney Diseases reported that urolithiasis increases the risk of stroke and heart failure.
medbe. en.