The main job of the kidneys is to filter & purify the blood to detoxify the body. Kidney stones (= nephrolithiasis) are hard stones that can form from crystalline substances in the urine in the kidneys, in the renal pelvis and in the urinary tract. Many small crystals leave the body without even being noticed. Crystals that are left behind can act as nuclei and turn into kidney stones. Certain eating habits can also favor kidney stones. Only when the stones migrate into the ureter do they cause pain: severe cramps in the lateral abdominal region, accompanied by nausea and vomiting (= renal colic). Men are affected more frequently than women. The cause is an oversaturation of the urine with stone-forming substances.

Causes of urine oversaturation with stone-forming substances

Increased excretion of stone-forming substances (such as calcium, phosphate, oxalate, uric acid) & at the same time one
reduced excretion of non-stone-forming substances (magnesium, citrate)
Increased urine concentration due to lack of fluids and dehydration (profuse sweating, dehydration, too little fluid for food and drinking water), tropical climate or chronic intestinal diseases
Calcium metabolism - disorders eg due to an overactive parathyroid gland with increased calcium excretion
Uric acid metabolism - Disorders with increased uric acid excretion (caused by enzyme defects or a diet containing purine (see more on gout, increased uric acid levels ), alcohol abuse or the breakdown of tumor tissue
Urine with a pH of less than 5.5 (for uric acid stones) or greater than 7.0 (for phosphate stones)

Risk factors that promote kidney stone formation:

Obesity
Diet: Specific drinking and eating habits
Insufficient fluid intake (consider total fluid: drinking fluid & fluid via food & meals)
Foods that dehydrate the body and oversaturate the urine with salts (e.g. asparagus, rhubarb)
Urinary stasis due to scars, constrictions or malformations in the kidneys or urinary tract
possibly food supplements that contain calcium & vitamin D (note dosage!)
Certain medications such as acetalzolamide, sulphonamides, triamterene, indinavir, and very high doses of acetylsalicylic acid (ASA) (> 4 g / day)
Family disposition (genetics) - occurrence of kidney stones in family members
Repeated urinary tract infections

Why is nutritional therapy important?

Nutritional therapy helps you to optimally support your kidneys in their function & to prevent kidney stones as well as to simply dissolve and thus remove existing kidney stones (small stones through plenty of fluid intake). Furthermore, it is of the utmost importance to optimally supply your body with all of the fatty acids, micronutrients (vitamins and minerals), energy and protein that are important for you. Overall, the therapy aims to avoid foods that promote inflammation and at the same time consume plenty of anti-inflammatory foods. Weight reduction may be advisable if you are overweight / obese. Special attention is also paid to the supply of fluids; a drinking and eating log can provide information about a lack of fluid intake. Nutritional therapy should also prevent new kidney stones (relapse prevention). Larger or jammed stones must be crushed or removed.

Patients with kidney disease should discuss with their doctor whether they need to control their fluid intake.

Types of kidney stones - composition

First of all, kidney gravel (fine stones) forms, these then become larger and larger stones.

Calcium-containing stones: (approx. 70% of all kidney stones) z. B. calcium oxalate stones or calcium phosphate stones
Uric acid stones: (about 15% of all kidney stones) = urate stones
Magnesium - ammonium phosphate stones: (approx. 10% of all kidney stones) = struvite or infection stones.
Cystine & xanthine stones: (approx. 2% of all kidney stones)

Functions of the kidneys:

Detoxification: urinary substances (creatinine, urea, uric acid), foreign substances, medication, environmental toxins
Keeping the water balance and osmotic pressure constant through electrolyte regulation
Hormone production: renin & erythropoietin, vitamin D activation in calcitriol
Maintenance of the acid-base balance: blood pH value: 7.4, supports the bicarbonate buffer (HCO3- + H + <-> H2CO3 <-> CO2 + H2O), H + excretion - regulation

Urination

Renin controls the filtration pressure
Filtration / d = 180 liters = 1.5 liters of urine / day

Kidney threshold of glucose: 180mg / dl / day

= max.absorption amount! -> more glucose is excreted as remainder (in diabetes mellitus)

Nephron (renal cortex) = functional unit

Nephrons consist of kidney corpuscles & tubules

1) Kidney corpuscles - primary urine formation

Glomerulus-vessel unit (arteries) -> ultrafiltration
Baumann capsule (close-meshed filter, proteins get stuck)

2) renal tubules (tubular apparatus)

- reabsorption, secretion, concentration
Secondary urine formation (terminal urine)
proximal tubule (reabsorption: AS, glucose, water, electrolytes)
Henle loop (water)
distal tubule (water, electrolytes)
Connecting tubules (electrolytes)

Collection pipe (water reabsorption point) collects the secondary urine & guides it into the renal pelvis

Classification of your weight - definition and classification of weight in relation to height.

Special percentile curves apply to children and adolescents; the BMI cannot simply be used here.

BMI and interpretation: BMI: body mass index. Formula: Body weight in kg : (body height in m) 2

Underweight: <18.5

Normal weight: 18.5 - 24.9

Overweight = pre-obesity: 25-29.9

Obesity grade I: 30 - 34.9

Obesity grade II: 35-39.9

Obesity grade III:> 40 = per magna

Nutritional therapy

Anti-inflammatory nutrition as a basis, individually tailored to you
Individual energy & protein requirement calculation
Holistic therapy - do you have any comorbidities that need to be taken into account during the consultation?
Overall fat selection, how should it be designed
How many animal foods (e.g. meat products, milk and dairy products, cheese, fish products, eggs) are recommended?
What do I have to look out for when choosing animal foods?
How can I counteract inflammatory processes through diet?
Body weight: If you are overweight / obese, weight reduction may be recommended.
Avoid micronutrient deficiencies and mineral deficiencies & possibly counteract them with nutrient preparations
Prevent protein deficiency / excess protein
Which nutrients do I need in which ratio?
Get enough fiber (> 30 g / day) through natural foods, possibly fiber substitution
Sufficient fluid: total fluid per day: 30 - 35 ml per kg body weight and day. Attention, this is not just a drinking liquid. The liquid from food (approx. 500 - 800 ml) must still be subtracted from this, so that an amount of approx. 1.3 - 2 l of drinking liquid is created. In consultation with your doctor, a fluid limit may be necessary, this will then be taken into account.
add valuable anti-carcinogenic (anti-cancer) secondary plant substances
A selection of foods tailored to your needs with cooking and technical information (for breakfast, snacks, lunch, dinner)
Do you like to eat your warm meal in the evening? I am happy to cater to your individual situation and we will create a plan on how you can implement your wholesome diet into your everyday life.
which oils are good for me? What should I watch out for in relation to the anti-inflammatory diet?
How much fat spread (butter / margarine / vegetable fat) can I use and which products are recommended?
Get enough Omgea-3 fatty acids and essential fatty acids
How can I boost and support my metabolism with natural foods?
Coordinate sensible meal frequency for your individual case - meal allocation
Define the desired weight stabilization / normalization & the estimated period for this
what should be considered with beverages and alcoholic beverages?
How does exercise affect your body and thus also your diet?
Avoid blood sugar fluctuations
Sweetening foods - sweeteners, glucose, fructose, sugar and sugar substitutes, what can I use and in what quantities? How high is the respective sweetness of the different products?
what should be considered when baking and cooking?
what are cheap snacks / main meals
Eating out - what should you watch out for?
Vacation, boat trip or hospital stay, what should be considered?
Flatulence, bloating, diarrhea, constipation, vomiting, heartburn, loss of appetite, pain related to eating, what can I do about it?
Daily plans as an example for practical implementation in everyday life
Enjoyment training
Optimizing your eating situation
long-term maintenance of a jointly defined weight
Strengthen the stomach and intestines with natural foods
Additional therapy options
Dietetic products in support of nutritional therapy
Food supplements - under certain circumstances, a supplement can be useful
and other topics