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Urology/Kidney Stone Prevention


Five months ago I was diagnosed with two kidney stones. I was able to pass one of them, and the other was removed surgically. I want to do what I can to avoid new stones.

I gave the passed stone to a urologist for analysis, but it was apparently lost because I never did find out what it was. Due to a diet that was inadvertently high in oxalates combines with not drinking enough water, my assumption is that the stones were Calcium Oxalate. I have never been told I had a high uric acid content in my urine, have had no problem with gout, and have never eaten an excessive amount of meat, so I do not think the stones were uric acid.

My diet prior to the stones included: almost daily eating wheat bran for breakfast; over a pound of almonds a week; use of soy milk on my cereal and in coffee; drinking decaf coffee all day; frequent use of kale and spinach for dinner; eating lots of hummus which contains sesame products; lots of raw and cooked tomatoes; fresh fish (salmon or flounder) either baked or grilled; five to six pieces of fruit per day(banana, apple, orange, pear,plum, tangerine, grapefruit etc). Very little in the way of fast food, but I did enjoy Chinese takeout maybe once a week, so a lot of salt there.

This is what I have done: I have greatly increased my daily water intake from approximately 24 ounces a day to 84-96 ounces a day. I have eliminated coffee, all nuts, all wheat bran cereals, hummus, and spinach from my diet. I did not have a high sodium diet to begin with, but I am taking steps to assure I do not exceed 2000 mg/day. I stopped using soy milk and have replaced it with skim milk. I am careful to eat a little fat free, sugar free yogurt or an ounce of cheese when I eat something like refried pinto beans or other foods of moderate oxalate content.

Do you have any additional suggestions, or could you correct some of the steps I have already taken. Thanks very much.


If you are serious about stone prevention, and it sounds like you are, then the only way to know where you are chemically is to do a 24 hour urine test and see.  Most of the steps you've taken seem reasonable and appropriate but without the chemical testing of the 24 hour urine, it's impossible to know for sure.  It's like giving insulin without knowing the blood sugar.  So ask one of your physicians about ordering a 24 hour urine test for kidney stone prevention testing.

Instead of focusing on your fluid intake, measure your urine output.  If you can urinate aboiut 2000 ml per day (a little over 1/2 gallon) then you are in the acceptable range for a stone former.  More is better, but you will spend that much more time in the bathroom.  Less may put you at additional risk for more stones.

I have prepared a public lecture at the Omaha VA on the subject of kidney stones and stone prevention.  It has been released for the public but I don't currently have any copies.  If you contact Administration at the Omaha VA, they may be able to help you get a copy or perhaps they can be persuaded to put it online on YouTube.  Good luck.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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