Exploring the Long Covid risk that happens when persistent kidney pain turns out to be Ureteral Stones, or Kidney Stones. The presence of a large 10 MM Kidney Stones was discovered in an Emergency Room, in this patient, a week of sudden resurgent vomiting, GI, and migraines, suddenly strange upper body chest pain, with sharp pain under the ribcage.
For many COVID Long Haulers, yet another trip to the emergency room for COVID Symptoms, feels like they are stuck in a bad episode of their own reality tv. Very little was written about the symptoms they experience, much less how they recover it.
Covid-19 symptoms may also be symptoms of other illnesses. Most importantly, do not use this list to ‘self-treat’. Contact your primary care physician to discern the severity, impact, and treatment. If you are experiencing associated COVID symptoms, or have been in contact with someone who has novel coronavirus, consult your doctor.
A COVID patient’s illness differs even by common symptom impact. Do not wait if a symptom is severe, but “known” for COVID. Seek medical care for persistent, problematic, or life threatening symptoms, whether COVID or not.
A kidney stone is a solid mass formed from substances in the urine. Treatments include observation, medications, minimally-invasive procedures and surgery. 0:00
- Observation 1:40
- Shockwave Lithotripsy 3:36
- Ureteroscopy (Stint) 5:47
- Percutaneous Nephrolithotomy
What are Kidney Stones?
Kidney stones are caused by the build-up of crystal-forming minerals in the urine that can eventually form into solid masses. These minerals include the likes of calclium, oxalate, uric acid and others. When this becomes more than the urine can dilute, the substances can combine to form kidney stones
Symptoms of Kidney Stones (Nephrolithiasis)
Sharp pain that may move in location or intensity in your side, back, below your ribs, in your lower abdomen or groin. Or pain/discomfort during urination.
- Nausea and vomiting
- Fever and chills
- Burning sensation during urination
- Needing to urinate more frequently
- Pain or difficulty/passing only small amounts of urine
- Pink, red, or brown blood in your urine (hematuria)
- Small stones, Cloudy or bad-smelling urine
Kidney with a stone, in a Covid Long Haul Patient.
Actual View of a 10mm Kidney Stone
WHAT IS THE COVID LINKAGE TO KIDNEY STONES?
Johns Hopkins found there was clear linkage to COVID19 patients with High Blood Pressure and Diabetes being at greater risk of Kidney disease. Key findings:
- COVID may target kidney cells
- Sustained low pulse oxygen can cause kidney damage
- Body fighting infection-cytokine storms can destroy kidney tissue
- COVID Blood Clots might impair function of kidneys
- Hypertension damages blood vessels supplying blood to kidneys
Less is known about Kidney Stones, but by following some of the causal agents a COVID Long Haul Patient must employ to survive, it becomes clear, what might help one symptom creates risk for other issues. Here are some direct causes from COVID:
- Dehydration. Not drinking enough water daily increases your risk of kidney stones. COVID Patients with GI and Digestive problems might be at a higher risk. People who live in warm, dry climates, or suffer hypertensive crisis and those who sweat a lot may be at higher risk than others.
- Certain supplements and medications, antibiotics, decrease the good bacteria in our gut that absorb oxalates. vitamin C to boost immunity, calcium-based antacids for persistent COVID Nausea, and the persistent need for medications used to treat migraines or depression can increase your risk of kidney stones.
Drink More Liquid and stay hydrated.
Avoiding dehydration is key to avoid kidney stones. Create a habit to drink regularly before you feel thirsty. Start the day with a large drink. Take a liter bottle with you to work and drink at least two of these bottles a day. Drink more if you work in a hot environment or are taking medicines. At least 3 liters (1 gallon) of fluid every 24 hours. That is 10 cups a day or over 3.5 pints. Hydration does not have to be all in water but it should not be sugary drinks.
Reduce intake of sugary drinks.
Large amounts of fructose corn syrup sweetened products like Coca-Cola, Pepsi, Red Bull, Rock Star, Full Throttle Energy Drinks, lemonade, or sweetened fruit juice cocktails or fruit punch. Fructose sweetened drinks are linked to calcium oxalate kidney stones.
Drink milk and eat 700 – 1200mg of calcium foods daily.
People who do not drink milk or consume enough dairy food face a greater risk of kidney stones. Low fat milk products such as skimmed milk, 1% or semi-skimmed have as much calcium without as much fat have equal ability for preventing stones.
Moderate or eliminate alcohol consumption.
Alcohol – beer and spirits increase the risk of gout kidney stones by up to 20%. Wine is generally ok in moderation.
Do Drink water before bed.
Stones seem to grow most at night. When you are sleeping you can not stay hydrated, so drink fluid before sleep.
Consider drinking an additional 500ml of natural orange juice (from concentrate or fresh) or 60ml of lemon juice diluted in a liter of water before bed. Diabetics are recommended to consume lemon juice diluted in water for a lower fructose option than the orange juice.
Hydration before sleep will not dissolve calcium stones, however it will fortify offering a significant amount of potassium citrate, which helps prevent formation of calcium oxalate and urate stones.
Diet for Kidney Stone Symptom Management
Reduce intake of oxalate rich foods
If you’re prone to kidney stones or at risk for kidney disease, ask your doctor if you need to adopt a low-oxalate diet. For most people, particularly on a plant based diet, the benefits of nutrient-dense, high-oxalate foods can outweigh their risks.
WebMD lists 8 foods that are high in Oxalates that should be avoided if kidney pain is an issue. They share why oxalates are and why it is important to avoid them. I had great success on my plant based diet for healing my heart from left ventricular hypertropy.
- Avoid eating foods are especially high in oxalate such as spinach, swiss chard, beans, rhubarb, or beetroot more than twice a week.
- Avoid excess vitamin C supplements like EmergenC (consume less than 1000mg per day), which are turned into oxalate.
With COVID induced Diabetes and Kidney Stones, came some new monitoring requirements for blood sugar management as well as oxalates.
Some of my favorite plant-based foods are high in oxalates. So while they are beneficial for health and nutritionally rich, some of my staple plant based favorites would have to go for the Kidney Stone Diet. Oxalates bind to calcium as they leave the body, can increase the risk of kidney stones for some people.
Follow a Kidney Disease Friendly diet
The American Kidney Foundation offers excellent Kidney Friendly Recipes and a guide to the components of a kidney-friendly diet. The Kidney Stone Diet plan involves reduced sodium, ( less than 6 grams of salt per day).
Eat five fruit and vegetables daily reduce intake of processed foods.
Processed foods have higher salt, added sugar, and fat. Eat unprocessed foods that are good sources of potassium. Patients who consume five portions of unprocessed fruits and vegetables have a lower risk of kidney stones. Potassium is also found in dairy (milk or yogurt), nuts and seeds (especially peanuts, sunflower seeds), all types of beans, vegetables (especially carrots, cabbage, and squash), tomatoes, starchy foods (including pasta, potatoes, and wholemeal bread), fish and pork.
Eat less red meat and processed meat
Eat less than 70 grams (cooked weight) of red or processed meat per day (for a heart and kidney patient, the red meat should be eliminated.
Processed meat refers preserved by smoking, curing, salting or adding preservatives and includes sausages, bacon, ham, salami and pates should be removed for overll health benefits as well as to reduce the risks of heart, kidneys, and bowel cancer diseases.
Maintain a healthy weight and wellness regimen
Lose weight if BMI is over 30
Obesity (when Body Mass Index is greater than 30) increases the risk of kidney stone recurrence by 50% for women and 30% for men. Plan to get active and lose weight gradually by adopting a healthier diet, taking consistent walks. If recovering COVID, discuss exercise with your doctor.
Diabetics with kidney stones need a greater focus
Diabetics with risk of Kidney disease or pain need to watch glucose and eating healthy with proper regular blood glucose management and monitoring.
KIDNEY STONE OBSERVATION AND MANAGEMENT APPROACHES:
What our COVID Patients were have been prescribed for OBSERVATION approach:
Over-the-counter pain medications, like ibuprofen (Advil, Motrin IB), acetaminophen (Tylenol), or naproxen (Aleve), to manage the pain until the stones pass. Doctors may also prescribe an alpha blocker, which relaxes the muscles in your ureter and helps pass stones quicker and with less pain or an antiemetic therapy.
- Ibuprofen – Motrin (600 MG) for pain as directed by doctor
- Metoclopramide (10MG) as directed by doctor
Talk to a qualified medical professional and your doctor to discuss what nutritional and dietary supplements might be right approach for you. Being well read on your condition can help you ask better questsions when meeting with your care team. It is important to understand that one approach does not fit all, and your doctor is your best advisor for what works with your particular medical profile.
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