Prospects for dietary therapy of recurrent nephrolithiasis
- PMID: 19095202
- DOI: 10.1053/j.ackd.2008.10.010
Prospects for dietary therapy of recurrent nephrolithiasis
Abstract
The goal of this article is to propose a randomized controlled trial (RCT) that tests a hypothesis that dietary manipulation prevents recurrent kidney stones. Dietary interventions based on epidemiologic and pathophysiologic data are reviewed. The only diet trial successful in preventing stones showed that calcium intake of 1,200 mg/d, accompanied by restriction of animal protein, salt, and oxalate ingestion, was superior to 400 mg of calcium and restricted oxalate intake. This study may be worth repeating in women and in a society in which salt restriction might be less effective (eg, United States). The net result of diet trials establishes significant positive effects on urine chemistries, but these have not yet shown efficacy with regard to stone recurrence. Oxalate restriction alone could be effective, but many questions regarding which populations to study are not defined, and dietary oxalate's contribution to stone formation is disputed. Would such a study be limited to patients identified as having high dietary oxalate intake or high intestinal oxalate absorption? Would colonization with Oxalobacter formigenes influence the result? The increased prevalence of stones is linked to weight gain and obesity, making weight loss a possible therapy to prevent stones. Randomized trials show that diets consisting of low-fat content or low-caloric content cause modest weight loss and might be effective in reducing stone formation. Because the efficacy of thiazides in the prevention of stones in patients with hypercalciuria is clear, I propose dietary comparison of higher calcium intake to thiazides for the prevention of calcium-based kidney stones.
Similar articles
-
Update on the medical management of stone disease.Curr Opin Urol. 2009 Mar;19(2):200-4. doi: 10.1097/MOU.0b013e328323a81d. Curr Opin Urol. 2009. PMID: 19188774 Review.
-
[Diet and nutrition in nephrolitiasis].Clin Ter. 2007 Jan-Feb;158(1):49-54. Clin Ter. 2007. PMID: 17405659 Italian.
-
[Randomized trials in the prevention of recurrent calcium oxalate stones].Nephrologie. 2003;24(6):303-7. Nephrologie. 2003. PMID: 14584297 Review. French.
-
Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria.N Engl J Med. 2002 Jan 10;346(2):77-84. doi: 10.1056/NEJMoa010369. N Engl J Med. 2002. PMID: 11784873 Clinical Trial.
-
Prevention of recurrent nephrolithiasis.Am Fam Physician. 1999 Nov 15;60(8):2269-76. Am Fam Physician. 1999. PMID: 10593318 Review.
Cited by
-
A polymorphism in the 3'-untranslated region of the matrix metallopeptidase 9 gene is associated with susceptibility to idiopathic calcium nephrolithiasis in the Chinese population.J Int Med Res. 2020 Dec;48(12):300060520980211. doi: 10.1177/0300060520980211. J Int Med Res. 2020. PMID: 33345667 Free PMC article.
-
SaRNA-mediated activation of TRPV5 reduces renal calcium oxalate deposition in rat via decreasing urinary calcium excretion.Urolithiasis. 2018 Jun;46(3):271-278. doi: 10.1007/s00240-017-1004-z. Epub 2017 Aug 3. Urolithiasis. 2018. PMID: 28776078
-
Epidemiology of stone disease across the world.World J Urol. 2017 Sep;35(9):1301-1320. doi: 10.1007/s00345-017-2008-6. Epub 2017 Feb 17. World J Urol. 2017. PMID: 28213860 Review.
-
Dietary recommendations and treatment of patients with recurrent idiopathic calcium stone disease.Urolithiasis. 2016 Feb;44(1):9-26. doi: 10.1007/s00240-015-0849-2. Epub 2015 Dec 8. Urolithiasis. 2016. PMID: 26645870 Review.
-
Medical and alternative therapies in urinary tract stone disease.World J Nephrol. 2015 Nov 6;4(5):492-9. doi: 10.5527/wjn.v4.i5.492. World J Nephrol. 2015. PMID: 26558186 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical