Skip to main content
SpringerLink
Log in

Dietary recommendations and treatment of patients with recurrent idiopathic calcium stone disease

  • Invited Review
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

This review describes the various dietary regimens that have been used to advise patients on how to prevent the recurrence of their calcium-containing kidney stones. The conclusion is that although there is some general advice that may be useful to many patients, it is more efficacious to screen each patient individually to identify his/her main urinary, metabolic, nutritional, environmental, and lifestyle risk factors for stone-formation and then tailor specific advice for that particular patient based on the findings from these investigations. If the patient can be motivated to adhere strictly to this conservative approach to the prophylactic management of their stone problem over a long time period, then it is possible to prevent them from forming further stones. This approach to stone management is considerably less expensive than any of the procedures currently available for stone removal or disintegration. In the UK, for each new stone episode prevented by this conservative approach to prophylaxis it is calculated to save the Health Authority concerned around £2000 for every patient treated successfully. In the long term, this accumulates to a major saving within each hospital budget if most stone patients can be prevented from forming further stones and when the savings are totalled up country-wide saves the National Exchequer considerable sums in unclaimed Sick Pay and industry a significant number of manpower days which would otherwise be lost from work. It is also of immense relief and benefit to the patients not to have to suffer the discomfort and inconvenience of further stone episodes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

CaOx:

Calcium oxalate

UA:

Uric acid

P sf :

Biochemical probability of forming stones

PRAL:

Potential renal acid load

References

  1. Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the United States: 1976–1994. Kidney Int 63:1817–1823

    Article  PubMed  Google Scholar 

  2. De SK, Liu X, Minga M (2014) Changing trends in the American diet and the rising prevalence of kidney stones. Urology 84:1030–1033

    Article  PubMed  Google Scholar 

  3. Lotan Y (2009) Economics and cost of care of stone disease. Adv Chronic Kidney Dis 16:5–10

    Article  PubMed  Google Scholar 

  4. Turney BW, Reynard JM, Noble JG, Keoghane SR (2012) Trends in urological stone disease. BJU Int 109:1082–1087

    Article  PubMed  Google Scholar 

  5. Robertson WG (2012) General and specific dietary advice for the prevention of stone recurrence. In: Talati JJ, Tiselius H-G, Albala DM, Ye Z (eds) Urolithiasis—basic science and clinical practice. Springer, London, pp 709–720

    Google Scholar 

  6. Robertson WG, Peacock M (1985) The origin of metabolic abnormalities in primary calcium stone disease—natural or unnatural selection? In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York, pp 287–290

    Chapter  Google Scholar 

  7. Andersen DA (1973) Environmental factors in the aetiology of urolithiasis. In: Cifuentes Delatte L, Rapado A, Hodgkinson A (eds) Urinary calculi. Karger, Basael, pp 130–144

    Google Scholar 

  8. Robertson WG, Peacock M, Hodgkinson A (1979) The effect of dietary changes on the incidence of urinary calculi in the UK between 1958 and 1976. J Chron Dis 32:469–476

    Article  CAS  PubMed  Google Scholar 

  9. Robertson WG (1987) Diet and calcium stones. Miner Electrolyte Metab 13:228–234

    CAS  PubMed  Google Scholar 

  10. Curhan GC, Willett WC, Rimm EB, Stampfer MJ (1993) A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. New Engl J Med 328:833–838

    Article  CAS  PubMed  Google Scholar 

  11. Prezioso D, Strazzulo P, Lotti T et al (2015) Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group. Arch Ital Urol Androl 87:105–120

    Article  PubMed  Google Scholar 

  12. Adams F (1939) The genuine works of Hippocrates. Williams and Wilkins, Baltimore

    Google Scholar 

  13. Robertson WG (2003) A risk factor model of stone-formation. Front Biosci 8:1330–1338

    Article  Google Scholar 

  14. Power C, Barker DJ, Nelson M, Winter PD (1984) Diet and renal stones: a case–control study. Br J Urol 56:456–459

    CAS  PubMed  Google Scholar 

  15. Peacock M, Hodgkinson A, Nordin BEC (1967) Importance of dietary calcium in the definition of hypercalciuria. Br Med J 3:469–471

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Robertson WG, Peacock M (1980) The cause of idiopathic calcium stone disease: hypercalciuria or hyperoxaluria? Nephron 26:105–110

    Article  CAS  PubMed  Google Scholar 

  17. Robertson WG, Hughes H (1993) Importance of mild hyperoxaluria in the pathogenesis of urolithiasis—new evidence in the light of the Arabian experience. Scan Microsc 7:391–402

    CAS  Google Scholar 

  18. Erickson SB, Cooper K, Broadus AE, Smith LH, Werness PG, Binder HJ, Dobbins JW (1984) Oxalate absorption and postprandial urine supersaturation in an experimental human model of absorptive hypercalciuria. Clin Sci 67:131–138

    Article  CAS  PubMed  Google Scholar 

  19. Robertson WG, Heyburn PJ, Peacock M, Hanes F, Swaminathan R (1979) The effect of a high animal protein intake on the risk of calcium stone-formation in the urinary tract. Clin Sci 57:285–288

    Article  CAS  PubMed  Google Scholar 

  20. Turney BW, Appleby PN, Reynard JM, Noble JG, Key TJ, Allen NE (2014) Diet and risk of kidney stones in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Epidemiol 29:363–369

    Article  CAS  PubMed  Google Scholar 

  21. Tracy CR, Best S, Bagrodia A, Poindexter JR, Adams-Huet B, Sakhaee K, Maalouf N, Pak CY (2014) Animal protein and the risk of kidney stones: a comparative metabolic study of animal protein sources. J Urol 192:137–141

    Article  CAS  PubMed  Google Scholar 

  22. Massey LK, Whiting SJ (1995) Dietary salt, urinary calcium and kidney stone risk. Nutr Rev 53:131–139

    Article  CAS  PubMed  Google Scholar 

  23. Damasio PC, Amaro CR, Cunha NB, Pichutte AC, Goldberg J, Padovani CR, Amaro JL (2011) The role of salt abuse on risk of hypercalciuria. Nutr J 10:3

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Thom JA, Morris JE, Bishop A, Blacklock NJ (1978) The influence of refined carbohydrate on urinary calcium excretion. Br J Urol 50:459–464

    Article  CAS  PubMed  Google Scholar 

  25. Yasui T, Okada A, Hamamoto S, Hirose M, Ando R, Kubota Y, Tozawa K, Hayashi Y, Gao B, Suzuki S, Kohri K (2013) the association between the incidence of urolithiasis and nutrition based on Japanese national Health and Nutrition Surveys. Urolithiasis 41:217–224

    Article  PubMed  Google Scholar 

  26. Reungjui S, Prasongwatana V, Premgamone A, Tosukhowong P, Jirakulsomchok S, Sriboonlue P (2002) Magnesium status of patients with renal stones and its effect on urinary citrate excretion. BJU Int 90:635–639

    Article  CAS  PubMed  Google Scholar 

  27. Anatol TI, Pinto Pereira L, Matthew J, Sawh L (2005) The relationship of magnesium intake to serum and urinary calcium and magnesium levels in Trinidadian stone formers. In J Urol 12:244–249

    CAS  Google Scholar 

  28. Domrongkitchaiporn S, Stitchantrakul W, Kochakarn W (2006) Causes of hypocitraturia in recurrent calcium stone formers: focusing on urinary potassium excretion. Am J Kidney Dis 48:546–554

    Article  CAS  PubMed  Google Scholar 

  29. Pearle MS, Goldfarb DS, Assimos DG et al (2014) Medical management of kidney stones: AUA guideline. J Urol 192:316–324

    Article  PubMed  Google Scholar 

  30. Robertson WG (2012) Methods for diagnosing the risk factors of stone-formation. Arab J Urol 10:250–257

    Article  PubMed Central  PubMed  Google Scholar 

  31. Shuster J, Finlayson B, Scheaffer R, Sierakowski R, Zoltek J, Dzegede S (1982) Water hardness and urinary stone disease. J Urol 128:422–425

    CAS  PubMed  Google Scholar 

  32. Caudarella R, Rizzoli E, Buffa A, Bottura A, Stefoni S (1998) Comparative study on the influence of 3 types of mineral water in patients with idiopathic calcium lithiasis. J Urol 159:658–663

    Article  CAS  PubMed  Google Scholar 

  33. Schwartz BF, Schenkman NS, Bruce JE, Leslie SW, Stoller ML (2002) Calcium nephrolithiasis; effect of water hardness on urinary electrolytes. Urology 60:23–27

    Article  PubMed  Google Scholar 

  34. Basiri A, Shakhssalim N, Khoshdel AR, Pakmanesh H, Radfar MH (2011) Drinking water composition and incidence of urinary calculus: introducing a new index. Iran J Kidney Dis 5:15–20

    PubMed  Google Scholar 

  35. Pak CYC, Sakhaee K, Crowther C, Brinkley L (1980) Evidence justifying a high fluid intake in treatment of nephrolithiasis. Ann Intern Med 93:36–39

    Article  CAS  PubMed  Google Scholar 

  36. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A (1996) Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155:839–843

    Article  CAS  PubMed  Google Scholar 

  37. Lotan Y, Buendia Jiménez I, Lenoir-Wijnkoop I, Daudon M, Molinier L, Tack I, Nuijten MJ (2013) Increased water intake as a prevention strategy for recurrent urolithiasis: major impact of compliance on cost-effectiveness. J Urol 189:935–939

    Article  CAS  PubMed  Google Scholar 

  38. Xu H, Zisman AL, Coe FL, Worcester EM (2013) Kidney stones: an update on current pharmacological management and future directions. Expert Opin Pharmacother 14:435–447

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Cheungpasitporn W, Rossetti S, Friend K, Erickson SB, Lieske JC (2015) Treatment effect, adherence, and safety of high fluid intake for the prevention of incident and recurrent kidney stones: a systematic review and meta-analysis. J Nephrol. doi:10.1007/s40620-015-0210-4

  40. Ticinesi A, Nouvenne A, Borghi L, Meschi T (2015) Water and other fluids in nephrolithiasis: state of the art and future challenges. Crit Rev Food Sci Nutr (Epub ahead of print)

  41. Al-Ali IH, Husain I, Robertson WG, Ouimet E, Waheed SA (1981) Metabolic aspects of calcium oxalate urolithiasis and the effect of allopurinol. Emirates Med J 3:292–299

    Google Scholar 

  42. Robertson WG (2012) Stone-formation in the Middle Eastern Gulf States—a review. Arab J Urol 10:265–272

    Article  PubMed Central  PubMed  Google Scholar 

  43. Jaeger Ph, Robertson WG (2004) Role of dietary intake and intestinal absorption in calcium stone-formation. Nephron Physiol 98:64–71

    Article  CAS  Google Scholar 

  44. Nouvenne A, Meschi T, Guerra A, Allegri F, Prati B, Fiaccadori E, Maggiore U, Borghi L (2009) Diet to reduce mild hyperoxaluria in patients with idiopathic calcium oxalate stone formation: a pilot study. Urology 73:725–730

    Article  PubMed  Google Scholar 

  45. Lange JN, Easter L, Amoroso R, Benfield D, Mufarri PW, Knight J, Holmes RP, Assimos DG (2013) Internet program for facilitating dietary modifications limiting kidney stone risk. Can J Urol 20:6922–6926

    PubMed  Google Scholar 

  46. Marshall RW, Cochran M, Hodgkinson A (1972) Relationship between calcium and oxalic acid intake in the diet and their excretion in the urine of normal and renal stone-forming subjects. Clin Sci 43:91–99

    Article  CAS  PubMed  Google Scholar 

  47. Lieske JC, Tremaine WJ, De Simone C, O’Connor HM, Li X, Bergstralh EJ, Goldfarb DS (2010) Diet, but not oral probiotics, effectively reduces urinary oxalate excretion and calcium oxalate supersaturation. Kidney Int 78:1178–1185

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. Terris MK, Issa MM, Tacker JR (2001) Dietary supplementation with cranberry concentrate tablets may increase the risk of nephrolithiasis. Urology 57:26–29

    Article  CAS  PubMed  Google Scholar 

  49. Harris KS, Richardson KE (1980) Glycolate in the diet and its conversion to urinary oxalate in the rat. Invest Urol 18:106–109

    CAS  PubMed  Google Scholar 

  50. Khan SR, Glenton PA, Byer KJ (2007) Dietary oxalate and calcium oxalate nephrolithiasis. J Urol 178:2191–2196

    Article  CAS  PubMed  Google Scholar 

  51. Wiessner JH, Garrett MR, Hung LY, Wille DF, Mandel NS (2011) Improved methodology to induce hyperoxaluria without treatment using hydroxyproline. Urol Res 39:373–377

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  52. Robertson WG, Peacock M (unpublished data)

  53. Nguyen Q-V, Kälin A, Drouve U, Casez J-P, Jaeger Ph (2001) Sensitivity to meat protein intake and hyperoxaluria in idiopathic calcium stone-formers. Kidney Int 59:2273–2281

    Article  CAS  PubMed  Google Scholar 

  54. Marangella M, Bianco O, Martini C, Petrarulo M, Vitale C, Linari F (1989) Effect of animal and vegetable protein on oxalate excretion in idiopathic calcium stone disease. Br J Urol 63:348–351

    Article  CAS  PubMed  Google Scholar 

  55. Urivetsky M, Kessaris D, Smith AD (1992) Ascorbic acid overdosing: a risk factor for calcium oxalate nephrolithiasis. J Urol 147:1215–1218

    Google Scholar 

  56. Auer BL, Auer D, Rodgers AL (1998) Relative hyperoxaluria, crystalluria and haematuria after megadose ingestion of vitamin C. Eur J Clin Invest 28:695–700

    Article  CAS  PubMed  Google Scholar 

  57. Traxer O, Huet B, Poindexter J, Pak CYC, Pearle MS (2003) Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 170:397–401

    Article  CAS  PubMed  Google Scholar 

  58. Taylor EN, Curhan GC (2008) Determinants of 24-h urinary oxalate excretion. Clin J Am Soc Nephrol 3:1453–1460

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  59. Gerster H (1997) No contribution of ascorbic acid to renal calcium oxalate stones. Ann Nutr Metab 41:269–282

    Article  CAS  PubMed  Google Scholar 

  60. Brinkley L, McGuire J, Gregory J, Pak CYC (1981) Bioavailability of oxalate in foods. Urology 17:534–538

    Article  CAS  PubMed  Google Scholar 

  61. Hossain RZ, Ogawa Y, Morozumi M, Sugaya K, Hatano T (2003) Urinary oxalic acid differs after oral loading of rats with various oxalate salts. Int J Urol 10:43–48

    Article  CAS  PubMed  Google Scholar 

  62. Gasińska A, Gajewska D (2007) Tea and coffee as the main sources of oxalate in diets of patients with kidney oxalate stones. Rocz Panstw Zakl Hig 58:61–67

    PubMed  Google Scholar 

  63. Savage GP, Charrier MJ, Vanhanen L (2003) Bioavailability of soluble oxalate from tea and the effect of consuming milk with the tea. Eur J Clin Nutr 57:415–419

    Article  CAS  PubMed  Google Scholar 

  64. Brogren M, Savage GP (2003) Bioavailability of soluble oxalate from spinach eaten with an without milk products. Asia Pac J Nutr 12:219–224

    CAS  Google Scholar 

  65. Earnest DL, Williams HE, Admirand WH (1975) A physicochemical basis for treatment of enteric hyperoxaluria. Trans Assoc Am Physicians 88:224–234

    CAS  PubMed  Google Scholar 

  66. Hylander E, Jarnum S, Nielsen K (1980) Calcium treatment of enteric hyperoxaluria after jejunoileal bypass for morbid obesity. Scand J Gastroenterol 15:349–352

    Article  CAS  PubMed  Google Scholar 

  67. Takei K, Ito H, Masai M, Kotake T (1998) Oral calcium supplement decreases urinary oxalate excretion in patients with enteric hyperoxaluria. Urol Int 61:192–195

    Article  CAS  PubMed  Google Scholar 

  68. Robertson WG, Hughes H, Husain I, Al-Faqih S, Arafat A, Chakrabarti A, Shamsuddin A, Tipton L (1994) Simultaneous treatment of calcium oxalate and uric acid stone disease in Saudi Arabia. In: Ryall R, Bais R, Marshall VR, Rofe AM, Smith LH, Walker VR (eds) Urolithiasis 2. Plenum Press, New York, pp 581–586

    Chapter  Google Scholar 

  69. Rodgers AL, Allie-Hamdulay S, Jackson GE, Sutton RA (2014) Enteric hyperoxaluria secondary to small bowel resection: use of computer simulation to characterize urinary risk factors for stone formation and assess potential treatment protocols. J Endourol 28:985–994

    Article  PubMed  Google Scholar 

  70. Gleeson MJ, Thompson AS, Mehta S, Griffith DP (1990) Effect of unprocessed wheat bran on calciuria and oxaluria in patients with urolithiasis. Urology 35:231–234

    Article  CAS  PubMed  Google Scholar 

  71. Hanson CF, Frankos VH, Thompson WO (1989) Bioavailability of oxalic acid from spinach, sugar beet fibre and a solution of sodium oxalate consumed by female volunteers. Food Chem Toxicol 27:181–184

    Article  CAS  PubMed  Google Scholar 

  72. Hatch M, Freel RW, Vaziri ND (1994) Mechanisms of oxalate absorption and secretion across the rabbit distal colon. Pflügers Arch 426:101–109

    Article  CAS  PubMed  Google Scholar 

  73. Allison MJ, Dawson KA, Mayberry WR, Foss JG (1985) Oxalobacter formigenes gen. nov., sp. nov.: oxalate-degrading anaerobes that inhabit the gastrointestinal tract. Arch Microbiol 141:1–7

    Article  CAS  PubMed  Google Scholar 

  74. Kwak C, Kim HK, Kim EC, Choi MS, Kim HH (2003) Urinary oxalate levels and the enteric bacterium Oxalobacter formigenes in patients with calcium oxalate urolithiasis. Eur Urol 44:475–481

    Article  CAS  PubMed  Google Scholar 

  75. Kumar R, Mukherjee M, Bhandari M, Kumar A, Sidhu H, Mittal RD (2002) Role of Oxalobacter formigenes in calcium oxalate stone disease: a study from North India. Eur Urol 41:318–322

    Article  CAS  PubMed  Google Scholar 

  76. Troxel SA, Sidhu H, Kaul P, Low RK (2003) Intestinal Oxalobacter formigenes colonization in calcium oxalate stone formers and its relation to urinary oxalate. J Endourol 17:173–176

    Article  PubMed  Google Scholar 

  77. Mikami K, Akakura K, Takei K, Ueda T, Mizoguchi K, Noda M, Miyake M, Ito H (2003) Association of absence of intestinal oxalate degrading bacteria with urinary calcium oxalate stone formation. Int J Urol 10:293–296

    Article  PubMed  Google Scholar 

  78. Siener R, Bangen U, Sidhu H, Hönow R, von Unruh G, Hesse A (2013) The role of Oxalobacter formigenes colonization in calcium oxalate stone disease. Kidney Int 83:1144–1149

    Article  CAS  PubMed  Google Scholar 

  79. Campieri C, Campieri M, Bertuzzi V, Swennen E, Matteuzzi D, Stefoni S, Pirovano F, Centi C, Ulisse S, Famularo G, De Simone C (2001) Reduction of oxaluria after an oral course of lactic acid bacteria at high concentration. Kidney Int 60:1097–1105

    Article  CAS  PubMed  Google Scholar 

  80. Stewart CS, Duncan SH, Cave DR (2004) Oxalobacter formigenes and its role in oxalate metabolism in the human gut. FEMS Microbiol Lett 230:1–7

    Article  CAS  PubMed  Google Scholar 

  81. Nordin BEC, Barry H, Bulusu L, Speed R (1973) Dietary treatment of recurrent calcium stone disease. In: Rapado A, Hodgkinson A, Cifuentes Delatte L (eds) Urinary calculi. Karger, Basel, pp 170–176

    Google Scholar 

  82. Messa P, Marangella M, Paganin L, Codardini M, Cruciatti A, Turrin D, Filiberto Z, Mioni G (1997) Different dietary calcium intake and relative supersaturation of calcium oxalate in the urine of patients forming renal stones. Clin Sci 93:257–263

    Article  CAS  PubMed  Google Scholar 

  83. Willis S, Thomas K (2010) Do oral calcium supplements increase the risk of urolithiasis? BJU Int 106:155–159

    Article  CAS  PubMed  Google Scholar 

  84. Sedrani SH (1984) Low 25-hydroxy vitamin D and normal serum calcium concentrations in Saudi Arabia: Riyadh region. Ann Nutr Metab 28:181–185

    Article  CAS  PubMed  Google Scholar 

  85. Goldfarb DS (2009) Prospects for dietary therapy of recurrent urolithiasis. Adv Chronic Kidney Dis 16:21–29

    Article  PubMed  Google Scholar 

  86. Sorensen MD, Kahn AJ, Reiner AP et al (2012) Impact of nutritional factors on incident kidney stone formation: a report from the WHI OS. J Urol 187:1645–1649

    Article  PubMed Central  PubMed  Google Scholar 

  87. Hess B, Jost C, Zipperle L, Takkinen R, Jaeger Ph (1998) High-calcium intake abolishes hyperoxaluria and reduces urinary crystallization during a 20-fold normal oxalate load in humans. Nephrol Dial Transplant 13:2241–2247

    Article  CAS  PubMed  Google Scholar 

  88. Siener R, Jahnen A, Hesse A (2004) Influence of a mineral water rich in calcium, magnesium and bicarbonate on urine composition and the risk of calcium oxalate crystallization. Eur J Clin Nutr 58:270–276

    Article  CAS  PubMed  Google Scholar 

  89. Robertson WG (2015) Potential role of fluctuations in the composition of renal tubular fluid through the nephron in the initiation of Randall’s Plugs and calcium oxalate crystalluria in a computer model of renal function. Urolithiasis 43(Suppl 1):S93–S107

    Article  CAS  Google Scholar 

  90. Basiri A, Shakhssalim N, Khoshdel AR, Radfar MH, Pakmanesh H (2009) Influential nutrient in urolithiasis incidence: protein or meat? J Ren Nutr 19:396–400

    Article  CAS  PubMed  Google Scholar 

  91. Caldwell EF, Mayor LR, Thomas MG, Danpure CJ (2004) Diet and the frequency of the alanine:glyoxylate aminotransferase PRO11Leu polymorphism in different human populations. Hum Genet 115:504–509

    Article  CAS  PubMed  Google Scholar 

  92. Knight J, Easter LH, Neiberg R, Assimos DG, Holmes RP (2009) Increased protein intake on controlled oxalate diets does not increase urinary oxalate excretion. Urol Res 37:63–68

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  93. Barkworth SA, Louis S, Walker VR, Hughes H, Robertson WG (1989) Stone type and urine composition in the Middle East with particular reference to Saudi Arabia. In: Walker VR, Sutton RAL, Cameron ECB, Pak CYC, Robertson WG (eds) Urolithiasis. Plenum Press, New York, p 715

    Chapter  Google Scholar 

  94. Robertson WG, Peacock M, Heyburn PJ, Hanes F, Rutherford A, Clementson E, Swaminathan R, Clark PB (1979) Should recurrent, calcium-containing stone-formers become vegetarians? Br J Urol 51:427–431

    Article  CAS  PubMed  Google Scholar 

  95. Siener R, Hesse A (2003) The effect of vegetarian and different omnivorous diets on urinary risk factors for uric acid stone formation. Eur J Nutr 42:332–337

    Article  CAS  PubMed  Google Scholar 

  96. Robertson WG, Peacock M, Marshall DH (1982) Prevalence of urinary stone disease in vegetarians. Eur Urol 8:334–339

    CAS  PubMed  Google Scholar 

  97. Sorensen MD, His RS, Chi T et al (2014) Dietary intake of fiber, fruit and vegetables decreases the risk of incident kidney stones in women: a Women’s Health Initiative report. J Urol 192:1694–1699

    Article  PubMed Central  PubMed  Google Scholar 

  98. Giannini S, Nobile M, Sartori L et al. (1999) Acute effects of moderate dietary protein restriction in patients with idiopathic hypercalciuria and calcium nephrolithiasis. Am J Clin Nutr 69:267–271

    CAS  PubMed  Google Scholar 

  99. Rotily M, Léonetti F, Iovanna C, Berthezene P, Dupuy P, Vazi A, Berland Y (2000) Effects of low animal protein or high-fiber diets on urine composition in calcium nephrolithiasis. Kidney Int 57:1115–1123

    Article  CAS  PubMed  Google Scholar 

  100. Borghi L, Schianci T, Meschi T, Guerra A, Allegri F, Maggiore U, Novarini A (2002) Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. New Engl J Med 346:77–84

    Article  CAS  PubMed  Google Scholar 

  101. Van Den Berg CJ, Kumar R, Wilson DM, Heath H 3rd, Smith LH (1980) Orthophosphate therapy decreases urinary calcium excretion and serum 1,25-dihydroxy vitamin D concentrations in idiopathic hypercalciuria. J Clin Endocrinol Metab 51:998–1001

    Article  Google Scholar 

  102. Heyburn PJ, Robertson WG, Peacock M (1982) Phosphate treatment of recurrent calcium stone disease. Nephron 32:314–319

    Article  CAS  PubMed  Google Scholar 

  103. Fleisch H, Bisaz S (1962) Isolation from urine of pyrophosphate, a calcification inhibitor. Am J Physiol 203:671–675

    CAS  PubMed  Google Scholar 

  104. Fleisch H, Bisaz S (1964) The inhibitory effect of pyrophosphate on calcium oxalate precipitation and its relation to urolithiasis. Experientia 20:276–277

    Article  CAS  PubMed  Google Scholar 

  105. Ettinger B (1976) Recurrent nephrolithiasis: natural history and effect of phosphate therapy. A double-blind controlled study. Am J Med 61:200–206

    Article  CAS  PubMed  Google Scholar 

  106. Johansson G, Backman U, Danielson BG, Fellström B, Ljunghall S, Wikström B (1980) Biochemical and clinical effects of the prophylactic treatment of renal calcium stones with magnesium hydroxide. J Urol 124:770–774

    CAS  PubMed  Google Scholar 

  107. Lindberg J, Harvey J, Pak CYC (1990) Effect of magnesium citrate and magnesium oxide on the crystallization of calcium salts in urine: changes produced by food-magnesium interaction. J Urol 143:248–251

    CAS  PubMed  Google Scholar 

  108. Zerwekh JE, Odvina CV, Wuermser LA, Pak CY (2007) Reduction of renal stone risk by potassium-magnesium citrate during 5 weeks of bed rest. J Urol 177:2179–2184

    Article  CAS  PubMed  Google Scholar 

  109. Eisner BH, Sheth S, Dretler SP, Herrick B, Pais VM Jr (2012) High dietary magnesium intake decreases hyperoxaluria in patients with nephrolithiasis. Urology 80:780–783

    Article  PubMed  Google Scholar 

  110. Simpson DP (1967) Regulation of renal citrate metabolism by bicarbonate ion and pH: observations in tissue slices and mitochondria. J Clin Invest 46:225–238

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  111. Pak CY, Sakhaee K, Fuller CJ (1983) Physiological and physiochemical correction and prevention of calcium stone formation by potassium citrate therapy. Trans Assoc Am Physicians 96:294–305

    CAS  PubMed  Google Scholar 

  112. Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak CY (1993) Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 150:1761–1764

    CAS  PubMed  Google Scholar 

  113. Jendle-Bengten C, Tiselius HG (2000) Long-term follow-up of stone-formers treated with a low dose of sodium potassium citrate. Scand J Urol Nephrol 34:36–41

    Article  CAS  PubMed  Google Scholar 

  114. Unwin RJ, Robertson WG (unpublished data)

  115. Coe FL, Evan A, Worcester EM (2011) Pathophysiology-based treatment of idiopathic calcium kidney stones. Clin J Am Soc Nephrol 6:2083–2092

    Article  PubMed  Google Scholar 

  116. Mandel EI, Taylor EN, Curhan GC (2013) Dietary and lifestyle factors and medical conditions associated with urinary citrate excretion. Clin J Am Soc Nephrol 8:901–908

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  117. Kohjimoto Y, Sasaki Y, Iguchi M, Inagaki T, Hara I (2013) Association of metabolic syndrome traits and severity of kidney stones: results from a nationwide survey on urolithiasis in Japan. Am J Kidney Dis 61:923–929

    Article  PubMed  Google Scholar 

  118. Robertson WG, Nair D, Laing C, Choong S, Jaeger P, Unwin RJ (2008) The role of “Metabolic Syndrome” in the formation of uric acid-containing stones. Urol Res 36:177–178

    Google Scholar 

  119. Maalouf NM (2011) Metabolic syndrome and the genesis of uric acid stones. J Ren Nutr 21:128–131

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  120. Weaver CM, Heaney RP, Martin BR, Fitzsimmons ML (1991) Human calcium absorption from whole-wheat products. J Nutr 121:1769–1775

    CAS  PubMed  Google Scholar 

  121. Nouvenne A, Meschi T, Prati B et al (2010) Effects of a low-salt diet on idiopathic hypercalciuria in calcium oxalate stone formers: a 3-mo randomized controlled trial. Am J Clin Nutr 91:565–570

    Article  CAS  PubMed  Google Scholar 

  122. Barilla DE, Townsend J, Pak CYC (1978) An exaggerated augmentation of renal calcium excretion after oral glucose in patients with renal hypercalciuria. Invest Urol 15:486–488

    CAS  PubMed  Google Scholar 

  123. Rao PN, Prendiville V, Buxton A, Moss DG, Blacklock NJ (1982) Dietary management of urinary risk factors in renal stone formers. Br J Urol 54:578–583

    Article  CAS  PubMed  Google Scholar 

  124. Remer T, Manz F (1995) Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc 95:791–797

    Article  CAS  PubMed  Google Scholar 

  125. Trinchieri A, Maletta A, Lizzano R, Marchesotti F (2013) Potential renal acid load and the risk of renal stone formation in case–control study. Eur J Clin Nutr 67:1077–1080

    Article  CAS  PubMed  Google Scholar 

  126. Taylor EN, Stampfer MJ, Curhan GC (2004) Dietary factors and the risk of incident kidney stones in men: new insights after 14 years follow-up. J Am Soc Nephrol 15:3225–3232

    Article  PubMed  Google Scholar 

  127. Taylor EN, Fung TT, Curhan GC (2009) DASH-style diet associates with reduced risk for kidney stones. J Am Soc Nephrol 20:2253–2259

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  128. Taylor EN, Stampfer MJ, Mount DB, Curhan GC (2010) DASH-style diet and 24-hour urine composition. Clin J Am Soc Nephrol 5:2315–2322

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  129. Noori N, Honarker E, Goldfarb DS et al (2014) Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: a randomized controlled trial comparing DASH (Dietary Approaches to Stop Hypertension)-style and low-oxalate diets. Am J Kidney Dis 63:456–463

    Article  CAS  PubMed  Google Scholar 

  130. Robertson WG (1998) The medical management of urinary stone disease. Eur Urol Update Series 7:139–144

    Google Scholar 

  131. Lotan Y, Buendia Jiménez I, Lenoir-Wijnkoop I, Daudon M, Molinier L, Tack I, Nuijten MJ (2012) Primary prevention of nephrolithiasis is cost-effective for a national healthcare system. BJU Int 110:E1060–E1067

    Article  PubMed  Google Scholar 

  132. Norman RW, Bath SS, Robertson WG, Peacock M (1984) When should patients with symptomatic stone disease be evaluated metabolically? J Urol 132:1137–1139

    CAS  PubMed  Google Scholar 

  133. Robertson WG (2011) Establishment and management of a stone clinic. In: Rao NP, Preminger GM, Kavanagh JP (eds) Urinary tract stone disease. Springer, London, pp 641–650

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford, OX3 9DU, UK

    W. G. Robertson

Authors
  1. W. G. Robertson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. G. Robertson.

Ethics declarations

Conflict of interest

There is no conflict of interest involved in the writing of this review.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robertson, W.G. Dietary recommendations and treatment of patients with recurrent idiopathic calcium stone disease. Urolithiasis 44, 9–26 (2016). https://doi.org/10.1007/s00240-015-0849-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-015-0849-2

Keywords

Search

Navigation