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A case-based review of dietary management of calcium oxalate stones

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Abstract

Purpose

The purpose of this paper is to help patients with calcium oxalate stones to access prevention and treatment options with dietary management.

Methods

Typical cases in our hospital and other hospitals were selected for case review; combined with literature review through PubMed search, comprehensive analysis and suggestions were put forward.

Results

By retrieving the literature with sufficient evidence, selecting, and summarizing, analysis of dietary liquid, oxalate and oxalate precursors, calcium, protein, fruits and vegetables, salt, high dietary fiber, and other content with high evidence index was carried out, respectively.

Conclusion

Through the retrospective analysis of typical cases and literature review, the importance of diet management in the prevention and treatment of calcium oxalate stones was emphasized again, and suggestions were put forward to promote the prevention and treatment of calcium oxalate stones.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

References

  1. Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT (1979) Renal stone epidemiology: a 25-year study in Rochester. Minnesota Kidney Int 16:624–631

    Article  CAS  PubMed  Google Scholar 

  2. Pak CYC (1998) Kidney stone. Lancet 351:1797–1801

    Article  CAS  PubMed  Google Scholar 

  3. Trinchieri A, Coppi F, Montanari E, Nero AD, Zanetti G, Pisani E (2000) Increase in the prevalence of symptomatic upper urinary track stones during the last ten years. Eur Urol 37:23–25

    Article  CAS  PubMed  Google Scholar 

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

    Google Scholar 

  5. Hesse A, Br€andle E, Wilbert D, K€ohrmann KU, Alken P (2003) Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 44:709–713

    Article  CAS  PubMed  Google Scholar 

  6. Turney BW, Reynard JM, Noble JG, Keoghane SR (2019) Trends in urological stone disease. BJU Int 109:1082–1087

    Article  Google Scholar 

  7. Romero V, Akpinar H, Assimos DG (2010) Kidney stones: a global picture of prevalence, incidence, and associated risk factors. Rev Urol 12:e86-96

    PubMed  PubMed Central  Google Scholar 

  8. Zeng G, Mai Z, Xia S, Wang Z, Zhang K, Wang L, Long Y, Ma J, Li Y, Wan SP, Wu W, Liu Y, Cui Z, Zhao Z, Qin J, Zeng T, Liu Y, Duan X, Mai X, Yang Z, Kong Z, Zhang T, Cai C, Shao Y, Yue Z, Li S, Ding J, Tang S, Ye Z (2017) Prevalence of kidney stones in China: an ultrasonography based cross-sectional study. BJU Int 120(1):109–116

    Article  PubMed  Google Scholar 

  9. Safarinejad MR (2007) Adult urolithiasis in a population-based study in Iran: prevalence, incidence, and associated risk factors. Urol Res 35:73–82

    Article  PubMed  Google Scholar 

  10. Alatab S, Pourmand G, Howairis ME et al (2016) National profiles of urinary calculi: a comparison between developing and developed worlds. Iran J Kidney Dis 10:51–61

    PubMed  Google Scholar 

  11. 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 

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

    Article  CAS  Google Scholar 

  13. Fakhoury MQ, Gordon B, Shorter B, Renson A, Borofsky MS, Cohn MR, Cabezon E, Wysock JS, Bjurlin MA (2019) Perceptions of dietary factors promoting and preventing nephrolithiasis: a cross-sectional survey. World J Urol 37(8):1723–1731

    Article  PubMed  Google Scholar 

  14. Zhai F, Wang H, Du S et al (2007) Lifespan nutrition and changing socioeconomic conditions in China. Asia Pac J Clin Nutr 16(Suppl. 1):374–382

    PubMed  Google Scholar 

  15. Singh P, Enders FT, Vaughan LE et al (2015) Stone composition among first-time symptomatic kidney stone formers in the community. Mayo Clin Proc 90:1356–1365

    Article  PubMed  Google Scholar 

  16. Lieske JC, Rule AD, Krambeck AE et al (2014) Stone composition as a function of age and sex. Clin J Am Soc Nephrol 9:2141–2146

    Article  PubMed  PubMed Central  Google Scholar 

  17. Worcester EM, Coe FL (2010) Clinical practice. Calcium kidney stones. N Engl J Med 363:954–963

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Worcester EM, Coe FL (2008) New insights into the pathogenesis of idiopathic hypercalciuria. Semin Nephrol 28:120–132

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Park S, Pearle MS (2007) Pathophysiology and management of calcium stones. Urol Clin North Am 34:323–334

    Article  PubMed  Google Scholar 

  20. Moe OW (2006) Kidney stones: pathophysiology and medical management. The Lancet 367:333–344

    Article  CAS  Google Scholar 

  21. Bhasin B, Ürekli HM, Atta MG (2015) Primary and secondary hyperoxaluria: understanding the enigma. World J Nephrol 4:235–244

    Article  PubMed  PubMed Central  Google Scholar 

  22. Šálek T (2020) Extreme diet without calcium may lead to hyperoxaluria and kidney stone recurrence-a case study. J Clin Lab Anal 34(12):e23512

    Article  PubMed  PubMed Central  Google Scholar 

  23. 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 

  24. Borghi L, Meschi T, Amato F et al (1996) Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155:839

    Article  CAS  PubMed  Google Scholar 

  25. Sarica K, Inal Y, Erturhan S, Yagci F (2006) The effect of calcium channel blockers on stone regrowth and recurrence after shock wave lithotripsy. Urol Res 34:184–189

    Article  CAS  PubMed  Google Scholar 

  26. Frank M, De Vries A, Tikva P (1966) Prevention of urolithiasis: education to adequate fluid intake in a new town situated in the Judean Desert Mountains. Arch Environ Health 13:625–630

    Article  CAS  PubMed  Google Scholar 

  27. Coen G, Sardella D, Barbera G et al (2001) Urinary composition and lithogenic risk in normal subjects following oligomineral versus bicarbonate-alkaline high calcium mineral water intake. Urol Int 67:49–53

    Article  CAS  PubMed  Google Scholar 

  28. Gutenbrunner C, Gilsdorf K, Hildebrandt G (1989) The effect of mineral water containing calcium on supersaturation of urine with calcium oxalate. Urologe A 28:15–19

    CAS  PubMed  Google Scholar 

  29. Rodgers AL (1998) The influence of South African mineral water on reduction of risk of calcium oxalate kidney stone formation. S AfrMed J 88:448–451

    CAS  Google Scholar 

  30. Trinchieri A, Boccafoschi C, Chisena S et al (1999) Study of the diuretic efficacy and tolerability of therapy with Rocchetta mineral water in patients with recurrent calcium kidney stones. Arch Ital Urol Androl 71:121–124

    CAS  PubMed  Google Scholar 

  31. Karagülle O, Smorag U, Candir F et al (2007) Clinical study on the eVect of mineral waters containing bicarbonate on the risk of urinary stone formation in patients with multiple episodes of CaOx-urolithiasis. World J Urol 25:315–323

    Article  PubMed  Google Scholar 

  32. Bertaccini A, Borghesi M (2009) Indications for a medium mineral high bicarbonate water (Cerelia) in urology. Arch Ital Urol Androl 81:192–194

    PubMed  Google Scholar 

  33. Siener R, Jahnen A (2004) Hesse A 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 

  34. Zimmermann DJ, Hesse A, von Unruh GE (2005) Influence of a high oxalate diet on intestinal oxalate absorption. World J Urol 23:324–329

    Article  CAS  PubMed  Google Scholar 

  35. Butz M, Hoffmann H, Kohlbecker G (1980) Dietary influence on serum and urinary oxalate in healthy subjects and oxalate stone formers. Urol Int 35:309–1514

    Article  CAS  PubMed  Google Scholar 

  36. Siener R, Ebert D, Nicolay C, Hesse A (2003) Dietary risk factors for hyperoxaluria in calcium oxalate stone formers. Kidney Int 63:1037–1043

    Article  PubMed  Google Scholar 

  37. Massey LK, Sutton RA (1993) Modification of dietary oxalate and calcium reduces urinary oxalate in hyperoxaluric patients with kidney stones. J Am Diet Assoc 93:1305–1307

    Article  CAS  PubMed  Google Scholar 

  38. Kırac M, Küpeli B, Irkilata L et al (2013) Effects of dietary interventions on 24-hour urine parameters in patients with idiopathic recurrent calcium oxalate stones. Kaohsiung J Med Sci 29:88–92

    Article  PubMed  Google Scholar 

  39. Siener R, Hesse A (2002) The effect of different diets on urine composition and the risk of calcium oxalate crystallisation in healthy subjects. Eur Urol 42:289–296

    Article  PubMed  Google Scholar 

  40. Ferraro PM, Curhan GC, D’Addessi A, Gambaro G (2017) Risk of recurrence of idiopathic calcium kidney stones: analysis of data from the literature. J Nephrol 30:227–233

    Article  PubMed  Google Scholar 

  41. Reiner AP, Kahn A, Eisner BH, Pletcher MJ, Sadetsky N, Williams OD, Polak JF, Jacobs DR, Stoller ML (2011) Kidney stones and subclinical atherosclerosis in young adults: the CARDIA study. J Urol 185:920–925

    Article  PubMed  Google Scholar 

  42. Sakhaee K (2008) Nephrolithiasis as a systemic disorder. Curr Opin Nephrol Hypertens 17:304–309

    Article  PubMed  Google Scholar 

  43. Friedlander JI, Antonelli JA, Pearle MS (2015) Diet: from food to stone. World J Urol 33(2):179–185

    Article  CAS  PubMed  Google Scholar 

  44. Nakada T, Sasagawa I, Furuta H et al (1988) Effect of high-calcium diet on urinary oxalate excretion in urinary stone formers. Eur Urol 15:264–270

    Article  CAS  PubMed  Google Scholar 

  45. Cupisti A (2011) Update on nephrolithiasis: Beyond symptomatic urinary tract obstruction. J Nephrol 24(Suppl. 18):S25–S29

    Article  PubMed  Google Scholar 

  46. Lange JN, Mufarrij PW, Wood KD, Holmes RP, Assimos DG (2012) The association of cardiovascular disease and metabolic syndrome with nephrolithiasis. Curr Opin Urol 22:154–159

    Article  PubMed  PubMed Central  Google Scholar 

  47. Bataille P, Pruna A, Gregoire I et al (1983) Critical role of oxalate restriction in association with calcium restriction to decrease the probability of being a stone former: insufficient effect in idiopathic hyper calciuria. Proc Eur Dial Transplant Assoc 20:401–406

    CAS  PubMed  Google Scholar 

  48. D’Alessandro C, Ferraro PM, Cianchi C, Barsotti M, Gambaro G, Cupisti A (2019) Which diet for calcium stone patients: a real-world approach to preventive care. Nutrients 11(5):1182

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Marangella M, Bianco O, Martini C et al (1989) Effect of animal and vegetable protein intake on oxalate excretion in idiopathic calcium stone disease. Br J Urol 63:348–351

    Article  CAS  PubMed  Google Scholar 

  50. Heilberg IP, Goldfarb DS (2013) Optimum nutrition for kidney stone disease. Adv Chronic Kidney Dis 20:165–174

    Article  PubMed  Google Scholar 

  51. Nouvenne A, Meschi T, Guerra A et al (2009) Diet to reduce mild hyper oxaluria in patients with idiopathic calcium oxalate stone formation:a pilot study. Urology 73:725–730

    Article  PubMed  Google Scholar 

  52. 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

    Article  CAS  PubMed  Google Scholar 

  53. Borghi L, Schianchi T, Meschi T et al (2002) Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 346:77–84

    Article  CAS  PubMed  Google Scholar 

  54. Borghi L, Meschi T, Maggiore U, Prati B (2006) Dietary therapy in idiopathic nephrolithiasis. Nutr Rev 64:301–312

    Article  PubMed  Google Scholar 

  55. Breslau NA, Brinkley L, Hill KD, Pak CY (1988) Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocrinol Metab 66:140–146

    Article  CAS  PubMed  Google Scholar 

  56. Mitwalli A, Ayiomamitis A, Grass L, Oreopoulos DG (1988) Control of hyperoxaluria with large doses of pyridoxine in patients with kidney stones. Int Urol Nephrol 20:353–359

    Article  CAS  PubMed  Google Scholar 

  57. Straub M, Hautmann RE (2005) Developments in stone prevention. Curr Opin Urol 15:119–126

    Article  PubMed  Google Scholar 

  58. Ferraro PM, Mandel EI, Curhan GC, Gambaro G, Taylor EN (2016) Dietary protein and potassium, diet-dependent net acid load, and risk of incident kidney stones. Clin J Am Soc Nephrol 11:1834–1844

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  CAS  Google Scholar 

  60. Curhan GC, Willett WC, Knight EL, Stampfer MJ (2004) Dietary factors and the risk of incident kidney stones in younger women: nurses’ health study II. Arch Intern Med 164:885–891

    Article  PubMed  Google Scholar 

  61. Nouvenne A, Meschi T, Prati B, Guerra A, Allegri F, Vezzoli G, Soldati L, Gambaro G, Maggiore U, Borghi L (2010) Effects of a low-salt diet on idiopathic hypercalciuria in calcium-oxalate stone formers: A 3-morandomized controlled trial. Am J Clin Nutr 91:565–570

    Article  CAS  PubMed  Google Scholar 

  62. Ohkawa T, Ebisuno S, Kitagawa M et al (1984) Rice bran treatment for patients with hypercalciuric stones: experimental and clinical studies. J Urol 132:1140–1145

    Article  CAS  PubMed  Google Scholar 

  63. Strohmaier WL, Kalchthaler M, Bichler KH (1988) Calcium metabolism in normal and in hypercalciuric patients on Farnolith, a dietary fibre preparation. Urol Res 16:437–440

    Article  CAS  PubMed  Google Scholar 

  64. 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 

  65. Rodgers AL, Siener R (2020) The efficacy of polyunsaturated fatty acids as protectors against calcium oxalate renal stone formation: a review. Nutrients 12(4):1069

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. 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(11):1178–1185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was financed by grants from the National Natural Science Foundation of China (No. 82070721 and 82270798), National Key Research and Development Program (No. 2020YFC2002700), Science and Technology Plan Project of Guangzhou (No. 202102010150).

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XZ, ZW: project development, data collection, manuscript writing; GZ: manuscript editing.

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Correspondence to Guohua Zeng.

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The authors declare no conflict of interest.

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The selected case is from the article “Extreme diet without calcium may lead to hyperoxaluria and kidney stone recurrence-a case study” published in JCLA by Šálek T in 2020.

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Zheng, X., Zhu, W. & Zeng, G. A case-based review of dietary management of calcium oxalate stones. World J Urol 41, 1269–1274 (2023). https://doi.org/10.1007/s00345-023-04324-z

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