Demographic, Dietary, and Urinary Factors and 24-h Urinary Calcium Excretion

Taylor, Eric N.; Curhan, Gary C.

doi:10.2215/cjn.02620409

Cited by 72 publications

(60 citation statements)

References 45 publications

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“…Of note, we previously reported that the magnitude of the independent association between calcium intake and urinary calcium in our study population was small (25). Our urinary calcium results are consistent with data from the initial trial examining the effect of the DASH diet on blood pressure (3).…”

Section: Discussionsupporting

confidence: 89%

DASH-Style Diet and 24-Hour Urine Composition

Taylor¹,

Stampfer²,

Mount³

et al. 2010

Clinical Journal of the American Society of Nephrology

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114

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Background and objectives: We previously observed associations between a Dietary Approaches to Stop Hypertension (DASH)-style diet and large reductions in kidney stone risk. This study examined associations between a DASH-style diet and 24-hour excretions of urinary lithogenic factors.Design, setting, participants, & measurements: We studied 3426 participants with and without nephrolithiasis in the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Studies (NHS) I and II. A dietary DASH score was based on seven components: high intake of fruits, vegetables, nuts and legumes, dairy products, and whole grains and low intake of sweetened beverages and red and processed meats. We used analysis of covariance to adjust for age, stone history, body size, and other factors.Results: Comparing participants in the highest to lowest quintiles of DASH score, multivariate-adjusted urinary calcium excretion was 3% greater in HPFS (P trend 0.12), 10% greater in NHS I (P trend <0.01), and 12% greater in NHS II (P trend 0.05). Urinary oxalate was 4% to 18% greater (P trend all <0.03), urinary citrate was 11% to 16% greater (P trend all <0.01), and urinary volume was 16% to 32% greater (P trend all <0.001). Higher DASH score was associated with higher urine potassium, magnesium, phosphate, and pH, and lower relative supersaturations (RSS) of calcium oxalate (women only) and uric acid.Conclusions: A DASH-style diet may reduce stone risk by increasing urinary citrate and volume. The small associations between higher DASH score and lower RSS suggest unidentified stone inhibitors in dairy products and/or plants.

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Section: Discussionsupporting

confidence: 89%

DASH-Style Diet and 24-Hour Urine Composition

Taylor¹,

Stampfer²,

Mount³

et al. 2010

Clinical Journal of the American Society of Nephrology

Self Cite

114

View full text Add to dashboard Cite

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“…Overall, participants' 24-h urinary phosphate excretion was only ∼700 mg/day at baseline, or ∼30% lower than the level we expected based on studies of individuals with normal kidney function consuming an American diet [25]. Furthermore, one patient who received the 1500-mg diet plus placebo developed new-onset hyperphosphataemia.…”

Section: Discussionmentioning

confidence: 55%

Pilot study of dietary phosphorus restriction and phosphorus binders to target fibroblast growth factor 23 in patients with chronic kidney disease

Isakova

Gutiérrez

Smith

et al. 2010

Nephrology Dialysis Transplantation

154

118

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Background. High levels of fibroblast growth factor 23 (FGF23) are associated with mortality and progression of chronic kidney disease (CKD). Reducing dietary phosphorus intake lowers FGF23 secretion in healthly individuals, but there is little data on its effects in patients with pre-dialysis CKD. Methods. Using a 2 × 2 factorial design, we randomly assigned 16 normophosphataemic CKD stage 3-4 patients to receive a 2-week treatment with either lanthanum carbonate 1000 mg three times daily or placebo, and to ingest a tightly controlled diet containing 750 or 1500 mg of dietary phosphorus daily. We analysed serial measurements of FGF23, parathyroid hormone, serum phosphate and calcium, and 24-h urinary phosphate and calcium excretion using repeated-measures analyses. Results. Compared with the 1500-mg phosphorus diet, patients assigned to the 750-mg diet had greater reduction in 24-h urinary phosphate excretion (66% vs. 29%; P < 0.0001). Lanthanum-treated patients experienced a significant reduction in 24-h urinary phosphate excretion compared with baseline (64%; P < 0.0001), but the difference compared with placebo did not reach significance (64% vs. 31%). Despite the significant reductions in 24-h urinary phosphate excretion, no group demonstrated a significant reduction in FGF23 levels; FGF23 levels actually increased significantly in the 1500-mg diet plus placebo group, suggesting dietary phosphorus loading. Conclusions. Although dietary phosphorus restriction and lanthanum lowered urinary phosphate excretion consistent with a rapid decrease in phosphorus absorption, inducing a reduction in FGF23 levels in CKD patients may require interventions with a longer duration than in healthy volunteers.

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“…It has been shown that calcium intakes within normal ranges, unlike salt and proteins, does not promote hypercalciuria (23,24). Higher dietary calcium has even been associated to a lower risk of kidney stones (25).…”

Section: Discussionmentioning

confidence: 99%