High-calcium intake abolishes hyperoxaluria and reduces urinary crystallization during a 20-fold normal oxalate load in humans

Hess, Bernhard; Jost, Carolina R.; Zipperle, Ljerka; Takkinen, Ritva; Jaeger, P

doi:10.1093/ndt/13.9.2241

Cited by 119 publications

(58 citation statements)

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“…Previous data suggested that orally administered calcium may bind oxalate in the intestinal tract, thereby reducing oxalate absorption and urinary excretion. [21][22][23] The impact of a DASH-style diet on the urinary excretion of calcium, a major risk factor for calcium kidney stone formation, is unclear. Higher calcium intake would be expected to increase urinary calcium, whereas lower sodium, lower animal protein, and higher intake of potassium-rich foods would be expected to decrease it.…”

Section: Discussionmentioning

confidence: 99%

DASH-Style Diet Associates with Reduced Risk for Kidney Stones

Taylor

Fung²,

Curhan³

2009

Journal of the American Society of Nephrology

299

185

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The impact of the Dietary Approaches to Stop Hypertension (DASH) diet on kidney stone formation is unknown. We prospectively examined the relation between a DASH-style diet and incident kidney stones in the Health Professionals Follow-up Study (n ϭ 45,821 men; 18 yr of follow-up), Nurses' Health Study I (n ϭ 94,108 older women; 18 yr of follow-up), and Nurses' Health Study II (n ϭ 101,837 younger women; 14 yr of follow-up). We constructed a DASH score based on eight components: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains and low intake of sodium, sweetened beverages, and red and processed meats. We used Cox hazards regression to adjust for factors that included age, BMI, and fluid intake. Over a combined 50 yr of follow-up, we documented 5645 incident kidney stones. Participants with higher DASH scores had higher intakes of calcium, potassium, magnesium, oxalate, and vitamin C and had lower intakes of sodium. For participants in the highest compared with the lowest quintile of DASH score, the multivariate relative risks for kidney stones were 0.55 (95% CI, 0.46 to 0.65) for men, 0.58 (95% CI, 0.49 to 0.68) for older women, and 0.60 (95% CI, 0.52 to 0.70) for younger women. Higher DASH scores were associated with reduced risk even in participants with lower calcium intake. Exclusion of participants with hypertension did not change the results. In conclusion, consumption of a DASH-style diet is associated with a marked decrease in kidney stone risk.

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Section: Discussionmentioning

confidence: 99%

DASH-Style Diet Associates with Reduced Risk for Kidney Stones

Taylor

Fung²,

Curhan³

2009

Journal of the American Society of Nephrology

299

185

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“…Both calcium loading studies and population-based studies previously described the inverse association between calcium intake and urinary oxalate (12,13,31), which presumably is due to binding of intestinal oxalate. The reason for the greater impact of dietary calcium on urinary oxalate in the stone-forming participants of our study is unknown.…”

Section: Discussionmentioning

confidence: 99%

Determinants of 24-hour Urinary Oxalate Excretion

Taylor¹,

Curhan²

2008

Clinical Journal of the American Society of Nephrology

150

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Background and objectives: Higher levels of urinary oxalate substantially increase the risk of calcium oxalate kidney stones. However, the determinants of urinary oxalate excretion are unclear. The objective was to examine the impact of dietary factors, age, body size, diabetes, and urinary factors on 24-h urinary oxalate.Design, setting, participants, and measurements: We conducted a cross-sectional study of 3348 stone forming and nonstone-forming participants in the Health Professionals Follow-up Study (men), the Nurses' Health Study (older women), and the Nurses' Health Study II (younger women).Results: Median urinary oxalate was 39 mg/d in men, 27 mg/d in older women, and 26 mg/d in younger women. Participants in the highest quartile of dietary oxalate excreted 1.7 mg/d more urinary oxalate than participants in the lowest quartile (P trend 0.001). The relation between dietary and urinary oxalate was similar in individuals with and without nephrolithiasis. Participants consuming 1000 mg/d or more of vitamin C excreted 6.8 mg/d more urinary oxalate than participants consuming <90 mg/d (P trend < 0.001). Body mass index, total fructose intake, and 24-h urinary potassium, magnesium, and phosphorus levels also were positively associated with urinary oxalate. Calcium intake and age were inversely associated with urinary oxalate. After adjustment for body size, participants with diabetes excreted 2.0 mg/d more urinary oxalate than those without diabetes (P < 0.01).Conclusions: The impact of dietary oxalate on urinary oxalate appears to be small. Further investigation of factors influencing urinary oxalate may lead to new approaches to prevent calcium kidney stones.

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“…However, a high calcium diet may lower urinary oxalate by binding oxalate in the intestinal tract, opposing the rise in urinary oxalate; in so doing, it averted the formation of crystals of calcium oxalate in urine [6]. …”

Section: Pathophysiology and Etiological Role In Stone Formation Of Dmentioning

confidence: 99%

Medical Management of Urinary Stone Disease

Pak¹

2004

Nephron Clin Pract

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A variety of dietary and metabolic factors may contribute or cause stone formation in idiopathic calcium oxalate nephrolithiasis. Dietary factors include a high intake of animal proteins, oxalate and sodium, and a low intake of fluids and potassium-containing citrus products. Some of the metabolic causes of stones are hypercalciuria, hypocitraturia, gouty diathesis, hyperoxaluria, and hyperuricosuria. Dietary modification, to be applied in all patients with stones includes a high fluid intake, restriction of oxalate and sodium, and balanced diet with animal proteins complemented by adequate intake of fruits and vegetables. When dietary modification is ineffective in controlling stone formation or in the presence of severe metabolic derangements, a pharmacologic intervention may be necessary. In a simple approach, thiazide or indapamide with potassium citrate is recommended for patients with hypercalciuria, and potassium citrate alone for the remaining normocalciuric subjects.

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High-calcium intake abolishes hyperoxaluria and reduces urinary crystallization during a 20-fold normal oxalate load in humans

Cited by 119 publications

References 0 publications

DASH-Style Diet Associates with Reduced Risk for Kidney Stones

DASH-Style Diet Associates with Reduced Risk for Kidney Stones

Determinants of 24-hour Urinary Oxalate Excretion

Medical Management of Urinary Stone Disease

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