The Effects of Dietary Excesses in Animal Protein and Sodium on the Composition and the Crystallization Kinetics of Calcium Oxalate Monohydrate in Urines of Healthy Men*

Kok, Dirk J.; Iestra, J.A.; Doorenbos, C. J.; Papapoulos, Socrates E.

doi:10.1210/jcem-71-4-861

Cited by 118 publications

(61 citation statements)

References 28 publications

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“…A moderate rise in urine pH was detected during ingestion of hard water as compared with low-calcium water; however, this phenomenon, which is secondary to the increased alkaline load of calcium bicarbonate, was not important, since the precipitation of calcium oxalate is not pH dependent [19]. …”

Section: Discussionmentioning

confidence: 99%

Effects of Water Hardness on Urinary Risk Factors for Kidney Stones in Patients with Idiopathic Nephrolithiasis

Bellizzi

Nicola

Minutolo

et al. 1998

Nephron

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Both amount and timing of dietary calcium intake influence the recurrence of renal calcium stones. We have evaluated whether the hardness of extra meal drinking water modifies the risk for calcium stones. The urinary levels of calcium, oxalate and citrate, i.e., the main urinary risk factors for calcium stones, were measured in 18 patients with idiopathic nephrolithiasis, maintained at fixed dietary intake of calcium (800 mg/day), after drinking for 1 week 2 liters per day, between meals, of tap water and at the end of 1 week of the same amount of bottled hard (Ca²⁺ 255 mg/l) or soft (Ca²⁺ 22 mg/l, Fiuggi water) water, in a double-blind randomized, crossover fashion. As compared with both tap and soft water, hard water was associated with a significant 50% increase of the urinary calcium concentration in the absence of changes of oxalate excretion; the calcium-citrate index revealed a significant threefold increase during ingestion of hard water as compared with respect to soft water (Fiuggi water), making the latter preferable even when compared with tap water. This study suggests that, in the preventive approach to calcium nephrolithiasis, the extra meal intake of soft water is preferable to hard water, since it is associated with a lower risk for recurrence of calcium stones.

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Section: Discussionmentioning

confidence: 99%

Effects of Water Hardness on Urinary Risk Factors for Kidney Stones in Patients with Idiopathic Nephrolithiasis

Bellizzi

Nicola

Minutolo

et al. 1998

Nephron

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“…Excess animal protein intake with the acid load that it conveys lowers urinary citrate [1,8], whereas dietary protein restriction does the opposite [9]. Urinary citrate positively correlates with net gastrointestinal absorption of alkali, which seems to be reduced in many idiopathic calcium stone formers [1].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for low urinary citrate in calcium nephrolithiasis: low vegetable fibre intake and low urine volume to be added to the list

Hess¹,

Michel²,

Takkinen³

et al. 1994

Nephrology Dialysis Transplantation

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Abstract. Risk factors for low urinary citrate excretion were assessed in 34 consecutive male recurrent idiopathic calcium stone formers (RCSF) who collected two 24-h urines while on free-choice diet. Overt hypocitraturia (hypo-cit) was denned as U C j t x V<1.70 mmol/day, and 'low' citraturia (lowcit) as U Clt xV between 1.70 and 2.11 mmol/day. Twenty-three RCSF had normocitraturia (normo-cit), six low-cit and five hypo-cit. U Cit x V positively correlated with urine volume (VOLUME, r = 0.44, P = 0.009), vegetable fibre intake (fibers, r = 0.46, P = 0.009) and Gl-alkali absorption (alkali, r = 0.47, P = 0.006), and volume, fibres and alkali tended to be lower among RCSF with low-/hypo-cit. A 3-day NH 4 C1 loading test (0.95 mEq/kg BW daily in 3 doses) was performed in RCSF as well as in 14 age-matched healthy male controls (C). On a plot of urine pH versus serum bicarbonate, 10 of 11 RCSF with low-/hypo-cit, but only six of 23 with normo-cit (P = 0.0004) fell off the normal range, indicating incomplete RTA. Two or more risk factors simultaneously occurred in only four of 23 RCSF with normo-cit, but in eight of 11 with low-/hypo-cit (P = 0.002). In conclusion, incomplete RTA is the most prevalent risk factor for low-/hypo-cit in RCSF, and decreases in vegetable fibres and urine volume emerge as two new risk factors for low urinary CIT.

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“…Ingested animal protein generates an acid load increasing urinary calcium excretion and reducing the excretion of citrate, an inhibitor of calcium stones. [20][21][22][23] The Canadian Urological Association (CUA) guidelines recommend reduced animal protein intake to stone formers (Table 1). 17 In contrast to current recommendations, over half of respondents (57%) did not advocate protein restriction to patients.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes, and practice patterns among healthcare providers in the prevention of recurrent kidney stones in Northern Ontario

Bos

Abara

Parmar

2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e795-804. http://dx.doi.org/10.5489/cuaj.1455 Published online November 24, 2014. AbstractIntroduction: Kidney stone recurrence is common. Preventive measures can lead to improved quality of life and costs savings to the individual and healthcare system. Guidelines to prevent recurrent kidney stones are published by various urological societies. Adherence to guidelines amongst healthcare professionals in general is poor, while adherence to preventive management guidelines regarding stone disease is unknown. To understand this issue, we conducted an online study to assess the knowledge, attitudes, and practice patterns of healthcare practitioners in Northern Ontario. Methods: We used the database of healthcare providers affiliated with the Northern Ontario School of Medicine, in Sudbury (East Campus) and Thunder Bay (West Campus), Ontario. We designed the survey based on current best practice guidelines for the management of recurrent kidney stones. Questions covered 3 domains: knowledge, attitudes, and practice patterns. Demographic data were also collected. The survey was distributed electronically to all participants. Results: A total of 68 healthcare providers completed the survey. Of these, most were primary care physicians (72%). To keep uniformity, we analyzed the data of this homogenous group. A total of 70% of the respondents were aware of the current guidelines; however, only 43% applied their knowledge in clinical practice. Most participants lacked confidence while answering most items in the attitude domain. Conclusions: Most primary care physician respondents were aware of the appropriate preventive measures for recurrent kidney stones; however, they do not appear to apply this knowledge effectively in clinical practice. A low response rate is a limitation of our study. Further studies involving a larger sample size may lead to information sharing and collaborative care among healthcare providers.

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The Effects of Dietary Excesses in Animal Protein and Sodium on the Composition and the Crystallization Kinetics of Calcium Oxalate Monohydrate in Urines of Healthy Men*

Cited by 118 publications

References 28 publications

Effects of Water Hardness on Urinary Risk Factors for Kidney Stones in Patients with Idiopathic Nephrolithiasis

Effects of Water Hardness on Urinary Risk Factors for Kidney Stones in Patients with Idiopathic Nephrolithiasis

Risk factors for low urinary citrate in calcium nephrolithiasis: low vegetable fibre intake and low urine volume to be added to the list

Knowledge, attitudes, and practice patterns among healthcare providers in the prevention of recurrent kidney stones in Northern Ontario

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