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The Kidney Stone Page |
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VEGGIES
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ABSTRACT
Nephrol Dial Transplant 1994;9(6):642-9
Risk factors for low urinary citrate in calcium nephrolithiasis: low vegetable fibre intake and low urine volume to be added to the list.
Hess B, Michel R, Takkinen R, Ackermann D, Jaeger P.
Policlinic of Medicine, University Hospital, Berne, Switzerland.
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 defined as UCit x V < 1.70 mmol/day, and 'low' citraturia (low-cit) as UCit x V between
1.70 and 2.11 mmol/day. Twenty-three RCSF had normocitraturia (normo-cit), six low-cit and five hypo-cit.
UCit 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 GI-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 NH4Cl 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.
ABSTRACT
Miner Electrolyte Metab 1994;20(6):410-3
Prevention of recurrent calcium stones: diet versus drugs.
Jaeger P, Policlinic of Medicine, University Hospital, Berne, Switzerland.
Excessive intakes of meat protein, oxalate and potentially sodium, as well as insufficient intakes of
vegetables fibers, calcium and fluid all lead to increased urinary crystallization. Renal stone disease,
however, does not have to ensue. The underlying condition in a given patient is of paramount importance to
allow 'bad eating habits' to lead to nephrolithiasis. Several of these underlying abnormalities have been
detected so far from which we recently derived the powder keg and tinderbox theory. Most of the time, the
dietary approach to nephrolithiasis allows recurrence of renal stone formation to be prevented. The
pharmacological approach should be reserved for refractory cases.
ABSTRACT
J Ren Nutr 1998 Jul;8(3):127-31
Potassium and sodium intake and excretion in calcium stone forming patients.
Martini LA, Cuppari L, Cunha MA, Schor N, Heilberg IP.
Master in Science, Universidade Federal de Sao Paulo-EPM, Sao Paulo, Brazil.
OBJECTIVE:
To determine mean potassium (K) intake and its correlation with urinary calcium (uCa) and citrate
excretion, as well as uCa, sodium (Na), and K levels of calcium stone forming patients. We determined the
K-rich foods most commonly consumed by these patients. DESIGN: Case-control.
SETTING:
University-affiliated outpatient renal Lithiasis Unit.
PATIENTS AND CONTROLS:
One hundred hypercalciuric calcium stone forming patients (CSF, 54 men/46 women), 37 with associated hypocitraturia, were sequentially enrolled in the study that was performed before the initiation of any care for their renal stones. The control group consisted of 100 age-matched healthy subjects (HS, 47 men/53 women) who were laboratory employees with no history of renal stones.
INTERVENTION:
The analyses consisted of a 3-day dietary record to determine the mean K and calcium (Ca) intakes, and a 24-hour urine sample with measurements of K, Ca, Na, and citrate.
MAIN OUTCOME MEASURE:
K and Na intake determined by dietary record.
RESULTS:
uCa and Na levels and the Na/K ratio were significantly higher for CSF versus HS (238 +/- 118 v 148 +/- 74 mg/24 hours, 238 +/- 100v 181 +/- 68 mEq/24 hours, 6.6 +/- 3.5 v 5.1 +/- 2.3, respectively, P < .05). The mean citrate excretion was lower in CSF than in HS patients (410 +/- 265 v 530 +/- 240 mg/24 hours). Mean uCa did not differ between groups. CSF patients showed a higher sodium chloride intake compared with HS (14 +/- 4 vs 8 +/- 3 g/day). The mean Ca intake of CSF and HS were 559 +/- 327 and 457 +/- 363 mg/day, respectively. The mean K intake of CSF and HS were 58 +/- 17 and 51 +/- 27 mEq/day. A positive correlation was observed between uCa and urinary sodium (r = .40 and r = .65, P < .05), urinary potassium and urinary citrate (r = .25 and r = .53, P < .05),
uCa and Na/K (r = .33 and r = .56, P < .05) respectively for CSF and HS. The following were the K-rich foods consumed at least once a day by these groups: beans (by 70% of CSF and 75% of HS), tomatoes (by 42% of CSF and 50% of HS), oranges (by 30% of CSF and 55% of HS), and bananas (by 42% of CSF and 23% of HS).
CONCLUSION:
Despite the consumption of K-rich foods at least once a day, the mean K intake by CSF patients was 58 mEq/day. This intake can still be considered to be low, although it meets recommended daily dietary allowance requirements. Therefore, we describe herein a population of CSF with high-Na intake and normal- to low-K intake, which may contribute to stone formation.
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