4.6 Review

Kidney Stone Prevention

Journal

ADVANCES IN NUTRITION
Volume 14, Issue 3, Pages 555-569

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.advnut.2023.03.002

Keywords

bioactive compound; citrate; diuresis; natural compound; nephrolithiasis; probiotics; protection; urolithiasis

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Kidney stone disease is a global health problem with increasing prevalence and high recurrence rate. Effective preventive strategies, including nutrition-based approaches, are crucial to reduce the burden of this disease. This article provides up-to-date knowledge and summarizes various preventive measures, including fluid intake, lifestyle modifications, dietary management, and the use of natural bioactive products and medications.
Kidney stone disease (KSD) (alternatively nephrolithiasis or urolithiasis) is a global health care problem that affects people in almost all of developed and developing countries. Its prevalence has been continuously increasing with a high recurrence rate after stone removal. Although effective therapeutic modalities are available, preventive strategies for both new and recurrent stones are required to reduce physical and financial burdens of KSD. To prevent kidney stone formation, its etiology and risk factors should be first considered. Low urine output and dehydration are the common risks of all stone types, whereas hypercalciuria, hyperoxaluria, and hypocitraturia are the major risks of calcium stones. In this article, up-to-date knowledge on strategies (nutrition-based mainly) to prevent KSD is provided. Important roles of fluid intake (2.5-3.0 L/d), diuresis (>2.0-2.5 L/d), lifestyle and habit modifications (for example, maintain normal body mass index, fluid compensation for working in high-temperature environment, and avoid cigarette smoking), and dietary man-agement [for example, sufficient calcium at 1000-1200 mg/d, limit sodium at 2 or 3-5 g/d of sodium chloride (NaCl), limit oxalate-rich foods, avoid vitamin C and vitamin D supplements, limit animal proteins to 0.8-1.0 g/kg body weight/d but increase plant proteins in patients with calcium and uric acid stone and those with hyperuricosuria, increase proportion of citrus fruits, and consider lime powder supplementation] are summarized. Moreover, uses of natural bioactive products (for example, caffeine, epigallocatechin gallate, and diosmin), medications (for example, thiazides, alkaline citrate, other alkalinizing agents, and allopurinol), bacterial eradication, and probiotics are also discussed.

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