Abstract
Objective
To compare dietary factors between incident symptomatic stone formers and controls,
and among the incident stone formers, to determine whether dietary factors were predictive
of symptomatic recurrence.
Patients and Methods
We prospectively recruited 411 local incident symptomatic kidney stone formers (medical
record validated) and 384 controls who were seen at Mayo Clinic in Minnesota or Florida
between January 1, 2009, and August 31, 2018. Dietary factors were based on a Viocare,
Inc, food frequency questionnaire administered during a baseline in-person study visit.
Logistic regression compared dietary risk factors between incident symptomatic stone
formers and controls. Incident stone formers were followed up for validated symptomatic
recurrence in the medical record. Cox proportional hazards models estimated risk of
symptomatic recurrence with dietary factors. Analyses adjusted for fluid intake, energy
intake, and nondietary risk factors.
Results
In fully adjusted analyses, lower dietary calcium, potassium, caffeine, phytate, and
fluid intake were all associated with a higher odds of an incident symptomatic kidney
stone. Among incident stone formers, 73 experienced symptomatic recurrence during
a median 4.1 years of follow-up. Adjusting for body mass index, fluid intake, and
energy intake, lower dietary calcium and lower potassium intake were predictive of
symptomatic kidney stone recurrence. With further adjustment for nondietary risk factors,
lower dietary calcium intake remained a predictor of recurrence, but lower potassium
intake only remained a predictor of recurrence among those not taking thiazide diuretics
or calcium supplements.
Conclusion
Enriching diets in stone formers with foods high in calcium and potassium may help
prevent recurrent symptomatic kidney stones.
Abbreviations and Acronyms:
AIC (Akaike Information Criterion), BMI (body mass index), FFQ (food frequency questionnaire), IQR (interquartile range), ROKS (Recurrence of Kidney Stone)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 01, 2022
Footnotes
Grant Support: This project was supported by grants DK100227 and DK83007 to the Mayo Clinic O’Brien Urology Research Center from the National Institute of Diabetes and Digestive and Kidney Diseases and made possible by grant AG034676 to the Rochester Epidemiology Project from the National Institutes of Health, US Public Health Service.
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© 2022 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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- The Optimal Dietary Calcium Intake for Preventing Incident and Recurrent Symptomatic Kidney Stone DiseaseMayo Clinic ProceedingsVol. 97Issue 8
- PreviewUntil the early 1990s, it was presumed that dietary calcium intake should be limited for preventing the onset and recurrence of calcium kidney stone formation, assuming that frequent consumption of milk and dairy products could unfavorably influence urinary calcium excretion. However, a prospective investigation conducted on 45,619 men without baseline history of kidney stones, published in 1993, showed an inverse relationship between baseline dietary calcium intake, assessed by a semiquantitative food frequency questionnaire, and the risk of incident symptomatic kidney stone disease after a 4-year follow-up period.
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