Effect of Calcium Restriction on Renal Excretion of Oxalate and the Probability of Stones in the Various Pathophysiological Groups with Calcium Stones

Bataille, Pierre; Charransol, G.; Grégoire, I.; Daigre, J.L.; Coevoet, B; Makdassi, R; Pruna, A; Locquet, P; Sueur, J.P.; Fournier, A

doi:10.1016/s0022-5347(17)51073-3

Cited by 90 publications

(28 citation statements)

References 18 publications

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“…The dietary calcium-induced variation of about 20% in mean oxaluria, observed in NC and DIHC patients, agrees well with that reported by other investigators (11,17).…”

Section: Discussionsupporting

confidence: 92%

Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients

Nishiura

Martini

Mendonça

et al. 2002

Braz J Med Biol Res

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Dietary calcium lowers the risk of nephrolithiasis due to a decreased absorption of dietary oxalate that is bound by intestinal calcium. The aim of the present study was to evaluate oxaluria in normocalciuric and hypercalciuric lithiasic patients under different calcium intake. Fifty patients (26 females and 24 males, 41 ± 10 years old), whose 4-day dietary records revealed a regular low calcium intake (≤500 mg/ day), received an oral calcium load (1 g/day) for 7 days. A 24-h urine was obtained before and after load and according to the calciuria under both diets, patients were considered as normocalciuric (NC, N = 15), diet-dependent hypercalciuric (DDHC, N = 9) or diet-independent hypercalciuric (DIHC, N = 26). On regular diet, mean oxaluria was 30 ± 14 mg/24 h for all patients. The 7-day calcium load induced a significant decrease in mean oxaluria compared to the regular diet in NC and DIHC (20 ± 12 vs 26 ± 7 and 27 ± 18 vs 32 ± 15 mg/24 h, respectively, P<0.05) but not in DDHC patients (22 ± 10 vs 23 ± 5 mg/ 24 h). The lack of an oxalate decrease among DDHC patients after the calcium load might have been due to higher calcium absorption under higher calcium supply, with a consequent lower amount of calcium left in the intestine to bind with oxalate. These data suggest that a longlasting regular calcium consumption <500 mg was not associated with high oxaluria and that a subpopulation of hypercalciuric patients who presented a higher intestinal calcium absorption (DDHC) tended to hyperabsorb oxalate as well, so that oxaluria did not change under different calcium intake.

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“…The dietary calcium-induced variation of about 20% in mean oxaluria, observed in NC and DIHC patients, agrees well with that reported by other investigators (11,17).…”

Section: Discussionsupporting

confidence: 92%

Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients

Nishiura

Martini

Mendonça

et al. 2002

Braz J Med Biol Res

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“…This inverse association has been confirmed in two other prospective studies in women [9,10] and in an updated analysis in men [30]. Although the mechanism of this effect is unknown, low calcium intake is known to increase oxalate absorption and urinary excretion [31], and individuals with lower calcium intake have lower 24 hour urine oxalate excretion. While the reduction in risk due to higher dietary calcium intake may be due to reducing urine oxalate, it is also possible that there is some other protective factor in dairy products (the major source of dietary calcium in the US).…”

Section: Dietary Factorsmentioning

confidence: 61%

Epidemiology of Stone Disease

Curhan

2007

Urologic Clinics of North America

400

193

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Epidemiology has improved our understanding and management of stone. These types of studies have quantified changes in patterns and burden of disease, while identification of risk factors has changed clinical practice and provided insight into pathophysiologic processes related to stone formation. Because nephrolithiasis is a complex disease, an understanding of the epidemiology, particularly the interactions among different factors, may help lead to approaches that reduce the risk of stone formation.Epidemiology is defined as the study of the distribution and determinants of disease. Epidemiology can help with the understanding and management of stone disease in several ways. First, epidemiologic studies can quantify changes in patterns and the burden of disease. Second, identification of risk factors in large epidemiologic studies may provide insight into pathophysiologic processes related to stone formation. Third, these types of studies allow examination of the interaction between factors, such as different dietary factors or geneenvironment interactions. Because nephrolithiasis is a complex disease, an understanding of the epidemiology, particularly the interactions among different factors, may help lead to approaches that reduce the risk of stone formation.

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“…Hypercalciuria and, even more, hyperoxaluria are important risk factors for lithogenesis [1], and pursuing a decrease in urinary calcium through a low calcium diet Coen/Sardella/Barbera/Ferrannini/ Comegna/Ferazzoli/Dinnella/D'Anello/ Simeoni may enhance intestinal oxalate absorption, increase oxaluria and raise the risk of renal stone formation [2,3]. Furthermore, patients with idiopathic hypercalciuria on a long-term, low calcium diet may end up with osteopenia [4].…”

Section: Introductionmentioning

confidence: 99%

Urinary Composition and Lithogenic Risk in Normal Subjects following Oligomineral versus Bicarbonate-Alkaline High Calcium Mineral Water Intake

Coen

Sardella²,

Barbera³

et al. 2001

Urol Int

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Objective: A normal dietary calcium intake to reduce intestinal oxalate absorption is essential to avoid recurrence of calcium oxalate stone formation. It is also important in the prevention of osteopenia in idiopathic hypercalciuria. The calcium content of waters used for hydration may vary from very low to relatively high and is an important factor in prevention or additional risk of stone formation. Therefore, the effect of drinking mineral waters of different calcium concentrations on lithogenic risk factors was studied in normal volunteers. Materials and Methods: Normal subjects were divided into two groups of 11 and 10 individuals each. All followed a prescribed diet with an average calcium content of 800 mg/day. The water intake for hydration consisted of 2 liters of an oligomineral water with a low calcium content, <20 mg/l (group A) or of a bicarbonate alkaline water with a high calcium content, 370 mg/l (group B). Results: Diuresis increased similarly in both groups; urine calcium increased by about 80 mg/day in group B. A rise in urine oxalate was observed in both groups, along with the increased urine volume. Osmolar excretion increased in group B; urine osmolality decreased significantly only in group A. In spite of the increase in calciuria in group B, Ca/citrate ratio was constant, due to an increase in citrate excretion. Inter-group differences in terms of activity products of calcium phosphate, calculated according with Tiselius’s methods, were found. The differences in AP(CaP) index 1 and AP(CaP) index 2 were significant, with higher values in group B, who drank the bicarbonate alkaline mineral water. Conclusions: Increased water intake between meals to prevent renal stone recurrence should preferably be achieved with a relatively low calcium water and calcium-rich mineral waters should be avoided.

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Effect of Calcium Restriction on Renal Excretion of Oxalate and the Probability of Stones in the Various Pathophysiological Groups with Calcium Stones

Cited by 90 publications

References 18 publications

Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients

Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients

Epidemiology of Stone Disease

Urinary Composition and Lithogenic Risk in Normal Subjects following Oligomineral versus Bicarbonate-Alkaline High Calcium Mineral Water Intake

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