Prevention of Urolithiasis

M, Frank; Vries, A. De

doi:10.1080/00039896.1966.10664630

Cited by 89 publications

(17 citation statements)

References 2 publications

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“…Another factor may be the state of hydration of the subject. That stones are more likely to form in the concentrating kidney is suggested firstly, by the increased incidence of stone disease in individuals mov ing to a hot dry environment [5,23], and secondly, by the fact that the therapeutic measure of inducing a water diuresis as a prophylaxis against stone formation has been shown to be effective in a clinical trial [14]. If calcium is handled in a manner similar to sodium, it might be anticipated that the concentration of calcium in the papilla may be increased in the concentrating kidney, and reduced during a diuresis.…”

Section: Discussionmentioning

confidence: 99%

The Concentration of Calcium in the Human Renal Papilla and the Tendency to Form Calcium Containing Renal Stones

Cooke¹,

Rosenzweig²

1971

Nephron

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The renal distribution of calcium was measured at necropsy in adult subjects from populations with and without a tendency to calcium stone formation. The mean concentration of calcium in tissue from the papilla tip was significantly higher than that from the base of the medulla in both populations, confirming the presence of a calcium concentration gradient in the adult human renal medulla. Both the mean concentration of calcium in the papilla tip, and the mean calcium concentration gradient in the medulla, were significantly higher in the white South Africans of European descent than in the Bantu in South Africa. Renal stone disease is rare in the latter. The possible association between high concentrations of calcium in the papilla tip and the tendency to calcium stone formation is discussed in terms of the renal handling of calcium and the aetiology of the calcium-containing stone.

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Section: Discussionmentioning

confidence: 99%

The Concentration of Calcium in the Human Renal Papilla and the Tendency to Form Calcium Containing Renal Stones

Cooke¹,

Rosenzweig²

1971

Nephron

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“…Frank et al ,[9] compared the incidence of urolithasis in two desert towns of Israel, Arad and Beersheba, after 3-years of education regarding fluids. They found a lower prevalence of urolithiasis in Arad (0.28% vs. 0.85%, P =0.001) with only a quarter litre increase in urine output (1071 ml vs. 804 ml).…”

Section: Fluidsmentioning

confidence: 99%

Preventive fluid and dietary therapy for urolithiasis: An appraisal of strength, controversies and lacunae of current literature

Agarwal¹,

Singh²,

Mavuduru³

et al. 2011

Indian J Urol

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Regulation of fluid and dietary intake habits is essential in comprehensive preventive management of urolithiasis. However, despite large body of epidemiological database, there is dearth of good quality prospective interventional studies in this regard. Often there is conflict in pathophysiological basis and actual clinical outcome. We describe conflicts, controversies and lacunae in current literature in fluid and dietary modifications in prevention of urolithiasis. Adequate fluid intake is the most important conservative strategy in urolithiasis-prevention; its positive effects are seen even at low volumes. Of the citrus, orange provides the most favorable pH changes in the urine, equivalent to therapeutic alkaline citrates. Despite being richest source of citrate, lemon does not increase pH significant due to its acidic nature. Fructose, animal proteins and fats are implicated in contributing to obesity, which is an established risk factor for urolithiasis. Fructose and proteins also contribute to lithogenecity of urine directly. Sodium restriction is commonly advised since natriuresis is associated with calciuresis. Calcium restriction is not advisable for urolithiasis prevention. Adequate calcium intake is beneficial if taken with food since it reduces absorption of dietary oxalate. Increasing dietary fiber does not protect against urolithiasis. Evidence for pyridoxine and magnesium is not robust. There is no prospective interventional study evaluating effect of many dietary elements, including citrus juices, carbohydrate, fat, dietary fiber, sodium, etc. Due to lack of good-quality prospective interventional trials it is essential to test the findings of pathophysiological understanding and epidemiological evidence. Role of probiotics and phytoceuticals needs special attention for future research.

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“…In 1966, an Israeli article [29]comparing the incidence of urolithasis in two desert towns, Arad and Beersheba, was published after an educational program had been run in Arad aimed at increasing fluid intake as a preventive measure against the risk of renal calculi. After 3 years, the prevalence of urolithiasis in Arad was lower than in Beersheba (0.28 vs. 0.85%, chi-square 36.6, p < 0.001), and the mean urine volume of the inhabitants of Arad was significantly higher than that of those of Beersheba (1,071 ± 398 vs. 804 ± 289 ml/day, p < 0.01).…”

Section: Urine Volume As a Preventive Measurementioning

confidence: 99%

Urine Volume: Stone Risk Factor and Preventive Measure

Borghi¹,

Meschi²,

Schianchi³

et al. 1998

Nephron

108

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Background: A high fluid intake is the oldest existing treatment for kidney stones, and, up until a few decades ago, it was the only preventive measure at the physician’s disposal for stone recurrences. Methods: Using the data available in literature and partly unpublished personal research, we examine the role of urine volume as a stone risk factor, its impact on calcium crystallization mechanisms and its real importance as a means of prevention. Results: To sum up, the most important findings are: (1) a low urine volume must be considered as a real risk factor, both as regards the onset of renal calculi and stone relapses; (2) an increase in urine volume induced by a high water intake produces favourable effects on the crystallization of calcium oxalate and does not reduce the activity of natural inhibitors; (3) a sufficiently high intake of water and probably other fluids such as coffee, tea, beer and wine has a preventive effect on nephrolithiasis and its recurrence, and (4) the role of fruit juice is still to be defined. Conclusions: A high intake of fluids, especially water, is still the most powerful and certainly the most economical means of prevention of nephrolithiasis, and it is often not used to advantage by stone formers.

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Prevention of Urolithiasis

Cited by 89 publications

References 2 publications

The Concentration of Calcium in the Human Renal Papilla and the Tendency to Form Calcium Containing Renal Stones

The Concentration of Calcium in the Human Renal Papilla and the Tendency to Form Calcium Containing Renal Stones

Preventive fluid and dietary therapy for urolithiasis: An appraisal of strength, controversies and lacunae of current literature

Urine Volume: Stone Risk Factor and Preventive Measure

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