Kidney stone primary prevention: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(2 intermediate revisions by the same user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Kidney stone}}
{{Kidney stone}}
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}{{ADS}}  


==Overview==
==Overview==
Effective measures for the primary prevention of nephrolithiais include diet control and high fluid intake.


==Primary Prevention==
==Primary Prevention==
*Effective measures for the primary prevention of nephrolithiais include:<ref>http://uroweb.org/wp-content/uploads/EAU-Guidelines-Urolithiasis-2015-v2.pdf</ref><ref name="pmid24915149">{{cite journal |vauthors=Ferraro PM, Lombardi G, Gambaro G |title=[Prevention of nephrolithiasis: a review] |language=Italian |journal=Urologia |volume=81 |issue=2 |pages=88–92 |date=2014 |pmid=24915149 |doi=10.5301/uro.5000075 |url=}}</ref>
*Effective measures for the primary prevention of nephrolithiais include:<ref>http://uroweb.org/wp-content/uploads/EAU-Guidelines-Urolithiasis-2015-v2.pdf</ref><ref name="pmid24915149">{{cite journal |vauthors=Ferraro PM, Lombardi G, Gambaro G |title=[Prevention of nephrolithiasis: a review] |language=Italian |journal=Urologia |volume=81 |issue=2 |pages=88–92 |date=2014 |pmid=24915149 |doi=10.5301/uro.5000075 |url=}}</ref><ref name="pmid11224695">{{cite journal |vauthors=Pearle MS |title=Prevention of nephrolithiasis |journal=Curr. Opin. Nephrol. Hypertens. |volume=10 |issue=2 |pages=203–9 |date=March 2001 |pmid=11224695 |doi= |url=}}</ref>
==== Diet ====
==== Diet ====
*Diet should be balanced with contributions from all food groups, without excesses of any kind. 
* A balanced diet is important along with its management for the risk groups.
** Fruits, vegetables, and fibers: fruit and vegetable intake should be encouraged because of the beneficial effects of fiber. The alkaline content of a vegetarian diet also gives rise to a desirable increase in urinary pH.
** It comprises fruits, vegetables, and fibers due to beneficial effects of fiber. The vegetarian diet provides alkaline content that help rise to a desirable increase in urinary pH.
** An excessive intake of oxalate-rich products should be limited or avoided to prevent an oxalate load. This includes fruit and vegetables rich in oxalate such as wheat bran. This is particularly important in patients in whom a high oxalate excretion has been demonstrated. The following products have a high content of oxalate:
** An excessive intake of oxalate-rich products should be limited or avoided to prevent an oxalate load. This includes fruit and vegetables rich in oxalate such as wheat bran. This is particularly important in patients in whom a high oxalate excretion has been demonstrated. The following products have a high content of oxalate:
*** Rhubarb, 530 mg oxalate/100 g
*** Rhubarb, 530 mg oxalate/100 g
Line 17: Line 18:
*** Nuts, 200 to 600 mg oxalate/100 g
*** Nuts, 200 to 600 mg oxalate/100 g
*** Vitamin C is a precursor of oxalate, taking more than 500 to 1000 mg/day is not recommended.
*** Vitamin C is a precursor of oxalate, taking more than 500 to 1000 mg/day is not recommended.
** Animal protein should be limited to 0.8 to 1 g/kg body weight. An excessive consumption of animal protein may give rise to hypercalciuria, hypocitraturia, low pH, hyperoxaluria, and hyperuricosuria.
** Protein intake should be carefully monitored as it may cause [[hypercalciuria]], [[hypocitraturia]], low pH, [[hyperoxaluria]], and [[hyperuricosuria]]. Animal protein should be limited to 0.8 to 1 g/kg body weight.  
** Calcium intake should not be restricted unless there are very strong reasons because of the inverse relationship between dietary calcium and calcium stone formation. The minimum daily requirement for calcium is 800 mg and the general recommendation is 1000 mg/day (refers to elemental calcium). Calcium supplements are not recommended except in cases of enteric hyperoxaluria.
** There is an inverse relationship between dietary calcium and calcium stone formation. The minimum daily requirement for calcium is 800 mg and the general recommendation is 1000 mg/day (refers to elemental calcium). Calcium supplements are not recommended except in cases of enteric [[hyperoxaluria]].
** A high consumption of sodium causes hypercalciuria by reduced proximal tubular reabsorption of calcium. Urinary citrate is reduced. The risk of forming sodium urate crystals is increased and the effect of thiazide in reducing urinary calcium is counteracted by a high sodium intake. The daily sodium intake should not exceed 3 g.
** A high consumption of sodium causes hypercalciuria by reduced proximal tubular reabsorption of calcium. Urinary citrate is reduced. The risk of forming sodium urate crystals is increased and the effect of thiazide in reducing urinary calcium is counteracted by a high sodium intake. The daily sodium intake should not exceed 3 g.
** The intake of food particularly rich in urate should be restricted in patients with hyperuricosuric calcium oxalate stone disease, as well as in patients with uric acid stone disease. The intake of urate should not exceed 500 mg/day. Examples of food rich in urate include:
** The intake of food particularly rich in urate should be restricted in patients with hyperuricosuric calcium oxalate stone disease, as well as in patients with uric acid stone disease. The intake of urate should not exceed 500 mg/day. Examples of food rich in urate include:
Line 28: Line 29:


==== Other measures ====
==== Other measures ====
* Adequate hydration
* High fluid intake
*  
** Increased fluid intake of 2-3 L per day is protective against stone disease.
 
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 01:02, 19 June 2018

Kidney stone Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Kidney stone from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Ultrasonography

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Kidney stone primary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Kidney stone primary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Kidney stone primary prevention

CDC on Kidney stone primary prevention

Kidney stone primary prevention in the news

Blogs onKidney stone primary prevention

Directions to Hospitals Treating Kidney stone

Risk calculators and risk factors for Kidney stone primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

Effective measures for the primary prevention of nephrolithiais include diet control and high fluid intake.

Primary Prevention

  • Effective measures for the primary prevention of nephrolithiais include:[1][2][3]

Diet

  •  A balanced diet is important along with its management for the risk groups.
    • It comprises fruits, vegetables, and fibers due to beneficial effects of fiber. The vegetarian diet provides alkaline content that help rise to a desirable increase in urinary pH.
    • An excessive intake of oxalate-rich products should be limited or avoided to prevent an oxalate load. This includes fruit and vegetables rich in oxalate such as wheat bran. This is particularly important in patients in whom a high oxalate excretion has been demonstrated. The following products have a high content of oxalate:
      • Rhubarb, 530 mg oxalate/100 g
      • Spinach, 570 mg oxalate/100 g
      • Cocoa, 625 mg oxalate/100 g
      • Tea leaves, 375 to 1450 mg oxalate/100 g
      • Nuts, 200 to 600 mg oxalate/100 g
      • Vitamin C is a precursor of oxalate, taking more than 500 to 1000 mg/day is not recommended.
    • Protein intake should be carefully monitored as it may cause hypercalciuria, hypocitraturia, low pH, hyperoxaluria, and hyperuricosuria. Animal protein should be limited to 0.8 to 1 g/kg body weight.
    • There is an inverse relationship between dietary calcium and calcium stone formation. The minimum daily requirement for calcium is 800 mg and the general recommendation is 1000 mg/day (refers to elemental calcium). Calcium supplements are not recommended except in cases of enteric hyperoxaluria.
    • A high consumption of sodium causes hypercalciuria by reduced proximal tubular reabsorption of calcium. Urinary citrate is reduced. The risk of forming sodium urate crystals is increased and the effect of thiazide in reducing urinary calcium is counteracted by a high sodium intake. The daily sodium intake should not exceed 3 g.
    • The intake of food particularly rich in urate should be restricted in patients with hyperuricosuric calcium oxalate stone disease, as well as in patients with uric acid stone disease. The intake of urate should not exceed 500 mg/day. Examples of food rich in urate include:
      • Calf thymus, 900 mg urate/100 g
      • Liver, 260 to 360 mg urate/100 g
      • Kidneys, 210 to 255 mg urate/100 g
      • Poultry skin, 300 mg urate/100 g
      • Herring with skin, sardines, anchovies, sprats, 260 to 500 mg urate/100 g

Other measures

  • High fluid intake
    • Increased fluid intake of 2-3 L per day is protective against stone disease.

References

  1. ↑ http://uroweb.org/wp-content/uploads/EAU-Guidelines-Urolithiasis-2015-v2.pdf
  2. ↑ Ferraro PM, Lombardi G, Gambaro G (2014). "[Prevention of nephrolithiasis: a review]". Urologia (in Italian). 81 (2): 88–92. doi:10.5301/uro.5000075. PMID 24915149.
  3. ↑ Pearle MS (March 2001). "Prevention of nephrolithiasis". Curr. Opin. Nephrol. Hypertens. 10 (2): 203–9. PMID 11224695.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Kidney_stone_primary_prevention&oldid=1477855"