Lifestyle Recommendations to Reduce the Risk of Kidney Stones

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Kidney stones and dietary habits

For many years now, diet has been known to play a key role in the development of kidney stones. Some authors postulate that the changes in the Western-style diet in recent decades have contributed substantially in increasing the prevalence of this condition. As this article shows, the foundations of an antilithogenic diet are correct intake of water, protein, salt, fruits and vegetables, milk and dairy products, carbohydrates, fats, and vitamins.

Kidney stones and body weight

The role of body weight, body mass index (BMI), and body composition in determining the lithogenic risk remains a subject for debate. Large epidemiologic studies47, 48 have documented an increase in the risk of kidney stones with an increase in body weight, BMI, and waist circumference. However, this increase in risk is accompanied by a redistribution in the type of stone disease in the overweight population compared with the general population, with a decrease in the prevalence of calcium

Kidney stones and exercise

The effects of exercise on reducing the risk of stone disease and on the lithogenic urinary risk factors have been studied in very few studies and on a limited number of patients. On the other hand, there is a significant amount of evidence correlating immobility or bed rest with a high risk of stone disease. Many experimental models have been performed on astronauts in the absence of gravity. The 2 most important studies assessing moderate exercise (70%–75% Vo2max)61, 62 revealed an increase

Kidney stones and stressful life events

A stressful lifestyle is associated with a higher risk of stone disease. This has been proved particularly in women. Stress increases not only the risk of onset of the disease but also the frequency of passage of stones already present. The physiopathologic mechanism has not been entirely clarified, although it would seem that hormonal causes are involved, and stress reduces certain antilithogenic factors such as magnesium and citrate, whereas calciuria, oxaluria, and uricosuria increase in

Melamine

In recent years, data have emerged about a possible relationship between environmental exposure to dietary additives and the development of kidney stones. In China, in late 2008, many cases (the estimated figure is 50,000) of kidney stones were observed in the pediatric population, whose spontaneous incidence is known to be very low. This epidemic was related to the consumption of powdered milk contaminated with melamine, a dietary additive used, legally, to increase the nitrogen content in

Summary

Diet and lifestyle choices have a significant influence on the risk of kidney stones. Both doctors and patients should be educated to consider a healthy lifestyle as an efficacious medical approach. Box 1 shows a simple list of 10 rules for the prevention of the risk of kidney stones. It would be useful to have evidence from controlled studies evaluating the long-term effects of diet and lifestyle modifications compared with medical therapy and clarifying the relationships between kidney

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    This work was supported by Fondazione per la Ricerca Scientifica Termale (FoRST) grants.

    The authors have nothing to disclose.

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