Journal Mobile Options
Table of Contents
Vol. 110, No. 3, 2008
Issue release date: November 2008

A Randomized Trial of Low-Animal-Protein or High-Fiber Diets for Secondary Prevention of Calcium Nephrolithiasis

Dussol B. · Iovanna C. · Rotily M. · Morange S. · Leonetti F. · Dupuy P. · Vazi A. · Saveanu A. · Loundou A. · Berland Y.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: The purpose of this trial was to evaluate the efficacy of a low-animal-protein diet (LAPD) or a high-fiber diet (HFD) for the prevention of calcium nephrolithiasis recurrence. Methods: We conducted a 4-year randomized trial comparing the effect of 2 diets in 175 idiopathic calcium stone formers. Fifty-five were assigned to a LAPD (<13% of total energy derived from protein), 60 were assigned to a HFD (>25 g/day fiber) and 60 were placed on a normal diet (control group). The primary outcome measure was the time to the first recurrence of calcium nephrolithiasis. Daily urine compositions were analyzed at baseline, at month 4 (M4), M12, M24, M36 and M48. Results: Seventy-three patients completed the trial (23 in the LAPD group, 27 in the HFD group and 23 in the control group). Recurrence was 48% (11/23) in the LAPD group, 63% (17/27) in the HFD group and 48% (11/23) in the control group (p = not significant). During follow-up, urinary calcium levels and other urine parameters did not change significantly in the 3 groups, except for a significant decrease in 24-hour urinary sulfate in the LAPD group. Conclusions: In idiopathic calcium stone formers, neither a LAPD nor a HFD appeared to provide protection against recurrence.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Johnson CM, Wilson DM, O’Fallon WM, Malek RS, Kurland LT: Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int 1979;16:624–631.
  2. Ramello A, Vitale C, Marangella M: Epidemiology of nephrolithiasis. J Nephrol 2000;13:S45–S50.
  3. Ljunghall S, Danielson B: A prospective study of renal stone recurrence. Br J Urol 1984;56:122–124.
  4. Curhan GC, Willett WC, Rimm EB, Stampfer MJ: A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 1993;328:833–838.
  5. Amanzadeh J, Gitomer WL, Zerwekh JE, et al: Effect of high protein diet on stone-forming propensity and bone loss in rats. Kidney Int 2003;64:2142–2149.
  6. Giannini S, Nobile M, Sartori L, et al: Acute effects of moderate dietary protein restriction in patients with idiopathic hypercalciuria and calcium nephrolithiasis. Am J Clin Nutr 1999;69:267–271.
  7. Breslau NA, Brinkley L, Hill KD, Pak CY: Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocrinol Metabol 1988;66:140–146.
  8. Goldfarb S: Dietary factors in the pathogenesis and prophylaxis of calcium nephrolithiasis. Kidney Int 1988;34:544–555.
  9. Hiatt RA, Ettinger B, Caan B, Quesenberry CP, Duncan D, Citron JT: Randomized controlled trial of a low animal protein, high fiber diet in the prevention of recurrent calcium oxalate kidney stones. Am J Epidemiol 1996;44:25–33.
  10. Borghi L, Schianchi T, Meschi T, et al: Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 2002;346:77–84.
  11. Bataille P, Presne C, Fournier A: Prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 2002;346:1667–1669.
  12. Rotily M, Leonetti F, Iovanna C, et al: Effects of low animal protein and high-fiber diets on urine composition in calcium nephrolithiasis. Kidney Int 2000;57:115–123.

    External Resources

  13. Brown CM, Ackerman DK, Purich DL: EQUIL 93: a tool for experimental and clinical urolithiasis. Urol Res 1994;22:119–126.
  14. Willet W: Nutritional Epidemiology. New York, Oxford University Press, 1990, p 396.
  15. Favier JC, Ireland-Ripert J, Toque C, Fienberg M: Répertoire Général des Aliments, ed 2. Revue et augmentée. Paris, INRA Tecdoc, 1995, p 897.
  16. Wasserstein AG, Stolley PD, Soper KA, Goldfarb S, Maislin G, Agus Z: Case-control study of risk factors for idiopathic calcium nephrolithiasis. Miner Electrolyte Metab 1987;13:85–95.
  17. Fellström B, Danielson BG, Karlstrom B, Lithell H, Ljunghall S, Vessby B, et al: Effect of high intake of dietary animal protein on mineral metabolism and urinary supersaturation of calcium oxalate in renal stone formers. Br J Urol 1984;56:263–269.
  18. Nguyen QV, Kälin A, Drouve U, Casez JP, Jaeger P: Sensitivity to meat protein intake and hyperoxaluria in idiopathic calcium stone formers. Kidney Int 2001;59:2273–2281.
  19. Breslau NA, Brinkley L, Hill KD, Pak CY: Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocrinol Metab 1988;66:140– 146.
  20. Goldfarb S: Dietary factors in the pathogenesis and prophylaxis of calcium nephrolithiasis. Kidney Int 1988;34:544–555.
  21. Leonetti F, Dussol B, Berthezene P, Thirion X, Berland Y: Dietary and urinary risk factors for stones in idiopathic calcium stone formers compared with healthy subjects. Nephrol Dial Transplant 1988;13:617–622.

    External Resources

  22. Marangella M, Bianco O, Martini C, Petrarulo M, Vitale C, Linari F: Effect of animal and vegetable protein intake on oxalate excretion in idiopathic calcium stone disease. Br J Urol 1989;63:348–351.
  23. Ebisuno S, Morimoto S, Yasukawa S, Ohkawa T: Results of long-term rice bran treatment on stone recurrence in hypercalciuric patients. Br J Urol 1991;67:237–240.
  24. Shah PJ, Green NA, Williams G: Unprocessed bran and its effect on urinary calcium excretion in idiopathic hypercalciuria. Br Med J 1980;281:426–429.
  25. Meschi T, Maggiore U, Fiaccadori E, et al: The effect of fruits and vegetables on urinary stone risk factors. Kidney Int. 2004;66:2402–2410.
  26. Jahnen A, Heynck H, Gertz B, Classen A, Hesse A: Dietary fibre: the effectiveness of a high bran intake in reducing renal calcium excretion. Urol Res 1992;20:3–6.
  27. Hirvonen T, Pietinen P, Virtanen M, Albanes D, Virtamo J: Nutrient intake and use of beverages and the risk of kidney stones among male smokers. Am J Epidemiol 1999;150:187–194.
  28. Taylor EN, Stampfer MJ, Curhan GC: Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225–3232.
  29. Curhan GC, Willett W, Knight EL, Stampfer MJ:Dietary factors and the risk of incident kidney stones in younger women (Nurses’ Health Study II). Arch Intern Med 2004;164:885–891.
  30. Krepinsky J, Ingram AJ, Churchill DN: Metabolic investigation of recurrent nephrolithiasis: compliance with recommendations. Urology 2000;56:915–920.
  31. Kocvara R, Plasgura P, Petrik A, Louzensky G, Bartonickova K, Dvoracek J: A prospective study of nonmedical prophylaxis after a first kidney stone. BJU Int 1999;84:393–398.
  32. Iguchi M, Umekawa T, Ishikawa Y, et al: Clinical effects of prophylaxis dietary treatment on renal stones. J Urol 1990;144:229–232.
  33. Zemel MB, Schuette SA, Hegsted M, Linkswiler HM: Role of the sulphur-containing amino acids in protein-induced hypercalciuria in men. J Nutr 1981;111:545–552.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50