Co 1. 2. 3.
4. 5. 6.
7.
Med
Med
_______________ orresponding autho
Student Research Shiraz University o Student Research Jundishapur Unive Research Center f School of Nutritio Sciences, Shiraz, Ir Department of N Jundishapur Unive Department of Su Medical Sciences,
Nutrition Research
Iran
Department of Bio University of Medi
The asso
in patien
Hadi Bazyar1,2 Mohammad H
Received: 20 D
Abstract
Background evaluate the ass Methods: In information wa (using food fre sample t test respectively. C Pearson test. Results: Out were male, wi beverages (p=0 of high-purine intake of vitam than in those w stones (p=0.01) 0.26) and Conclusion: purine, fructose effective in the
Keywords: Ur
Conflicts of Interes Funding:Student R
*This work has bee
Copyright© Iran
Cite this articl intakes and stone
Introducti
Kidney ston
dical Journa
J Islam Repub Ir
________________ or: Dr Afsane Ahmad
Committee, Schoo of Medical Sciences, Committee, Schoo
ersity of Medical Sci for Health Sciences on and Food Scien ran
Nutrition, School o ersity of Medical Sci urgery, Shaheed Fa
Shiraz, Iran
h Center, Shiraz Uni ostatistics, School o ical Sciences, Ahvaz
ociation b
nts with
2
, Afsane Ahm Hossein Hagh
Dec 2017
d: Kidney stone sociation betwe n this cross sect as collected, an equency questio and one-way A Chi square test w
t of 110 particip ith the mean B 0.03) was signif foods was sign min A (p=0.02), with uric acid st ). There was a -fructose (p=0.0
There was a e, and oxalate a e treatment of k
rinary stones, N
st: None declared Research Committe
en published under
University of Medi
le as:Bazyar H e formation in pat
on
ne is a commo
al of the Islam
ran. 2019(20 Feb
_
di, ahmadi.afsane@
ol of Nutrition and , Shiraz, Iran
ol of Allied Medical
iences, Ahvaz, Iran s, Department of C nces, Shiraz Unive of Allied Medical iences, Ahvaz, Iran ghihi Hospital, Shir iversity of Medical of Public Health, Ah z, Iran
between
urinary s
madi*3, Ahmad ighizadeh7
Published: 2
e is a common een dietary inta tional study, 11 nd anthropomet onnaire, analyze ANOVA were was also used t
pants in this stu BMI of 24.21±
ficantly greater nificantly highe , beta-carotene tones, while caf significant corr 048, correlation significant rela and formation o idney stones.
Nutritional facto
ee of Shiraz Universi
rCC BY-NC-SA 1.0 li
ical Sciences
, Ahmadi A, Zar tients with urinary
on and costly
mic Republic
);33.8. https://doi
@gmail.com
d Food Sciences,
Sciences, Ahvaz Clinical Nutrition, rsity of Medical Sciences, Ahvaz raz University of Sciences, Shiraz, hvaz Jundishapur
n dietary
stones in
d Zare Javid4,
20 Feb 2019
and costly dise ake and stone fo 10 patients with tric indices, dis ed by Nut 4 sof used to comp to compare qua
udy, 37 (33.6% ±2.96 kg/m2. T r in patients wit er in patients wi
(p=0.03), and ffeine intake wa relation between n coefficient = 0 ationship betwe of kidney stones
ors, Nutrients, O
ity of Medical Scien
icense.
re Javid A, Irani y stones in Shiraz
disease (1), w
c of Iran (MJ
i.org/10.34171/m
↑What is “alr
Prevalence of to unhealthy regimen. This costs on cou investigate th Iran.
→What this
The results of was significan with uric ac consumed in However, the dietary referen reference valu
y intakes
n Shiraz
Dariush Irani5
ase, but it may ormation in pati h kidney stone sease-related v ftware, to estim pare the quant alitative variabl
%) were female, The mean intak th calcium ston ith uric acid sto
fructose (p=0.0 as significantly n consumption 0.18) with spon een consuming s. Therefore, ad
Obesity, Physica
nces.
i D, Mohammadi z. Med J Islam Re
which is fo
IRI)
mjiri.33.8
ready known” in
f kidney stones, e lifestyle (reduced s problem endan untries. To date, e relationship bet
article adds:
f this study showe ntly higher in the id stones. Howe the group with mean intake of nce intakes (DRI ues used to plan a
and ston
5
, Mohsen Mo
be improved b ients with urina e were selected ariables, physic mate micro and m
itative variable les. The correla
, with the mean ke of calcium-c es compared to ones than in tho 03) was signifi y higher in patie
of high-oxalic ntaneous stone e g vitamin A, b dopting a health
al activity
i Sartang M, Hag epub Iran. 2019 (
ormed by min
this topic:
especially in deve d physical activit ngers public heal no cross section tween dietary int
ed that the mean i e group with calc ever, high-purine uric acid stone c vitamin D and ca I) in both groups. and assess nutrien
ne forma
ohammadi Sar
by a healthy die ary stones in Sh from Faghihi h cal activity (us macro nutrients es between the ation between v
n BMI of 27.0 ± containing food o those with uric ose with calcium
cantly higher in ents with uric a
beverages (p=0 expulsion.
eta-carotene, a hy diet and incre
ghighizadeh MH (20 Feb);33:8. htt
neral density
eloping countries ty and increased lth and imposes nal study has b take and stone fo
intake of calcium cium stones comp e foods were s compared to calc alcium were sign . DRI is a genera nt intakes of healt
ation
rtang6,
et. The aim of th hiraz.
hospital, Shiraz sing IPAQ), an
s) were evaluat e 2 groups and variables was d
± 4.68 kg/m2, ds (p=0.02) an c acid stones. T um stones (p=0.
in patients with acid than in tho 0.005, correlati
and foods cont easing physical
H. The association tps://doi.org/10.3
due to chang
, is increasing du obesity) and foo great therapeuti een conducted t rmation in Shiraz
m-containing food pared to the grou ignificantly mor cium stone group nificantly less tha al term for a set o thy participants.
his study was to
z. Demographi d dietary intak ed. Independen d multi groups etermined using
and 73 (66.4% nd high-fructos The mean intak 007). The mean h calcium stone ose with calcium
on coefficient =
taining calcium activity may b
n between dietar 34171/mjiri.33.8
ges in urinary
ue d ic to z,
ds up re p. an of
o
c ke nt s, g
%) e ke n es m =
m, e
ry
y
Nutrition and
environmenta most importa stone is mor long-term im types of cryst ing calcium o stones (struvi of 2 or more calcium oxal stones (5). Th 5% in female prevalence of per 1000 (7). mon in men t ple working the summer. people (8). O stone formati kidney stone High-fiber an stones (11). containing fo ed with redu consumption crease oxalat without distur of animal pro increases urin the formation cated that in recurrence is in those with cium diet (14 these individu Consumption grams, is asso of stone form taining high p erate amount protein, reduc tually increas (17). Salt is a calcium ston forming kidn formation and pickled cucum foods (18). I oxalate, prote crease the risk in water, pot stone formati reduces the ri stones. In add reducing the found a stro sumption and (21).
Prevalence ent regions is study has bee
d kidney stone
al conditions ant factor in re prevalent i mmobility, and talline compo
oxalate, calci te), uric acid, forms of ston late, are invo he prevalence es and 10%-1 f kidney stone
Kidney ston than in wome in hot and lo This ratio is Obesity and o
ion (9). The r es was identi nd fruit diets Increased ods (almonds uced risk of s of high-oxala te secretion, rbing oxalate otein (like egg nary uric acid n of calcium a men with ca higher in tho a low protein 4). Also, there
uals with an n of 100 gra ociated with a mation (15). U potassium frui of low-fat da ces the risk o ses the amoun another factor nes, especially neys. There is d consumptio mber, canned In general, it ein, sodium, k of formation tassium, and ion (19). Dri isk of stone fo dition,
sugar-risk of stone ong correlatio d increased ris
of kidney sto s difference, en conducted i
es
(2). Low uri stone format in those with d osteoporosis unds for urina ium phosphat
and cysteine nes (4). Calciu olved in abou e of kidney sto 15% in males e disease was
e disease is 4 en and is more ow-mobile env also higher in overweight ar role of nutritio fied in adult may protect a consumption s and bananas stone formatio
ate foods may even in he metabolism ( g white) reduc d, which are h and uric acid s alcium stones, se with a low n, low sodium e is a risk of
increase in m ams of meat,
a 30%-50% in Using a DASH its and vegeta airy and a low f kidney ston nt of urinary s
contributing t y in people s a relationsh on of salty su d food, sausag
is suggested ascorbic acid n of kidney sto magnesium r inking fluids, ormation in pa free lemon ju e formation (2 on between h sk of formatio
ones and food and to date, n in Shiraz to in
ine volume is tion; also, ki h hypothyroid s (3). There a ary stones, inc te, bacteria-re
and a combin um stones, m ut 80% of ki one disease is s (6). In Iran reported to b 4 times more e common in vironments an n obese and w re risk factor on in formatio t population
against the ris of magnes ) may be asso on (12). Incre y significantl ealthy individ (13). Consump ces urinary pH
harmful agent stones. It was , the rate of s w calcium diet m, and normal hospitalization meat consump
compared to ncrease in the H diet (a diet ables), with a m
amount of an es (16), which secretion of ci to the formatio who have st hip between s ubstances, suc ges, and prep that diets ric d, and purine ones and diets reduce the ris especially w atients with ki uice is effectiv
20). Some stu high-fructose
n of kidney st
patterns in di no cross sect nvestigate the
s the idney dism, are 5 clud-elated nation mainly idney s 3%-n, the be 4.2
com- peo-nd in white rs for on of (10). sk of sium- ociat-eased ly in-duals, mption H and ts for indi-stone t than l
cal-n for ption. o 50 e risk con- mod-nimal
h ac-itrate on of tone-stone ch as pared ch in e in-s rich sk of water, idney ve in udies con-tones
iffer-tional
rela-tions Ther betw with
M
In ston selec 2016 pant Com 9769 parti com infec stud supp tests colle the ston tion used teris resid mas num sy, ques tionn tions (coe were 3000 ered son cons ques 42% sum mea tal s with parti mete metr SPS test quan grou varia used as m as si intak trien ston intak (n=1
ship between refore, this st ween dietary h urinary stone
Methods
n this cross se nes who refer cted using co 6. An informe ts. The prese mmittee of Shi 9). The partic icular diet, an mplications, su ction. Of the dy due to tak plements, and s, ultrasounds
ected. The typ morphologica ne was conside compared to d to collect da stics (age, sex dence), anthro
s index), info mber of stones
surgery, fami stionnaire (IPA
naire (FFQ). s as heavy act efficient of 4), e added up. Th 0, and greater d as light, mod
must work c sider the sco stionnaire we % and 70% by mable foods wa
asured using J scale, with a h the least po icipant was as er was used w ric indices we S version 19 w
and one-way ntitative varia ups, respective ables was don d for correlatio mean ± standa
ignificant. The kes of energy, nts. For certa ne, the intakes
kes (DRI) by 100) in this s
n dietary inta udy aimed to intake and s es in Shiraz.
ectional study rred to Faghih
onvenience s ed consent wa ent study wa iraz Universit ipants aged 18 nd did not hav uch as inflam participants, king calcium, d antacids. S , and the phy pe of stone w al analysis by ered for each
other stones. ata, which inc x, occupation, opometric ind ormation abou
, spontaneous ily history of AQ), and vali The IPAQ co tivity (coeffici , and walking he activities ra r than 3000 m derate, and he continuously
re. The valid re confirmed, y retest method
as reported as apanese body precision of ossible clothin
sked to stand with a precisio ere compared was used for d y ANOVA w ables between ely. Comparis ne using chi s on measureme rd deviation, e Nut 4 softwa , carbohydrate in nutrients c s were compa y one-sample study was est
akes and sto o determine th stone formatio
y, 115 patient ihi hospital in sampling met as obtained fro as approved b ty of Medical
8-60 years, di ve any underly mmation, kidn
5 were exclu vitamin D a Some specific ysician’s appro was determined y a microsco
stone with >5 A 5-part que cluded demog educational l dices (height, ut the diseas s expulsion, u f stones), phy idated food fr ontained 3 sec ient of 8), mo g (coefficient anged from 0 min/w, which eavy respectiv
for at least dity and relia
, with Cronb d (22). The a s servings. Bo y composition 0.1 kg, with ng. To measu
against the w on of 0.5 cm. d with CDC 2 data analysis. were used to n the 2 grou son between square test. Pe
ent. All data w and p<0.05 w are was used t e, protein, fat, considerably ared with die e t test. The timated using
ne formation he association on in patient
ts with kidney n Shiraz were thod in 2015 om the partici by the Ethic Sciences (No id not follow a ying or related ney or bladde
uded from the and vitamin C c biochemica oval were also d according to ope. The main 50% composi stionnaire wa raphic charac level, place o weight, body e (stone type se of lithotrip ysical activity equency ques ctions of ques oderate activity
of 3.3), which to 600, 600 to h were consid
vely. The per 10 minutes to ability of thi ach's alpha o mount of con dy weight wa n monitor digi out shoes and ure height, the wall, and a tape The anthropo -20 standards Independent compare the ups and mult n qualitative earson test wa were expressed was considered to estimate the , and micronu
related to the etary reference e sample size g the Cochran n.
n ts
y e - i-s o. a d er e C al o o n i-as c-of
y e,
p-y s-y h o
d- r-o
s of n-as
i-d e e
o-s. t e ti e as d d e
u-e e e n
formula, with
Results
Out of 110 female, with (66.4%) were kg/m2. Also,
tients had cal cystine stones excluded for b calcium-conta group with c uric acid ston cantly more c compared to (p=0.007). Th the group with in the group w ever, no sign groups in the mean intakes were significa
Table 1.Demo
Variable †Job
†Education
†Habitation
†Physical activ
†Type of urina
*Height (cm) *Weight (kg) * BMI (Kg / m *Age (year) †. The data are pr *. The data are pr
Table 2.Comp
Foodstuff
Potassium-rich Calcium-rich f High oxalate fo Drinks with hig High-sodium f High-purine fo High Fructose High-magnesiu *Significant with
h α=0.0, p=q=0
0 participants the mean BM e male, with
75.7% of fem lcium oxalate s). Also, 2 pa better analysi aining foods calcium stone nes (p=0.02). H
consumed in o the group he mean intak h uric acid sto with calcium nificant differe
e mean intake s of vitamin
antly higher i
ographic indices o
vity
ary stones
m2)
resented as "number
resented as "mean ±
parison of mean fo
h fruits foods
oods gh oxalate foods oods
Drinks um foods h p<0.05 using t - te
0.5, and d=0.1
in this study, MI of 27.0±4. the mean BM male and 74%
stones (18.9% atients with cy
s (Table 1). T was significa es compared t High-purine f the group wi p with calci ke of high-fruc one was signif
oxalate stones ence was obse e of other foo
A, beta-carot in patients wit
of participants ba
Unemploye The worke housewife Employee Total Illiterate-eleme
Tips Secondary sch
Academic Total Village
City Total Low Moderate
High Total Calcium oxa
Uric acid Sistine Total
r (percent)."
± SD".
food intake per we Stone type
est
1 (23).
, 37 (33.6%) .68 kg/m2, an
MI of 24.21± % of the male % uric acid, ystine stones The mean intak antly higher in to the group foods were sig
ith uric acid s um stone g ctose beverag ficantly lower s (p=0.038). H erved between ods (Table 2).
tene, and fruc th calcium ox
sed on sex Sex
ed er e e
entary
hool c
e
late d
eek based on type Calcium oxalat
24.75 ± 9.53 18.68 ± 7.82 9.64 ± 7.42 25.59 ± 15.93
13.13 ± 7.02 11 ± 4.59 5.83 ± 4.22 6.47 ± 4.39
were nd 73 ±2.96 e pa-1.9%
were ke of n the with gnifi-stone group ges in r than
How-n the . The uctose xalate
ston How uric ston intak Ther and in th ed t phor c, w intak than intak cant take rus, resu tion ston sign beve R=0
15 64
47
e of urinary stone te
Food intake (s mea
nes than in p wever, caffein acid stone t nes (p=0.01). T
ke of other nu re was no sign sex (p=0.61) he 2 groups. T
o kidney ston rus, vitamin D were compared
ke of vitamin n DRI in both
ke of sodium, tly greater tha e of other micr
and magnesiu ults of Pearson
between hig ne expulsion in nificant correl
erages and st 0.18); nonethe
Female
0 (0) 0 (0) 34 (91.8)
3 (8.1) 37 (100) 20 (54.1) 8 (21.6) 5 (13.5) 4 (10.8) 37 (100) 18 (48.6) 19 (51.4) 37 (100) 23 (62.2) 7 (18.9) 7 (18.9) 37 (100) 28 (75.5) 7 (18.9)
2 (5.4) 37 (100) 54.97 ± 6.82 4.67 ± 10.81 27 ± 4.68 7.35 ± 11.13
e
Uric ac ervings per week an ± SD
21.81 ± 14.88 ± 9.42 ± 6 25.09 ± 1 13 ± 4 13.86 ± 4.38 ± 2 6.38 ± 4
atients with ne intake was
han in the g There was no utrients betwe nificant differ and calcium o The intake of m
nes, including D, calcium, B d with DRI in n D and calci h groups (p< vitamin B6, a an DRI in bot
ronutrients, su um, were sim n correlation sh
gh-oxalate be n 1 year (p=0
ation was fou tone expulsion less, this relat
cid k)
9.53 5.11 6.12 12.42
.58 4.83 2.61 4.48
uric acid sto s higher in th group with ca significant di een the 2 grou rence between oxalate and u micronutrient g sodium, pot B6, magnesium
n all participan ium were sig <0.05). Howev
and vitamin C th groups (p< uch as potassi milar to DRI ( howed a signi everages and 0.005, R=0.26) und between n during 1 y tionship was n
Mal
29 (39 23 (31 0 (0 21 (28 73 (1 18 (24 18 (24 18 (24 19 (2 73 (1 30 (41 43 (58 73 (1 20 (27 21 (28 32 (43 73 (1
54 (7 19 (2 0 (0 73 (1 173.61 ± 73.13 ±
24.21 ± 42.46±
ones (p<0.05) he group with alcium oxalate fference in the ups (Table 3) n age (p=0.83 ric acid stone ts mostly relat tassium, phos m, and vitamin
nts. The mean nificantly les ver, the mean C were signifi <0.05). The in ium, phospho (Table 4). The ificant correla d spontaneou ). Moreover, a
high-fructose year (p=0.048
not significan
le
9.7) 1.5) 0)
8.8) 00) 4.7) 4.7) 4.7) 26)
00) 1.1) 8.9) 00) 7.4) 8.8) 3.8) 00) 74) 26) 0)
00) ± 7.11
10.77 ± 2.96 12.02
p
0.14 0.02* 0.88 0.88 0.91 0.007* 0.038* 0.92
). h e e ). ) s t- s-n n s n i- n- o-e a-us
a e 8, nt
Nutrition and
in other food expulsion wa tap water tha consumed stro but none were
Table 3.Comp
Stone t Nutrient Energy (kcal/d Carbohydrate ( Protein (g/d) Total fat (g/d) Saturated fat (g Mono fat (g/d) Cholesterol (g/ Poly fat (g / d) Vitamin A (RE Beta-carotene Vitamin D (ug Vitamin C (mg Vitamin B6 Calcium (mg/d Potassium (mg phosphor (mg/ Sodium (mg/d) Magnesium (m Fructose (g/d) Caffeine (mg/d *Significant with Mono fat, unsatu Poly fat, unsatura g = gram, mg = m
Table 4.Comp
Nutrient Potassium (mg Vitamin D (ug Phosphor (mg Calcium (mg/d Sodium (mg/d) Magnesium (m Vitamin c (mg B6 (mg/d) *Significant with ** mean ± SD
Table 5.The re
Type of food High- potassium High-oxalate fo High-oxalate dr High-calcium f High- sodium f High- purine fo High- fructose High-magnesiu Caffeine *Significant with
Table 6.The re
Type of drink
Consumed wate
Consumed tea
P< 0.05 was co a. One way Ano
d kidney stone
d groups (Tab as observed m an in others (p ong tea than l e significant (
parison of the mea type
d) (g/d)
g/d) )
/d) E)
(ug / d) g/d)
g/d)
d) g/d)
/d) ) mg/d)
d)
h p<0.05 using t- tes urated fat with a dou ated fat with multip milligram, RE = ret
parison of the mea
g/d) 508
g/d)
g/d) 7
d) 8
) 3
mg/d) 4
g/d) 22
h p<0.05 using t –te
elationship betwee
m fruits oods
rinks foods foods oods
drinks um foods
p<0.05 based on Pe
elationship betwee
er Mine
Purif ordin Ligh Heav onsidered signific ova, b. Independe
es
ble 5). Also, s more in partic
p=0.81) and light tea (p=0. (Table 6).
an intake of nutri
st uble bond ple double bonds
inol equivalent, ug
an intake of nutri
Male (n=73 84.38 ± 3010.45**
0.75 ± 0.68 65.89 ± 393.32 33.48 ± 468.38 3071.36 ± 2584 38.35 ± 237.65 27.34 ± 139.10 4.30 ± 3.39 est
en food groups an
earson-coefficient (
en water and tea c
eral water (n=1) fied water (n=1) nary (Pipe) water
t tea (n=43) vy tea (n=67)
ant. ent t – test
spontaneous s cipants consum
also in those .63) during 1
ients based on typ Calcium ox
Mean ± S 1432.94 ± 59 225.42 ± 15
43.71 ± 15 28.5 ± 1 12.54 ± 5. 8.68 ± 6.3 97.03 ± 50
3.05 ± 1.4 2704.24 ± 20 1374.83 ± 12 0.71 ± 0.6 260.43 ± 13
3.85 ± 3.0 777.68 ± 44 4657.54 ± 28 732.40 ± 38 2757.99 ± 10 407.61 ± 23 33.68 ± 17 148.61 ±
= microgram
ients with DRI Intake 3) Female
* 3931
0
597 269
339 221 3
nd stone expulsio
(p < 0.05).
consumption with Fr
(n=8)
stone uming who year,
Di
In men er, r
pe of urinary ston xalate
SD 99.99 56.96 5.64
2 .55 38 0.49
43 031.53 205.93
68 33.24
08 46.45 865.09 82.53 084.59 32.46 7.64
96
(n=37) 1.51 ± 2808.99 0.53 ± 0.49
635 ± 300 7.76 ± 332.75 96.43 ± 855.26
9.87 ± 229.92 1.40 ± 119.93 3.24 ± 2.97
on
Spon Correlation coe 0.03 -0.1 0.26 -0.13 0.15 0.063
0.18 0.03 -0.033
h frequency of sp requency of spont
Mean
iscussion
n the past, pa nded to limit t recent studies
ne
M 162
26 4 3
10
188 94
25
68 481 68 266
39 2 23
Male 4700
15 700 1000 2300 400-420
90 1.3-1.7
ntaneous stone ex efficient
pontaneous stone taneous stone exp
year n ± standard devia
2.5±1.5 2.63 ± 1.36 2.95 ± 2.67 2.72 ± 2.1 2.95 ± 2.61
tients with ca he intake of h s do not conf
Uric acid Mean ± SD 23.88 ± 804.27 63.98 ± 193.67 46.50 ± 20.68 30.48 ± 18.02 12.91 ± 7.49
8.92 ± 5.65 01.04 ± 54.41
3.58 ± 2.79 80.45 ± 1432.85 45.88 ± 783.25
0.58 ± 0.44 52.67 ± 142.87
4.21 ± 3.87 81.98 ± 421.30 16.68 ± 3371.74 89.45 ± 326.70
66.02 ± 905.92 97.78 ± 261.27 25.59 ± 14.64 34.03 ± 159.89
DRI e Female
4700 15 700 1000 2300 0 310-320
75 1.3-1.5
xpulsion duration
expulsion duratio pulsion duration 1
ation
alcium stones high-calcium firm it (24). I
Male 0.27 <0.001*
0.15 0.003* 0.013* 0.31 <0.001* <0.001*
1 year p 0.73 0.26 0.005*
0.15 0.10 0.51 0.048*
0.7 0.73
on 1 year
1 p
0.8
0.6
s were recom foods, howev In the presen
p
0.19 0.29 0.46 0.51 0.78 0.86 0.72 0.35 0.02* 0.03* 0.27 0.79 0.62 0.32 0.81 0.6 0.69 0.85 0.03* 0.01*
p Female
0.10 <0.001*
0.19 <0.001*
0.008* 0.51 <0.001*
0.001*
1a
3b
m- v-nt
study, it was DRI even in found that the with an incre was not signif size of the sub ducted by Le was lower in participants ( for oxalate a increase urina the mean con nificantly hig than in patien cated that red 1000 to 120 sources may b urinary oxala from food is e is not known through diet h whether the o The misinform bias of the 24 nal absorption ious availabil may be the r sorption from cretion of ox oxalate forma well understo completely at study conduc levels, high p urinary oxalat
Consuming for kidney sto found that the increases the than calcium of Tracy et al tein increases healthy indivi on uric acid le to beef or chi pH and uric amino acids acid results in the risk of sto In this stud expulsion dur ordinary cons stone expulsi heavy tea tha tea and low study by Brz black tea, an stones format (with low lev ate choice for
s found that c n patients wit
e amount of u ease in the hi
ficant, which bjects. Simila onetti et al, it
patients with (25). Consider
absorption, d ary oxalate (2 nsumption of h gher in patien nts with uric a ducing the int 00 milligrams be a useful ap ate (27). Abou expected to b n whether th has a major co oxalate in the mation about 4-hour food re
n of oxalate in lity of oxalat easons behind m oxalate beve xalate (28). T ation from in ood, In fact,
ttributed to th cted on the ef
production o te levels (29). g animal prote ones formatio e intake of hi risk of form oxalate stones l, who found t s the serum an
iduals. In add evels due to h icken (30). It acid decrease and that the n an increase i one formation dy, it was fou ring 1 year w sumption of w ion was more an light tea, w percentage in ezicha et al, i nd green tea h tion, respectiv vels of oxalate r patients with
calcium intak th calcium st urinary excret gh-calcium fo
may be due to arly, in a
case-t was found case-th h calcium ston
ring the impo decreasing cal 26). Moreover high-oxalate b nts with calciu acid stones. M
take of high-s per day ca pproach to red ut 40% to 50%
e secreted in he amount of ontribution in e body plays the amount o ecall and FFQ n different ind te from diffe d this, as incr erages increas Therefore, as nternal and fo
the stone for he food intak ffects of diet o
f internal ox .
ein is consider on. In the pre igh-purine foo
ation of uric s. This was sim that consumpt nd urinary lev dition, fish ha higher levels o has been ind e due to acidi conversion o in urinary leve
(31). und that the f
was higher in water than ot e frequent in with a high pe n green tea c it was indicat had the highe vely (32). Th e) is considere
h kidney ston
ke was lower tones. It was tion reduced a oods intake, b o the small sa -control study hat calcium in nes than in he ortance of cal lcium intake r, it was found beverages was um oxalate st Moreover, it is oxalate foods alcium from duce the amou % of oxalate in
urine. Howev f oxalate rece stone formatio a significant f food oxalate Q, different in
dividuals, and rent food sou reased oxalate ses the urinar
the proportio ood sources is rmation canno ke. According on urinary ox alate caused
red as a risk f esent study, it ods, such as m
acid stones, m milar to the re tion of animal vels of uric ac d a greater im f purine comp icated that uri ic load by sul of purine into el, which incre
frequency of s n patients wit
ther groups. A those consum ercentage in b consumption. ted that heavy est rate of ox herefore, green
ed as an appr nes. Jeong et a
than also along but it ample y
con-ntake ealthy lcium may d that s sig-tones
indi-s and
food unt of ntake ver, it eived on or role. e, the ntesti-d var-urces e ab-ry se-on of
s not ot be g to a xalate high
factor t was meat, more esults l pro-cid in mpact pared rinary lfuric o uric eases
stone th an Also, uming black In a y tea, xalate n tea
ropri-al
in-dica prev gala thes in b the n it wa erag sign In sign Pietr betw cium ed th daily and stud intak (36) leve due In was and cons form sults mec lism mula its le tose both rece ated So tient the m stud puls sign DRI sodi lead creti um mov calc cium It w cant may hand incre supe play ston So meta
ated that green vent stone for ate-catechin (3
e 2 studies, it lack tea may number and e as found that ges, such as b nificantly. n the present s nificantly grea ro Manuel et ween dietary in m oxalate ston
hat healthy pe y had up to 56 up to 61% i dies showed th ke in men, th ). One mechan els may conver to increased o n the present
found betwe stone expuls sumption is i mation of calc s are consisten
hanisms inclu m, which may
ated AMP is c evels (38). Ot
in insulin re h of which are ent studies ind d with a higher odium restrict ts with kidney most importan dy, there was
sion and high-nificant. Sodiu I in this study ium chloride ding to bone c
ion of calcium intake reduc ves bone calc
ium from the m levels and u was also showe
tly reduces uri y increase the r
d, high sodium easing NADP eroxide dismu ys an importan nes (45).
ome studies r abolites of vit
n tea, despite i rmation becau
33). Thus, ac t is suggested
be a possible expulsion of s higher consum black tea, inc
study, the leve ter in both gr t al showed ntake of vitam nes (34). How
eople who con 6% increased increased ston hat with a sma heir risk of st nism of action rt to oxalate w oxidative stres study, a sign en the intake sion. Taylor e
ndependently ium and uric nt with the re ude using AT result in AM converted into ther mechanism esistance and e associated w dicate that me
r risk of kidne tion is a usua y stones, as hi nt factors in s a positive cor -sodium food, um intake in bo
y. Frassetto et intake may in calcium releas m (42). It was ces calcium
ium, and stim intestine, thr rinary secretio ed that increa inary citrate le risk of stone f m intake induc PH oxidase en utase (SOD) e nt role in patho
reported that tamin D, such
its free oxalate use of the pre ccording to d that high lev
e mechanism stones. In the mption of hig creased the st
els of vitamin roups than DR
no significan min C and for wever, Baxman
nsumed 1g of urinary secret ne formation all increase in tones increase n is that high which secreted ss in kidney st nificant positi of high-fruct et al showed y associated w
acid stones ( esults of our s TP during fru MP accumulati o uric acid, w sms include th metabolic sy with chronic a etabolic syndr
ey stones (40) al recommend igh sodium in stone formatio rrelation betw , but this diffe oth groups wa et al showed t
ncrease metab se and increas s found that in
reuptake by mulates the re rough which t on of calcium asing sodium evels in adults formation (47) ces oxidative nzyme activity enzyme activit hogenesis of ca
increased lev h as 1,25 di-hy
e content, may esence of epi
the results o vels of oxalate
for increasing present study h-oxalate bev one expulsion
n C intake wa RI. A study by nt relationship rmation of cal nn et al report f ascorbic acid
tion of oxalate (35). Severa n ascorbic acid
ed up to 31% h ascorbic acid d into the urine
tones (37). ive correlation tose beverage d that fructose
with increased 21). These re study. Possible uctose metabo
ion. The accu which increase he role of fruc yndrome (39) acidosis. Some
ome is associ .
dation for pa ntake is one o on (41). In thi ween stone ex erence was no as greater than that additiona bolic acidosis sed urinary se ncreased sodi the kidneys eabsorption o the serum cal m increase (43) intake signifi s (15), and thi ). On the othe stress through y and reducing ty (44), which alcium oxalate
vels of active ydroxyvitamin y i-of
e g y,
v-n
as y p l- t-d e al d % d e
n s e d
e-e o- u-s
c-), e
i- a-of
s x-ot
n al s,
e- i-s, of l-).
i-s er h g h e
e n
Nutrition and
D, increase c mation of urin that vitamin D ly lower than ta-analysis stu min D levels kidney stones D increased t (47). In this were not incl cal studies re droxyvitamin urinary secret supplements i is controversi the main sour the food sourc should be pa plement in the dose of vitam droxyvitamin stones.
Vitamin A the formation intake of this with calcium stones. Grase creased the g (50). In anoth vitamin A in stones than i were not con exists in anim tion of foods cium oxalate son.
Caffeine is stone formati that stone ex caffeine intak which may be et al showed creases with i the results of that caffeine mation by in (52). Thus, ca ing ADH horm
Conclusion
Recommen sumption of h spite several kidney stones their dietary h
Acknowled
This work w search Comm ences. The a
d kidney stone
calcium secre nary stone. In D intakes from
DRI in patien udy, Hai Wan s were signifi s than in healt the risk of sto
study, patien luded. Howev eported no ass n D levels and tion of calciu in the formati ial (48). In th rce of vitamin ces of this vita aid to the pote e formation o min D intake n D are also
deficiency is n of kidney st s vitamin was m oxalate ston
es et al showe growth and f her study by ntake was hig
in other patie nsistent with mal and dairy
containing th stones may b
another subst ion. The resul xpulsion reduc
ke, but the r e due to the sm
that the risk o increasing caf f our study. O prevents calc ncreasing the
affeine may p mone in termi
n
ndations shoul high oxalate
problems as s, patients sho habits and red
dgments
was financiall mittee of Shir authors appre es
tion (46) and n the present s m food source nts with kidne ng et al showe ficantly highe
thy individual one formation nts who rece ver, several ot sociation betw formation of um. Thus, the ion of kidney his study, the r
n D was not c amin are limit ential role of f kidney stone e and serum o key determ
s considered a ones (49). In
significantly nes than thos ed that vitamin formation of
Nemati et al, gher in patien ents. The resu ours. Since v foods (51), t his vitamin in be considered
tance whose e lts of the pres ced in patient reduction wa mall sample s of developing ffeine intake, w One possible m
cium and uric volume of u lay a preventi inal tubules (2
ld focus on r food sources. sociated with ould be encou duce their body
ly supported b raz University eciate the hel
d increase the study, it was f s were signifi ey stones. In a ed that serum r in patients ls and that vit n in these pat eived supplem
ther epidemio ween serum 25
kidney stones role of vitam y stones in hum
role of sunlig considered an ted, more atten f this vitamin
es. In addition levels of 25 minants of ki
as a risk fact the present st higher in pat se with uric n A deficienc stones in ani it was found nts with uric ults of their s vitamin A m the high consu
patients with as a possible
effect is studie sent study sho ts with increa as not signifi
ize. Pietro Ma kidney stone which is simil mechanism ma c acid stones urine and dilu ive role by im 29).
reducing the . Furthermore h the treatmen
uraged to imp y weight.
by the Studen y of Medical
p of Student e for-found icant-a me- vita-with tamin tients ments
ologi-5 hy-s and min D mans ght as nd, as ntion sup-n, the 5
hy-idney
tor in tudy, tients acid cy
in-imals d that acid study mostly ump-h cal-e rcal-ea-
rea-ed on owed asing icant, anuel es
de-lar to ay be s
for-ution
mpair- con-e, de-nt of prove
nt Re- Sci-t
Re-sear ence Shir nel a
Inf
In clud
St
Th ining cost tient (Ma
Co
The
Re 1. Jo
Re 197 2. C
Va hyp 3. W ren 4. M 199 5. M Sta com 6. St
Tim Sta 7. Ta Co Sci 8. Bl Ka Teh 9. Ta risk 10.
Wa sto 50 11. H
for int Tra 12. S eff for 200 13. S red 20 14. B
et a idi 15. K
die the of 16. T
red 9. 17. T
ch Committe es and cooper raz. The autho and the partici
formed conse
nformed conse ded in the stud
tudy limitation
he limitations g healthy pe s of laborator ts because the any patients di
onflict of Inter
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