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Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria.
N Engl J Med 2002; 346(2):77-84NEJM

Abstract

BACKGROUND

A low-calcium diet is recommended to prevent recurrent stones in patients with idiopathic hypercalciuria, yet long-term data on the efficacy of a low-calcium diet are lacking. Recently, the efficacy of a low-calcium diet has been questioned, and greater emphasis has been placed on reducing the intake of animal protein and salt, but again, long-term data are unavailable.

METHODS

We conducted a five-year randomized trial comparing the effect of two diets in 120 men with recurrent calcium oxalate stones and hypercalciuria. Sixty men were assigned to a diet containing a normal amount of calcium (30 mmol per day) but reduced amounts of animal protein (52 g per day) and salt (50 mmol of sodium chloride per day); the other 60 men were assigned to the traditional low-calcium diet, which contained 10 mmol of calcium per day.

RESULTS

At five years, 12 of the 60 men on the normal-calcium, low-animal-protein, low-salt diet and 23 of the 60 men on the low-calcium diet had had relapses. The unadjusted relative risk of a recurrence for the group on the first diet, as compared with the group on the second diet, was 0.49 (95 percent confidence interval, 0.24 to 0.98; P=0.04). During follow-up, urinary calcium levels dropped significantly in both groups by approximately 170 mg per day (4.2 mmol per day). However, urinary oxalate excretion increased in the men on the low-calcium diet (by an average of 5.4 mg per day [60 micromol per day]) but decreased in those on the normal-calcium, low-animal-protein, low-salt diet (by an average of 7.2 mg per day [80 micromol per day]).

CONCLUSIONS

In men with recurrent calcium oxalate stones and hypercalciuria, restricted intake of animal protein and salt, combined with a normal calcium intake, provides greater protection than the traditional low-calcium diet.

Authors+Show Affiliations

Department of Clinical Sciences, University of Parma, Parma, Italy. loris.borghi@unipr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11784873

Citation

Borghi, Loris, et al. "Comparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria." The New England Journal of Medicine, vol. 346, no. 2, 2002, pp. 77-84.
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(2):77-84.
Borghi, L., Schianchi, T., Meschi, T., Guerra, A., Allegri, F., Maggiore, U., & Novarini, A. (2002). Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. The New England Journal of Medicine, 346(2), pp. 77-84.
Borghi L, et al. Comparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria. N Engl J Med. 2002 Jan 10;346(2):77-84. PubMed PMID: 11784873.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. AU - Borghi,Loris, AU - Schianchi,Tania, AU - Meschi,Tiziana, AU - Guerra,Angela, AU - Allegri,Franca, AU - Maggiore,Umberto, AU - Novarini,Almerico, PY - 2002/1/11/pubmed PY - 2002/1/25/medline PY - 2002/1/11/entrez SP - 77 EP - 84 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 346 IS - 2 N2 - BACKGROUND: A low-calcium diet is recommended to prevent recurrent stones in patients with idiopathic hypercalciuria, yet long-term data on the efficacy of a low-calcium diet are lacking. Recently, the efficacy of a low-calcium diet has been questioned, and greater emphasis has been placed on reducing the intake of animal protein and salt, but again, long-term data are unavailable. METHODS: We conducted a five-year randomized trial comparing the effect of two diets in 120 men with recurrent calcium oxalate stones and hypercalciuria. Sixty men were assigned to a diet containing a normal amount of calcium (30 mmol per day) but reduced amounts of animal protein (52 g per day) and salt (50 mmol of sodium chloride per day); the other 60 men were assigned to the traditional low-calcium diet, which contained 10 mmol of calcium per day. RESULTS: At five years, 12 of the 60 men on the normal-calcium, low-animal-protein, low-salt diet and 23 of the 60 men on the low-calcium diet had had relapses. The unadjusted relative risk of a recurrence for the group on the first diet, as compared with the group on the second diet, was 0.49 (95 percent confidence interval, 0.24 to 0.98; P=0.04). During follow-up, urinary calcium levels dropped significantly in both groups by approximately 170 mg per day (4.2 mmol per day). However, urinary oxalate excretion increased in the men on the low-calcium diet (by an average of 5.4 mg per day [60 micromol per day]) but decreased in those on the normal-calcium, low-animal-protein, low-salt diet (by an average of 7.2 mg per day [80 micromol per day]). CONCLUSIONS: In men with recurrent calcium oxalate stones and hypercalciuria, restricted intake of animal protein and salt, combined with a normal calcium intake, provides greater protection than the traditional low-calcium diet. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/11784873/full_citation L2 - http://www.nejm.org/doi/full/10.1056/NEJMoa010369?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -