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Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up.

Abstract

Diet plays an important role in the pathogenesis of kidney stones. Because the metabolism of many dietary factors, such as calcium, may change with age, the relation between diet and kidney stones may be different in older adults. Uncertainty also remains about the association between many dietary factors, such as vitamin C, magnesium, and animal protein, and the risk of kidney stone formation. To examine the association between dietary factors and the risk of incident, symptomatic kidney stones in men and to determine whether these associations vary with age, a prospective cohort study was conducted of 45,619 men without a history of nephrolithiasis. Self-administered food frequency questionnaires were used to assess diet every 4 yr. A total of 1473 incident symptomatic kidney stones were documented during 477,700 person-years of follow-up. For men aged <60 yr, the multivariate relative risk (RR) for stone formation in the highest quintile of dietary calcium as compared with the lowest quintile was 0.69 (95% confidence interval [CI], 0.56 to 0.87; P = 0.01 for trend). By contrast, there was no association between dietary calcium and stone formation in men aged 60 yr or older. The multivariate RR for men who consumed 1000 mg or greater of vitamin C per day compared with those who consumed less than the recommended dietary allowance of 90 mg/d was 1.41 (95% CI, 1.11 to 1.80; P = 0.01 for trend). Other dietary factors showed the following multivariate RR among men in the highest quintile of intake compared with those in the lowest: magnesium, 0.71 (95% CI, 0.56 to 0.89; P = 0.01 for trend); potassium, 0.54 (95% CI, 0.42 to 0.68; P < 0.001 for trend); and fluid, 0.71 (95% CI, 0.59 to 0.85; P < 0.001 for trend). Animal protein was associated with risk only in men with a body mass index <25 kg/m(2) (RR, 1.38; 95% CI, 1.05 to 1.81; P = 0.03 for trend). Sodium, phosphorus, sucrose, phytate, vitamin B(6), vitamin D, and supplemental calcium were not independently associated with risk. In conclusion, the association between calcium intake and kidney stone formation varies with age. Magnesium intake decreases and total vitamin C intake seems to increase the risk of symptomatic nephrolithiasis. Because age and body size affect the relation between diet and kidney stones, dietary recommendations for stone prevention should be tailored to the individual patient.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Channing Laboratory, Third Floor, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA. entaylor@partners.org

    ,

    Source

    MeSH

    Adult
    Aged
    Ascorbic Acid
    Calcium, Dietary
    Dietary Proteins
    Follow-Up Studies
    Humans
    Incidence
    Kidney Calculi
    Magnesium
    Male
    Middle Aged
    Nutrition Assessment
    Potassium, Dietary
    Risk Factors
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    15579526

    Citation

    Taylor, Eric N., et al. "Dietary Factors and the Risk of Incident Kidney Stones in Men: New Insights After 14 Years of Follow-up." Journal of the American Society of Nephrology : JASN, vol. 15, no. 12, 2004, pp. 3225-32.
    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(12):3225-32.
    Taylor, E. N., Stampfer, M. J., & Curhan, G. C. (2004). Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. Journal of the American Society of Nephrology : JASN, 15(12), pp. 3225-32.
    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(12):3225-32. PubMed PMID: 15579526.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. AU - Taylor,Eric N, AU - Stampfer,Meir J, AU - Curhan,Gary C, PY - 2004/12/8/pubmed PY - 2005/2/3/medline PY - 2004/12/8/entrez SP - 3225 EP - 32 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 15 IS - 12 N2 - Diet plays an important role in the pathogenesis of kidney stones. Because the metabolism of many dietary factors, such as calcium, may change with age, the relation between diet and kidney stones may be different in older adults. Uncertainty also remains about the association between many dietary factors, such as vitamin C, magnesium, and animal protein, and the risk of kidney stone formation. To examine the association between dietary factors and the risk of incident, symptomatic kidney stones in men and to determine whether these associations vary with age, a prospective cohort study was conducted of 45,619 men without a history of nephrolithiasis. Self-administered food frequency questionnaires were used to assess diet every 4 yr. A total of 1473 incident symptomatic kidney stones were documented during 477,700 person-years of follow-up. For men aged <60 yr, the multivariate relative risk (RR) for stone formation in the highest quintile of dietary calcium as compared with the lowest quintile was 0.69 (95% confidence interval [CI], 0.56 to 0.87; P = 0.01 for trend). By contrast, there was no association between dietary calcium and stone formation in men aged 60 yr or older. The multivariate RR for men who consumed 1000 mg or greater of vitamin C per day compared with those who consumed less than the recommended dietary allowance of 90 mg/d was 1.41 (95% CI, 1.11 to 1.80; P = 0.01 for trend). Other dietary factors showed the following multivariate RR among men in the highest quintile of intake compared with those in the lowest: magnesium, 0.71 (95% CI, 0.56 to 0.89; P = 0.01 for trend); potassium, 0.54 (95% CI, 0.42 to 0.68; P < 0.001 for trend); and fluid, 0.71 (95% CI, 0.59 to 0.85; P < 0.001 for trend). Animal protein was associated with risk only in men with a body mass index <25 kg/m(2) (RR, 1.38; 95% CI, 1.05 to 1.81; P = 0.03 for trend). Sodium, phosphorus, sucrose, phytate, vitamin B(6), vitamin D, and supplemental calcium were not independently associated with risk. In conclusion, the association between calcium intake and kidney stone formation varies with age. Magnesium intake decreases and total vitamin C intake seems to increase the risk of symptomatic nephrolithiasis. Because age and body size affect the relation between diet and kidney stones, dietary recommendations for stone prevention should be tailored to the individual patient. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/15579526/full_citation L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=15579526 DB - PRIME DP - Unbound Medicine ER -