Summary
The most important measure in the prophylaxis of idiopathic calcium urolithiasis is dietary advice. Patients should be kept to a high-fluid intake, increasing their diuresis by at least 0.51. The mineral content of drinking water seems to be of minor importance, but the liquid should be low in carbohydrates and oxalate. The intake of animal proteins should be reduced to no more than five meals with meat, fish or poultry per week. Excesses of oxalate-rich food must be avoided. The daily intake of calcium in dairy products should be in the range of 800–1200 mg. Sodium and refined carbohydrates should be moderately restricted. Medical treatment is indicated only in cases of recurrence under the appropriate diet. Selective treatment according to urinary chemical composition is favoured; alkali citrate, thiazides, allopurinol, and pyridoxine are of major interest.
Similar content being viewed by others
References
Ackermann D, Baumann JM, Futterlieb A, Zingg EJ (1988) Influence of calcium content in mineral water on chemistry and crystallization conditions in urine of calcium stone formers. Eur Urol 14:305
Backman U, Danielson BG, Johansson G, Ljunghall S, Wikström B (1980) Treatment of recurrent calcium stone formation with cellulose phosphate. J Urol 123:9
Brocks P, Dahl C, Wolf H, Transbol I (1981) Do thiazides prevent recurrent idiopathic calcium stones? Lancet II:124
Butz M, Schwab G (1990) Alkalicitrate versus diet: a randomized long-term trial in recurrent calcium stone formers. In: Vahlensieck W, Gasser G, Hesse A, Schoencich G (eds) Proceedings of the 1st European Symposium on Urolithiasis. Excerpta Medica, Amsterdam Hong Kong Princeton Sydney Tokyo, p 184
Churchill DN (1987) Medical treatment to prevent recurrent calcium urolithiasis. Miner Electrolyte Metab 13:294
Churchill DN, Taylor DW (1985) Thiazides for patients with recurrent calcium stones: still an open question. J Urol 133:749
Classen A, Busch B, Gertz B, Weber A, Miersch WD, Hesse A (1989) Dietary fiber and urolithiasis: II. Effects of a high dietary fiber intake on the urine composition in man. In: Walker VR, Sutton RAL, Cameron ECB, Pak CJC, Robertson WG (eds) Urolithiasis. Plenum Press, New York London, p 869
Danielson BG, Fellström B, Wikström B (1989) Glycosaminoglycans as inhibitors of renal stone formation. In: Walker VR, Sutton RAL, Cameron ECB, Pak CYC, Robertson WG (eds) Urolithiasis. Plenum Press, New York London, p 101
Ebisuno S, Morimoto S, Yoshida T, Fukatani T, Yasukawa S, Ohkawa T (1986) Rice-bran treatment for calcium stone formers with idiopathic hypercalciuria. Br J Urol 58:592
Ettinger B (1976) Recurrent nephrolithiasis: natural history and effect of phosphate therapy. Am J Med 61:200
Ettinger B, Tang A, Citron JT, Livermore B, Williams T (1986) Randomized trial of allopurinol in the prevention of calcium oxalate calculi. N Engl J Med 315:1386
Ettinger B, Citron JT, Livermore B, Domant LI (1988) Chlorthalidone reduces calcium oxalate calculous recurrence but magnesium hydroxide does not. J Urol 139:679
Gill HS, Ros GA (1986) Mild metabolic hyperoxaluria and its response to pyridoxine. Urol Int 41:393
Goldfarb S (1988) Dietary factors in the pathogenesis and prophylaxis of calcium nephrolithiasis. Kidney Int 34:544
Hosking DH, Erickson SB, Berg CJ von den, Wilson DM, Smith LH (1983) The stone clinic effect in patients with idiopathic calcium urolithiasis. J Urol 130:1115
Jaeger P, Portmann L, Jacquet AF, Burckhardt P (1984) Drinking water for stone formers: is the calcium content relevant? Eur Urol 10:53
Jaeger P, Portmann L, Jacquet AF, Burckhardt P (1985) Influence of the calcium content of the diet on the incidence of mild hyperoxaluria in idiopathic renal stone formers. Am J Nephrol 5:40
Lacrum E, Larsen S (1985) Thiazide prophylaxis of urolithiasis: a double blind study in general practice. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York London, p 475
Li MK, Kavanagh JP, Prendiville V, Buxton A, Moss DG, Blacklock NJ (1986) Does sucrose damage kidneys? Br J Urol 58:353
Ljunghall S (1985) Incidence of renal stones in Western countries. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York London, p 31
Ljunghall S, Fellström P, Johansson G (1988) Prevention of renal stones by a high fluid intake? Eur Urol 14:381
Marks RG (1982) Designing a research project. Van Nostrand Reinhold, New York, p 124
Minano L, Petta S, Paradiso Galatioto G, Goldoni S, Tubaro A (1985) A placebo controlled double-blind study of allopurinol in severe recurrent idiopathic renal lithiasis. Preliminary results. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York London, p 521
Mortensen JT, Schultz A, Ostergaard AH (1986) Thiazides in the prophylactic treatment of recurrent idiopathic kidney stones. Int Urol Nephrol 18:265
Nakada T, Sasagawa I, Furuta H, Katayama T, Shimazaki J (1988) Effect of high-calcium diet on urinary oxalate excretion in urinary stone formers. Eur Urol 15:264
Pak CYC, Nicar MJ, Britton F (1983) Clinical experience with sodium cellulose phosphate. World J Urol 1:180
Pak CJC, Fuller C, Sakhaee K, Preminger GM, Britton F (1985) Long-term treatment of calcium nephrolithiasis with potassium citrate. J Urol 134:11
Pierce LW, Bloom B (1945) Observations on urolithiasis among American troops in a desert area. J Urol 54:466
Rao PN, Gordon C, Davis D, Blacklock NJ (1982) Are stone formers maladapted to refined carbohydrates? Br J Urol 54:575
Rao PN, Jenkins IL, Robertson WG, Peacock M, Blacklock NJ (1985) The effect of “high fibre biscuits” on urinary risk factors for stone formation. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York London, p 425
Robertson WG, Peacock M (1980) The cause of idiopathic calcium stone disease: hypercalciuria or hyperoxaluria? Nephron 26:105
Robertson WG, Peacock M (1982) The pattern of urinary stone disease in Leeds and in the United Kingdom in relation to animal protein intake during the period 1960–1980. Urol Int 37:394
Robertson WG, Peacock M, Heyburn PJ, Marshall DH, Clark PB (1978) Risk factors in calcium stone disease of the urinary tract. Br J Urol 50:449
Robertson WG, Peacock M, Heyburn PJ, Hanes FA (1980) Epidemiological risk factors in calcium stone disease. Scand J Urol Nephrol 53:15
Robertson WG, Peacock M, Selby PL, Williams RE, Clark P, Chisholm GD, Hargreaves TB, Rose MB, Wilkinson H (1985) A multicentre trial to evaluate three treatments for recurrent idiopathic calcium stone disease — a preliminary report. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York London, p 545
Scholz D, Schwille PO, Sigel A (1982) Double-blind study with thiazide in recurrent calcium lithiasis. J Urol 128:903
Shuster J, Finlayson B, Schaeffer R, Sierakowski R, Zoltek J, Dzegede S (1982) Water hardness and urinary stone disease. J Urol 128:422
Shuster J, Finlayson B, Schaefer L, Sierakowski R, Zoltek J, Dzegede S (1985) Primary liquid intake and urinary stone disease. J Chronic Dis 38:907
Smith MJV (1977) Placebo versus allopurinol for renal calculi. J Urol 117:690
Strauss AL, Coe FL, Deutsch L, Parks JH (1982) Factors that predict relapse of calcium nephrolithiasis during treatment. Am J Med 72:17
Strohmaier WL, Kalchthaler M, Bichler KH (1989) Calcium metabolism in normal subjects and in hypercalciuric patients treated with Farnolith. In: Walker VR, Sutton RAL, Cameron ECB, Pak CJC, Robertson WG (eds) Urolithiasis. Plenum Press, New York London, p 873
Thomas WC (1978) Use of phosphates in patients with calcareous renal calculi. Kidney Int 13:390
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ackermann, D. Prophylaxis in idiopathic calcium urolithiasis. Urol. Res. 18, S37–S40 (1990). https://doi.org/10.1007/BF00301526
Issue Date:
DOI: https://doi.org/10.1007/BF00301526