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Update in Urology, Endourology • IBJUInt. braz j urol 47 (4) • Jul-Aug 2021 • https://doi.org/10.1590/S1677-5538.IBJU.2021.04.04   copy
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Editorial Comment: Fluid Intake and Dietary Factors and the Risk of Incident Kidney Stones in UK Biobank: A Population-based Prospective Cohort Study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Thomas J. Littlejohns 1 1 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; , Naomi L. Neal 2 2 Oxford Stone Group, Oxford University Hospitals NHS Trust, Oxford, UK; , Kathryn E. Bradbury 3 3 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand; , Hendrik Heers 4 4 Department of Urology and Paediatric Urology, Philipps-Universität Marburg, Marburg, Germany; , Naomi E. Allen 5 5 Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; , Ben W. Turney 6 6 Oxford Stone Group, Oxford University Hospitals NHS Trust, Oxford, UK

Eur Urol Focus. 2020 Jul 15;6(4):752-761

COMMENT

Prevalence of kidney stone disease is high and it is still increasing (11. Scales CD Jr, Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012;62:160-5.). Stone recurrence rate is also high and can achieve half of patients in a 10-year follow-up (22. Fink HA, Akornor JW, Garimella PS, MacDonald R, Cutting A, Rutks IR, et al. Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials. Eur Urol. 2009;56:72-80.). Therefore, nephrolithiasis has a significant impact on kidney stone formers life and important costs related to patient care. In this scenario, prevention work is an essential tool to decrease patient's suffering and reduce medical expenses.

Fluids intake, vegetables and fruits consumption and some herbs are considered protective against kidney stone formation, whereas salt and meat are associated with a higher chance of nephrolithiasis (33. Ferraro PM, Bargagli M, Trinchieri A, Gambaro G. Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients. 2020;12:779.–55. Pucci ND, Marchini GS, Mazzucchi E, Reis ST, Srougi M, Evazian D, et al. Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention. Int Braz J Urol. 2018;44:758-64.). However, most of studies have limited number of patients and some data are conflicting. Littlejohns et al have presented a study with a large population from a prospective database including almost 500 000 people showing that higher total fluid intake is associated wit a lower risk of kidney stones after adjustment for lifestyle and socioecomic factors. Also fruits and fibers are protective, while meat and salt are associated with a increased risk of kidney stone formation. Although these findings are not really a novelty, this study provides a better quality evidence for our recommendations when clinically managing kidney stone formers. Of course, this study has limitations inherent to its design, as it does not take into account dietary changes overtime and some potential confounders may not be considered in the analysis.

Urologists should be encouraged to counsel their patients for dietary modifications aiming to reduce kidney stone formation. It is a low cost strategy and easy method for improving patient's quality of life.

REFERENCES

  • 1
    Scales CD Jr, Smith AC, Hanley JM, Saigal CS; Urologic Diseases in America Project. Prevalence of kidney stones in the United States. Eur Urol. 2012;62:160-5.
  • 2
    Fink HA, Akornor JW, Garimella PS, MacDonald R, Cutting A, Rutks IR, et al. Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials. Eur Urol. 2009;56:72-80.
  • 3
    Ferraro PM, Bargagli M, Trinchieri A, Gambaro G. Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients. 2020;12:779.
  • 4
    Afkari R, Feizabadi MM, Ansari-Moghadam A, Safari T, Bokaeian M. Simultaneous use of oxalate-degrading bacteria and herbal extract to reduce the urinary oxalate in a rat model: A new strategy. Int Braz J Urol. 2019;45:1249-59.
  • 5
    Pucci ND, Marchini GS, Mazzucchi E, Reis ST, Srougi M, Evazian D, et al. Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention. Int Braz J Urol. 2018;44:758-64.

Publication Dates

  • Publication in this collection
    30 July 2021
  • Date of issue
    Jul-Aug 2021
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