Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials
Fink HA, Akornor JW, Garimella PS, MacDonald R, Cutting A, Rutks IR, Monga M, Wilt TJ
Published in European Urology
Methodology
Systematic review and meta-analysis of randomised controlled trials of dietary, fluid and pharmacological/supplement interventions for secondary prevention of nephrolithiasis, pooling stone recurrence outcomes.
Key Findings
Meta-analysis of randomised trials in recurrent kidney stone formers found increased fluid intake roughly halved stone recurrence, and among supplements thiazides, citrate salts and allopurinol reduced recurrence in calcium stone formers; low-animal-protein/high-fibre diets alone did not reduce recurrence and dietary calcium restriction was not beneficial.
Conclusions
Higher fluid intake plus citrate or thiazide therapy are the interventions with the best randomised evidence for preventing kidney stone recurrence, while restrictive diets and most supplements are unsupported.
Limitations
Limited number of trials per intervention with modest sample sizes, variable follow-up and adherence, heterogeneous stone composition and definitions of recurrence, and older trials at unclear risk of bias.
Supplements Studied
Meta-analysis of randomised trials in recurrent kidney stone formers found increased fluid intake roughly halved stone recurrence, and among supplements thiazides, citrate salts and allopurinol reduced recurrence in calcium stone formers; low-animal-protein/high-fibre diets alone did not reduce recurrence and dietary calcium restriction was not beneficial.
Related Health Concerns
Study Details
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Disclosures
Funding
US Agency for Healthcare Research and Quality / Department of Veterans Affairs
This information is for educational purposes only. Always consult a healthcare professional before starting any supplement regimen.