THE ROLE OF CALCIUM IN THE PREVENTION OF KIDNEY STONES: OLDER REVIEW, BUT STILL ACTUAL CONCLUSIONS In summary, hypercalciuria is a risk factor for kidney stone formation and low bone mass. Though dietary calcium increases urinary calcium, recent epidemiologic data suggests that high calcium intake may, in contrast, reduce risk of an initial stone. The observational data should be interpreted with some caution because calcium was not the only dietary difference, and an unmeasured but associated confounding variable may have been present. For the normal population, full dietary calcium recommendations should be advocated. There is ample evidence that adequate calcium intake should protect against bone loss if not also against stone formation. In the hypercalciuric stone-forming population, a more prudent course should be advised. Along with increased fluid intake and restriction of salt, oxalate and animal flesh, its members should be advised to start consistent intake of one serving of dairy daily. Dietary calcium should be gradually increased as guided by the urinary calcium, and hypocalciuric agents should be added as necessary. Future studies should be designed to examine the specific intervention of increased calcium intake, both by diet and by supplement, on urinary parameters and stone formation, particularly in hypercalciuric stone-formers who may respond conversely. Moreover, we must still determine whether the potential protection against stones is provided by calcium or by other factors present in dairy. Also, in hypercalciuric stone-formers, more work must be done to elucidate the direct cause of bone loss.
Posted on: Wed, 14 Aug 2013 08:24:48 +0000
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