Doctor's Review: Medicine on the Move

November 29, 2021
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A DASH for your kidney stones

We used to think that only a few specific foods promoted kidney disease. So we would tell patients to eliminate foods high in oxalate, for example, but not worry about the rest of their diet. Now, new studies suggest that an overall dietary pattern will reduce the risk of developing kidney stones, while at the same time helping manage some of the conditions associated with their development like high blood pressure and metabolic syndrome.

The US department of Health and Human Services recommends following the DASH diet for the treatment of hypertension.1 It includes eating more fruits, vegetables, nuts, legumes, low-fat dairy and whole grains, while reducing red meat, processed meat and sweetened drinks. The diet is lower in sodium and contains normal to high levels of calcium and lower levels of animal protein, and increases urinary citrate levels, all of which contribute to bringing down the incidence of kidney stones. However, it also contains higher levels of vitamin C and oxalate, which are believed to increase the risk of forming kidney stones.

Yet, new research suggests that following a DASH diet can reduce the incidence of kidney stones, even in people with a history of them. This effect has been seen in different age groups, and in men and women.2

A subsequent study measured urinary output and composition in participants following the DASH diet and found that urinary citrate levels and urinary volume were increased.3 In this study, the urinary volume increase was independent of the amount of fluids consumed. It is thought that this might be due to the increased amount of fluid in the vegetables and fruits in the diet itself. The authors also suggest that there may be substances present in lower-fat dairy products or in fruits, vegetables and legumes that have not yet been identified that could act to inhibit the formation of kidney stones.

In addition, studies found that being overweight or obese and having metabolic syndrome are also associated with an increased risk of developing kidney stones.4,5 However, there is concern that weight-loss diets that are high in animal protein, or where the client is poorly hydrated or loosing too much lean body mass, can actually lead to the development of kidney stones.6 The DASH diet has also been used to promote weight loss and improve metabolic risk factors in people with metabolic syndrome.7

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