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Previous Volume 328:833-838 March 25, 1993 Number 12 Next

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ABSTRACT

Background A high dietary calcium intake is strongly suspected of increasing the risk of kidney stones. However, a high intake of calcium can reduce the urinary excretion of oxalate, which is thought to lower the risk. The concept that a higher dietary calcium intake increases the risk of kidney stones therefore requires examination.

Methods We conducted a prospective study of the relation between dietary calcium intake and the risk of symptomatic kidney stones in a cohort of 45,619 men, 40 to 75 years of age, who had no history of kidney stones. Dietary calcium was measured by means of a semiquantitative food-frequency questionnaire in 1986. During four years of follow-up, 505 cases of kidney stones were documented.

Results After adjustment for age, dietary calcium intake was inversely associated with the risk of kidney stones; the relative risk of kidney stones for men in the highest as compared with the lowest quintile group for calcium intake was 0.56 (95 percent confidence interval, 0.43 to 0.73; P for trend, <0.001). This reduction in risk decreased only slightly (relative risk, 0.66; 95 percent confidence interval, 0.49 to 0.90) after further adjustment for other potential risk factors, including alcohol consumption and dietary intake of animal protein, potassium, and fluid. Intake of animal protein was directly associated with the risk of stone formation (relative risk for men with the highest intake as compared with those with the lowest, 1.33; 95 percent confidence interval, 1.00 to 1.77); potassium intake (relative risk, 0.49; 95 percent confidence interval, 0.35 to 0.68) and fluid intake (relative risk, 0.71; 95 percent confidence interval, 0.52 to 0.97) were inversely related to the risk of kidney stones.

Conclusions A high dietary calcium intake decreases the risk of symptomatic kidney stones. .

Source Information

From the Departments of Epidemiology (W.C.W., E.B.R., M.J.S.) and Nutrition (W.C.W.), Harvard School of Public Health; the Medical Service, Renal Division, Brockton-West Roxbury Veterans Affairs Medical Center (G.C.C.); and the Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital (G.C.C., W.C.W., M.J.S.) -- all in Boston.

Address reprint requests to Dr. Curhan at the Department of Nutrition, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115.

Full Text of this Article

Related Letters:

Calcium and Kidney Stones
Burtis W. J., Broadus A. E., Insogna K. L., Stern R., Curhan G. C., Willett W. C., Stampfer M. J.
Extract | Full Text  
N Engl J Med 1993; 329:508-509, Aug 12, 1993. Correspondence

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