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Previous Volume 346:77-84 January 10, 2002 Number 2 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Ingelfinger, J. R. Editorial by Bushinsky, D. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background A low-calcium diet is recommended to prevent recurrent stones in patients with idiopathic hypercalciuria, yet long-term data on the efficacy of a low-calcium diet are lacking. Recently, the efficacy of a low-calcium diet has been questioned, and greater emphasis has been placed on reducing the intake of animal protein and salt, but again, long-term data are unavailable.

Methods We conducted a five-year randomized trial comparing the effect of two diets in 120 men with recurrent calcium oxalate stones and hypercalciuria. Sixty men were assigned to a diet containing a normal amount of calcium (30 mmol per day) but reduced amounts of animal protein (52 g per day) and salt (50 mmol of sodium chloride per day); the other 60 men were assigned to the traditional low-calcium diet, which contained 10 mmol of calcium per day.

Results At five years, 12 of the 60 men on the normal-calcium, low-animal-protein, low-salt diet and 23 of the 60 men on the low-calcium diet had had relapses. The unadjusted relative risk of a recurrence for the group on the first diet, as compared with the group on the second diet, was 0.49 (95 percent confidence interval, 0.24 to 0.98; P=0.04). During follow-up, urinary calcium levels dropped significantly in both groups by approximately 170 mg per day (4.2 mmol per day). However, urinary oxalate excretion increased in the men on the low-calcium diet (by an average of 5.4 mg per day [60 µmol per day]) but decreased in those on the normal-calcium, low-animal-protein, low-salt diet (by an average of 7.2 mg per day [80 µmol per day]).

Conclusions In men with recurrent calcium oxalate stones and hypercalciuria, restricted intake of animal protein and salt, combined with a normal calcium intake, provides greater protection than the traditional low-calcium diet.

Source Information

From the Departments of Clinical Sciences (L.B., T.S., T.M., A.G., F.A., A.N.) and Internal Medicine and Nephrology (U.M.), University of Parma, Parma, Italy.

Address reprint requests to Dr. Borghi at the Department of Clinical Sciences, University of Parma, Via Gramsci 14, 43100 Parma, Italy, or at loris.borghi{at}unipr.it.

Full Text of this Article

Related Letters:

Prevention of Recurrent Stones in Idiopathic Hypercalciuria
Teichman J., Muldowney F.P., Bataille P., Presne C., Fournier A., Gavras I., Borghi L., Maggiore U., Bushinsky D. A.
Extract | Full Text | PDF  
N Engl J Med 2002; 346:1667-1669, May 23, 2002. Correspondence

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