The Role of Diet in Kidney Stone Formation: A Comprehensive Narrative Review (Atena Editora)

Abstract

INTRODUCTION The review discusses the critical role of diet in the pathogenesis and prevention of kidney stones, highlighting that different dietary components, such as calcium, proteins, sodium, oxalates, fluids, and certain micronutrients like citrate and magnesium, can either increase or decrease the risk of stone formation. The introduction establishes the complexity of dietary influences on stone risk, emphasizing the need for individualized dietary recommendations based on the patient's metabolic profile and risk factors. OBJETIVE To explore the influence of various dietary components on the formation and prevention of kidney stones, emphasizing the role of calcium, proteins, sodium, oxalates, fluids, citrate, magnesium, purines, carbohydrates, and specific foods and beverages. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Dietary Calcium” AND “Kidney Stones” OR Animal Protein” AND “Sodium Intake OR Stone Formation” OR “Oxalate-rich Foods” OR “Fluid Intake” in the last years. RESULTS AND DISCUSSION The results highlight the paradoxical role of dietary calcium, where higher intake is associated with a reduced risk of calcium oxalate stones, in contrast to the increased risk posed by calcium supplements. The discussion covers the adverse effects of high animal protein and sodium intake, which contribute to increased urinary excretion of stone-forming solutes. It also addresses the protective roles of adequate hydration, dietary citrate, and magnesium, alongside the potential benefits of plant-based proteins and fiber-rich diets. The section explores complex interactions between specific foods and beverages and their varying effects on stone risk. CONCLUSION The conclusion emphasizes that kidney stone formation is a multifactorial process where diet is a key modifiable risk factor. It supports individualized dietary counseling tailored to the patient's unique metabolic and risk profiles, while advocating for further research to clarify the complex interactions between diet, metabolism, and stone formation. The review underlines the importance of integrating dietary management into the overall clinical strategy for preventing kidney stones.