| Abstract: | The progressive increase in the incidence of calcium oxalatephosphate calculi of the upper urinary tract during the 20th century in Western Europe and North America appears associated with affluence. Changes in diet over that time period have produced changes in urinary solutes which would increase the probability of calculus formation. Increased ingestion of animal protein produces a significant increase in the urinary excretion of calcium, oxalate and uric acid. Dietary calcium, oxalate and purine increase the excretion of calcium, oxalate and uric acid directly. Urine oxalate also increases with an increased ingestion of calcium but, paradoxically, also increases with severe dietary calcium restriction. Oral carbohydrate loading increases urinary calcium and magnesium excretion. Changes in urinary calcium excretion induced by dietary fiber appears related to the phytate content. A rational, though not of proven efficacy, dietary approach to urolithiasis therapy includes restriction of animal protein, avoidance of excess oxalate ingestion, a normal calcium intake, and water intake sufficient to generate 2 liters of urine per day. |
