Abstract
Objectives: Kidney stone disease (KSD) has a strong association with diet metabolic syndrome. This review aims at exploring the lithogenic risk posed by the current most popular diets. Our approach was to search for the effect of each diet type on the major urinary risk factors, to try to draw conclusions regarding the association of a specific diet type and KSD. Methods: This systematic review searched for the available literature exploring the association between the existing popular fad diets and KSD. Articles in English, French and Spanish were included, without restriction of the search period with the final search done in August 2021. Results: Total number of studies and studies for each diet type was as follows: 22 articles for the low carbohydrate diet, 20 articles for high protein diets, 26 articles for vegetarian and vegan diets. There exists a substantial variability in different low carbohydrate and high protein diets, and considerable overlap between modern popular fad diets. High carbohydrate intake might increase urine uric acid, calcium and oxalate levels. High protein diets increase urine calcium and uric acid and lower urine pH and citrate. Consumption of fruits and vegetables increases the urinary volume and urinary citrate. In vegan diets, sufficient daily calcium intake is important to avoid possible secondary hyperoxaluria. Conclusions: Few studies evaluated the direct relationship between modern fad diets and KSD. In general, the reduction of carbohydrate in the diet, and counterbalancing protein rich diets with sufficient intake of fruits and vegetables, seem to play a protective role against KSD formation. Maintaining sufficient calcium intake in vegan and vegetarian diets is important. Additional research is needed to directly evaluate the link between KSD and each diet type.
Highlights
Kidney stone disease (KSD), with an estimated prevalence of up to 10–14% in industrialized nations [1,2], is closely related to obesity and other components of the Metabolic Syndrome (Mets) [3]
This review aims at exploring the lithogenic risk posed by the current most popular diets
Given the close relationship between KSD and obesity, it is surprising to find how limited the literature is when searching for the effects of diets to treat obesity, on the risk for KSD, as highlighted in the PRISMA flow chart
Summary
Kidney stone disease (KSD), with an estimated prevalence of up to 10–14% in industrialized nations [1,2], is closely related to obesity and other components of the Metabolic Syndrome (Mets) [3]. The early steps involve mineral precipitation secondary to reduced fluid intake and over-saturation of their urinary levels, followed by crystal nucleation, aggregation, and growth to particles measuring a few hundred microns. These particles might agglomerate into small stones that continue to grow in the renal collecting system, in different rates, according to the underlying pathology. Whether associated to oxalate or phosphate, represent the majority of stones They are influenced by excessive urine calcium and oxalate levels, due to high dietary intake or intestinal malabsorption syndromes, or a rise of urine calcium due to parathyroid disease. Uric acid stones on the other hand, which constitute almost 10–15% of stones, are closely linked to high dietary protein and uric acid intake, and to metabolic acidosis in addition to insulin-dependence
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