Prophylaxis in idiopathic calcium urolithiasis.

The most important measure in the prophylaxis of idiopathic calcium urolithiasis is dietary advice. Patients should be kept to a high-fluid intake, increasing their diuresis by at least 0.51. The mineral content of drinking water seems to be of minor importance, but the liquid should be low in carbohydrates and oxalate. The intake of animal proteins should be reduced to no more than five meals with meat, fish or poultry per week. Excesses of oxalate-rich food must be avoided. The daily intake of calcium in dairy products should be in the range of 800-1200 mg. Sodium and refined carbohydrates should be moderately restricted. Medical treatment is indicated only in cases of recurrence under the appropriate diet. Selective treatment according to urinary chemical composition is favoured; alkali citrate, thiazides, allopurinol, and pyridoxine are of major interest.