Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
Nutrients. 2020 Mar 15;12(3):779. doi: 10.3390/nu12030779.
Nephrolithiasis is a common medical condition influenced by multiple environmental factors, including diet. Since nutritional habits play a relevant role in the genesis and recurrence of kidney stones disease, dietary manipulation has become a fundamental tool for the medical management of nephrolithiasis. Dietary advice aims to reduce the majority of lithogenic risk factors, reducing the supersaturation of urine, mainly for calcium oxalate, calcium phosphate, and uric acid. For this purpose, current guidelines recommend increasing fluid intake, maintaining a balanced calcium intake, reducing dietary intake of sodium and animal proteins, and increasing intake of fruits and fibers. In this review, we analyzed the effects of each dietary factor on nephrolithiasis incidence and recurrence rate. Available scientific evidence agrees on the harmful effects of high meat/animal protein intake and low calcium diets, whereas high content of fruits and vegetables associated with a balanced intake of low-fat dairy products carries the lowest risk for incident kidney stones. Furthermore, a balanced vegetarian diet with dairy products seems to be the most protective diet for kidney stone patients. Since no study prospectively examined the effects of vegan diets on nephrolithiasis risk factors, more scientific work should be made to define the best diet for different kidney stone phenotypes.
肾结石是一种常见的医学病症，受多种环境因素影响，包括饮食。由于营养习惯在肾结石病的发生和复发中起着重要作用，饮食控制已成为肾结石医学管理的基本工具。饮食建议旨在减少大多数成石风险因素，降低尿液的过饱和度，主要针对草酸钙、磷酸钙和尿酸。为此，目前的指南建议增加液体摄入、保持平衡的钙摄入量、减少钠和动物蛋白的饮食摄入，并增加水果和纤维的摄入。在这篇综述中，我们分析了每种饮食因素对肾结石发病率和复发率的影响。现有科学证据一致认为，高肉类/动物蛋白摄入和低钙饮食有不良影响，而富含水果和蔬菜并结合低脂肪乳制品的均衡摄入与肾结石的最低风险相关。此外，含有乳制品的均衡素食似乎是肾结石患者最具保护作用的饮食。由于没有前瞻性研究检查纯素饮食对肾结石风险因素的影响，因此应该开展更多的科学工作来确定针对不同肾结石表型的最佳饮食。
