Prevention of recurrent calcium stones: diet versus drugs.

Excessive intakes of meat protein, oxalate and potentially sodium, as well as insufficient intakes of vegetables fibers, calcium and fluid all lead to increased urinary crystallization. Renal stone disease, however, does not have to ensue. The underlying condition in a given patient is of paramount importance to allow 'bad eating habits' to lead to nephrolithiasis. Several of these underlying abnormalities have been detected so far from which we recently derived the powder keg and tinderbox theory. Most of the time, the dietary approach to nephrolithiasis allows recurrence of renal stone formation to be prevented. The pharmacological approach should be reserved for refractory cases.