Dietary Factors and the Risk of Incident Kidney Stones in Men: New Insights after 14 Years of Follow-up
Abstract
Diet plays an important role in the pathogenesis of kidney stones. Because the metabolism of many dietary factors, such as calcium, may change with age, the relation between diet and kidney stones may be different in older adults. Uncertainty also remains about the association between many dietary factors, such as vitamin C, magnesium, and animal protein, and the risk of kidney stone formation. To examine the association between dietary factors and the risk of incident, symptomatic kidney stones in men and to determine whether these associations vary with age, a prospective cohort study was conducted of 45,619 men without a history of nephrolithiasis. Self-administered food frequency questionnaires were used to assess diet every 4 yr. A total of 1473 incident symptomatic kidney stones were documented during 477,700 person-years of follow-up. For men aged <60 yr, the multivariate relative risk (RR) for stone formation in the highest quintile of dietary calcium as compared with the lowest quintile was 0.69 (95% confidence interval [CI], 0.56 to 0.87; P = 0.01 for trend). By contrast, there was no association between dietary calcium and stone formation in men aged 60 yr or older. The multivariate RR for men who consumed 1000 mg or greater of vitamin C per day compared with those who consumed less than the recommended dietary allowance of 90 mg/d was 1.41 (95% CI, 1.11 to 1.80; P = 0.01 for trend). Other dietary factors showed the following multivariate RR among men in the highest quintile of intake compared with those in the lowest: magnesium, 0.71 (95% CI, 0.56 to 0.89; P = 0.01 for trend); potassium, 0.54 (95% CI, 0.42 to 0.68; P < 0.001 for trend); and fluid, 0.71 (95% CI, 0.59 to 0.85; P < 0.001 for trend). Animal protein was associated with risk only in men with a body mass index <25 kg/m(2) (RR, 1.38; 95% CI, 1.05 to 1.81; P = 0.03 for trend). Sodium, phosphorus, sucrose, phytate, vitamin B(6), vitamin D, and supplemental calcium were not independently associated with risk. In conclusion, the association between calcium intake and kidney stone formation varies with age. Magnesium intake decreases and total vitamin C intake seems to increase the risk of symptomatic nephrolithiasis. Because age and body size affect the relation between diet and kidney stones, dietary recommendations for stone prevention should be tailored to the individual patient.
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A prospective cohort study suggested that intake of oral doses of vitamin C higher than 1 g increases the risk of stone formation significantly by 41%.
“A prospective cohort study suggested that intake of oral doses of vitamin C higher than 1 g increases the risk of stone formation significantly by 41% [209].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [209]
Cites
Reproducibility and validity of a semiquantitative food frequency questionnaire
WILLETT, W. C., SAMPSON, L., STAMPFER, M. J., ROSNER, B., BAIN, C., WITSCHI, J., HENNEKENS, C. H., & SPEIZER, F. E. (1985) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114086 · Cited by 4,274 · see citing works
Self-citationRE: “TOTAL ENERGY INTAKE: IMPLICATIONS FOR EPIDEMIOLOGIC ANALYSES”
Palmgren, J., & Kushi, L. H. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115841 · Cited by 2,712 · see citing works
Rimm, E. B., Giovannucci, E. L., Stampfer, M. J., Colditz, G. A., Litin, L. B., & Willett, W. C. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116211 · Cited by 2,104 · see citing works
Self-citationVitamin C pharmacokinetics in healthy volunteers: evidence for a recommended dietary allowance
Levine, M., Conry-Cantilena, C., Wang, Y., Welch, R. W., Washko, P. W., Dhariwal, K. R., Park, J. B., Lazarev, A., Graumlich, J. F., King, J., et al. (1996) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.93.8.3704 · Cited by 1,325 · see citing works
A Prospective Study of Dietary Calcium and Other Nutrients and the Risk of Symptomatic Kidney Stones
Curhan, G. C., Willett, W. C., Rimm, E. B., & Stampfer, M. J. (1993) · New England Journal of Medicine · doi:10.1056/nejm199303253281203 · Cited by 1,183 · see citing works
Self-citationComparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria
Borghi, L., Schianchi, T., Meschi, T., et al. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa010369 · Cited by 1,040 · see citing works
Borghi, L., Meschi, T., Amato, F., Briganti, A., Novarini, A., & Giannini, A. (1996) · The Journal of Urology · doi:10.1016/s0022-5347(01)66321-3 · Cited by 919 · see citing works
Vitamin D in preventive medicine: are we ignoring the evidence?
Zittermann, A. (2003) · British Journal Of Nutrition · doi:10.1079/bjn2003837 · Cited by 877 · see citing works
Curhan, G. C., Willett, W. C., Speizer, F. E., Spiegelman, D. L., & Stampfer, M. J. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-126-7-199704010-00001 · Cited by 740 · see citing works
Self-citationRenal stone epidemiology: A 25-year study in Rochester, Minnesota
Johnson, C. M., Wilson, D. M., O’Fallon, W. M., et al. (1979) · Kidney International · doi:10.1038/ki.1979.173 · Cited by 523 · see citing works
Contribution of dietary oxalate to urinary oxalate excretion
Holmes, R. P., Goodman, H. O., & Assimos, D. G. (2001) · Kidney International · doi:10.1046/j.1523-1755.2001.00488.x · Cited by 502 · see citing works
Relationship of Animal Protein-Rich Diet to Kidney Stone Formation and Calcium Metabolism*
Breslau, N. A., Brinkley, L. J., Hill, K., & Pak, C. Y. C. (1988) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-66-1-140 · Cited by 480 · see citing works
Dietary Factors and the Risk of Incident Kidney Stones in Younger Women
Curhan, G. C., Willett, W. C., Knight, E. L., & Stampfer, M. J. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.8.885 · Cited by 479 · see citing works
Self-citationTwenty-four–hour urine chemistries and the risk of kidney stones among women and men
Curhan, G. C., Willett, W. C., Speizer, F. E., & Stampfer, M. J. (2001) · Kidney International · doi:10.1046/j.1523-1755.2001.00746.x · Cited by 389 · see citing works
Self-citationDemographic and geographic variability of kidney stones in the United States
Soucie, J. M., Thun, M. J., Coates, R. J., et al. (1994) · Kidney International · doi:10.1038/ki.1994.347 · Cited by 331 · see citing works
Hamm, L. L. (1990) · Kidney International · doi:10.1038/ki.1990.265 · Cited by 312 · see citing works
Chlorthalidone Reduces Calcium Oxalate Calculous Recurrence but Magnesium Hydroxide Does Not
Ettinger, B. B., Citron, J. T., Livermore, B. M., et al. (1988) · The Journal of Urology · doi:10.1016/s0022-5347(17)42599-7 · Cited by 293 · see citing works
Lemann, J., Pleuss, J. A., Gray, R. W., & Hoffmann, R. G. (1991) · Kidney International · doi:10.1038/ki.1991.123 · Cited by 230 · see citing works
FREQUENCY OF UROLITHIASIS IN A PREPAID MEDICAL CARE PROGRAM
Hiatt, R. A., Dales, L. G., FRIEDMAN, G. D., et al. (1982) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113297 · Cited by 208 · see citing works
Some factors influencing the urinary excretion of oxalic acid in man
Zarembski, P. M., & Hodgkinson, A. J. (1969) · Clinica Chimica Acta · doi:10.1016/0009-8981(69)90218-6 · Cited by 187 · see citing works
Effect of ascorbic acid consumption on urinary stone risk factors
TRAXER, O., HUET, B., POINDEXTER, J., PAK, C. Y. C., & PEARLE, M. S. (2003) · Journal of Urology · doi:10.1097/01.ju.0000076001.21606.53 · Cited by 169 · see citing works
Barilla, D. E., Notz, C., Kennedy, D. A., et al. (1978) · The American Journal of Medicine · doi:10.1016/0002-9343(78)90576-4 · Cited by 160 · see citing works
Dietary risk factors for hyperoxaluria in calcium oxalate stone formers
Siener, R., Ebert, D., Nicolay, C., & Hesse, A. (2003) · Kidney International · doi:10.1046/j.1523-1755.2003.00807.x · Cited by 157 · see citing works
Hiatt, R. A., Ettinger, B. B., Caan, B. J., Quesenberry, C. P., Duncan, D., & Citron, J. T. (1996) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a008851 · Cited by 154 · see citing works
Kok, D. J., Iestra, J. A., Doorenbos, C. J., & Papapoulos, S. E. (1990) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-71-4-861 · Cited by 142 · see citing works
A Prospective Study of the Intake of Vitamins C and B6, and the Risk of Kidney Stones in Men
Curhan, G. C., Willett, W. C., Rimm, E. B., & Stampfer, M. J. (1996) · The Journal of Urology · doi:10.1016/s0022-5347(01)66027-0 · Cited by 141 · see citing works
Self-citationEFFECTS OF CALCIUM AND MAGNESIUM ON URINARY OXALATE EXCRETION AFTER OXALATE LOADS
Liebman, M., & COSTA, G. (2000) · The Journal of Urology · doi:10.1016/s0022-5347(05)67680-x · Cited by 136 · see citing works
Factors influencing the crystallisation of calcium oxalate in urine—Critique
Robertson, W. G., Scurr, D. S., & Bridge, C. M. (1981) · Journal of Crystal Growth · doi:10.1016/0022-0248(81)90064-6 · Cited by 135 · see citing works
Invited Commentary: Some Limitations of Semiquantitative Food Frequency Questionnaires
Sempos, C. T. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116212 · Cited by 134 · see citing works
Hess, B. J. M. (1998) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/13.9.2241 · Cited by 132 · see citing works
Saltzman, J. R., & Russell, R. M. (1998) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(05)70005-4 · Cited by 115 · see citing works
Pharmacokinetic perspectives on megadoses of ascorbic acid
Blanchard, J., Tozer, T. N., & Rowland, M. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/66.5.1165 · Cited by 105 · see citing works
The importance of renal net acid excretion as a determinant of fasting urinary calcium excretion
Lemann, J., Gray, R. W., Maierhofer, W. J., et al. (1986) · Kidney International · doi:10.1038/ki.1986.60 · Cited by 96 · see citing works
Nutrient Intake and Use of Beverages and the Risk of Kidney Stones among Male Smokers
Hirvonen, T., Pietinen, P., Virtanen, M. J., et al. (1999) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009979 · Cited by 90 · see citing works
Calcium turnover and nutrition through the life cycle.
Abrams, S. A. (2001) · PubMed · doi:10.1079/pns200082 · Cited by 59 · see citing works
Lindberg, J. S., Harvey, J. A., & Pak, C. Y. C. (1990) · The Journal of Urology · doi:10.1016/s0022-5347(17)39924-x · Cited by 48 · see citing works
Risk Factors for Kidney Stones in Older Women in the Southern United States
Hall, W. D., Watts, N. B., Pettinger, M. B., et al. (2001) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200107000-00003 · Cited by 45 · see citing works
Bergsland, K. J., KINDER, J. M., Asplin, J. R., et al. (2002) · The Journal of Urology · doi:10.1016/s0022-5347(05)64987-7 · Cited by 31 · see citing works
Renal Stone Disease in Older Adults
Goldfarb, D. S., Parks, J. H., & Coe, F. L. (1998) · Clinics in Geriatric Medicine · doi:10.1016/s0749-0690(18)30122-8 · Cited by 26 · see citing works
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Doseděl, M., Jirkovský, E., Macáková, K., Krčmová, L., Javorská, L., Pourová, J., Mercolini, L., Remião, F., Nováková, L., Mladěnka, P., et al. (2021) · Nutrients · doi:10.3390/nu13020615 · Cited by 553 · see citing works
Oudemans-van Straaten, H. M., Man, A. M. S.-D., & de Waard, M. C. (2014) · Critical Care · doi:10.1186/s13054-014-0460-x · Cited by 299 · see citing works
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Jovic, T. H., Ali, S. R., Ibrahim, N., Jessop, Z. M., Tarassoli, S. P., Dobbs, T. D., Holford, P., Thornton, C. A., & Whitaker, I. S. (2020) · Nutrients · doi:10.3390/nu12092550 · Cited by 234 · see citing works
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Taylor, E. N., & Curhan, G. C. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01410308 · Cited by 173 · see citing works
Self-citationHealth effects of protein intake in healthy adults: a systematic literature review
Pedersen, A. N., Kondrup, J., & Børsheim, E. (2013) · Food & Nutrition Research · doi:10.3402/fnr.v57i0.21245 · Cited by 167 · see citing works
O’Connor, E. A., Evans, C. V., Ivlev, I., Rushkin, M. C., Thomas, R. G., Martin, A., & Lin, J. S. (2022) · JAMA · doi:10.1001/jama.2021.15650 · Cited by 151 · see citing works
Myths, Artifacts, and Fatal Flaws: Identifying Limitations and Opportunities in Vitamin C Research
Michels, A., & Frei, B. (2013) · Nutrients · doi:10.3390/nu5125161 · Cited by 111 · see citing works
de Souza, R. J., Swain, J. F., Appel, L. J., & Sacks, F. M. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.1.1 · Cited by 72 · see citing works
Ghalibaf, M. H. E., Kianian, F., Beigoli, S., Behrouz, S., Marefati, N., Boskabady, M., & Boskabady, M. H. (2023) · Inflammopharmacology · doi:10.1007/s10787-023-01169-1 · Cited by 60 · see citing works
Williams, D. J., Edwards, D., Pun, S., Chaliha, M., Burren, B., Tinggi, U., & Sultanbawa, Y. (2016) · Food Research International · doi:10.1016/j.foodres.2016.08.004 · Cited by 60 · see citing works
Shi, R., Li, Z., Chen, D., Wu, Q., Zhou, X., & Tie, H. (2018) · Clinical Cardiology · doi:10.1002/clc.22951 · Cited by 51 · see citing works
- Authors
- Taylor, E. N., Stampfer, M. J., & Curhan, G. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Taylor, Eric N.
- Stampfer, Meir J.
- Curhan, Gary C.
- Venue
- Journal of the American Society of Nephrology
- Published
- 2004-12
- Volume
- 15
- Issue
- 12
- Pages
- 3225-3232
- ISSN
- 1046-6673 (ISSN-L)
- OpenAlex
- W2119410610
- Cited by
- 497
- References
- 39
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 26 · 2023: 31 · 2022: 26 · 2021: 18 · 2020: 33 · 2019: 14 · 2018: 16 · 2017: 32 · 2016: 28 · 2015: 30 · 2014: 41 · 2013: 39 · 2012: 35
- FWCI
- 6.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Society of Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Kidney Stones and Urolithiasis Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Keywords
- kidney stones, dietary factors, men, calcium intake, vitamin C, magnesium, potassium, fluid intake, animal protein, sodium, phosphorus, sucrose, body mass index, age differences, older men, risk factors
- MeSH terms
- Adult, Aged, Ascorbic Acid, Calcium, Dietary, Dietary Proteins, Follow-Up Studies, Humans, Kidney Calculi, Magnesium, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Nutrition Assessment, Incidence, Potassium, Dietary
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