Dietary and lifestyle factors for primary prevention of nephrolithiasis: a systematic review and meta-analysis

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#alcohol-drinking #calcium-dietary #carbonated-beverages #coffee #diet

Dietary and lifestyle factors for primary prevention of nephrolithiasis: a systematic review and meta-analysis

Lin et al., 2020 | BMC Nephrol | Meta Analysis

Citation

Lin Bing-Biao, Lin Ming-En, ... He Xue-Jun. Dietary and lifestyle factors for primary prevention of nephrolithiasis: a systematic review and meta-analysis. BMC Nephrol. 2020-Jul-11;21(1):267. doi:10.1186/s12882-020-01925-3

Abstract

BACKGROUND: Dietary and lifestyle factors may play an important role in the increasing prevalence of nephrolithiasis. We aimed to review and quantify the associations between lifestyle factors and incident nephrolithiasis and suggest lifestyle changes for the primary prevention of nephrolithiasis. METHODS: PubMed, EMBASE, and Cochrane Library were searched up to May 2019, for observational studies and randomized controlled trials (RCTs) that assessed modifiable lifestyle factors and risk of nephrolithiasis in adults. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were computed using a random effects model. The I2 statistic was employed to evaluate heterogeneity. Subgroup analysis, sensitivity analysis and meta-regression were also conducted whenever possible. RESULTS: Fifty relevant articles with 1,322,133 participants and 21,030 cases in total were identified. Prominent risk factors for incident stones were body mass index (1.39,1.27-1.52), dietary sodium (1.38, 1.21-1.56), fructose, meat, animal protein, and soda. In contrast, protective factors included fluid intake (0.55, 0.51-0.60), a Dietary Approaches to Stop Hypertension (DASH) style diet (0.69, 0.64-0.75), alcohol (0.69, 0.56-0.85), water, coffee, tea, vegetables, fruits, dietary fiber, dietary calcium (0.83, 0.76-0.90), and potassium. Vitamin D (1.22, 1.01-1.49) and calcium (1.16, 1.00-1.35) supplementation alone increased the risk of stones in meta-analyses of observational studies, but not in RCTs, where the cosupplementation conferred significant risk. CONCLUSIONS: Several modifiable factors, notably fluid intake, dietary patterns, and obesity, were significantly associated with nephrolithiasis. Long-term RCTs are required to investigate the cost-effectiveness of dietary patterns for stone prevention. The independent and combined effects of vitamin D and calcium supplementation on nephrolithiasis need further elucidation.

Key Findings

Fifty relevant articles with 1,322,133 participants and 21,030 cases in total were identified. Prominent risk factors for incident stones were body mass index (1.39,1.27-1.52), dietary sodium (1.38, 1.21-1.56), fructose, meat, animal protein, and soda. In contrast, protective factors included fluid intake (0.55, 0.51-0.60), a Dietary Approaches to Stop Hypertension (DASH) style diet (0.69, 0.64-0.75), alcohol (0.69, 0.56-0.85), water, coffee, tea, vegetables, fruits, dietary fiber, dietary calci

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 1322133
Age Range See abstract
Condition hypertension

MeSH Terms

  • Alcohol Drinking
  • Calcium, Dietary
  • Carbonated Beverages
  • Coffee
  • Diet
  • Dietary Approaches To Stop Hypertension
  • Dietary Fiber
  • Dietary Supplements
  • Drinking Behavior
  • Drinking Water
  • Fruit
  • Humans
  • Life Style
  • Nephrolithiasis
  • Potassium, Dietary
  • Primary Prevention
  • Tea
  • Vegetables
  • Vitamin D

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09