What are the dietary recommendations for the treatment of hypercalciuria?

Updated: Apr 23, 2019
  • Author: Stephen W Leslie, MD, FACS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The following are recommendations in the dietary treatment of hypercalciuria:

  • Limit daily calcium intake to 600-800 mg/day unless otherwise instructed

  • Limit dietary oxalate, especially when calcium intake is reduced; high oxalate levels are found in strong teas; nuts; chocolate; coffee; colas; green, leafy vegetables (eg, spinach); and other plant and vegetable products

  • Avoid excessive purines and animal protein (< 1.7 g/kg of body weight)

  • Reduce sodium (salt) and refined sugar to the minimum possible

  • Increase dietary fiber (12-24 g/day)

  • Limit alcohol and caffeine intake

  • Increase fluid intake, especially water (sufficient to produce at least 2 L of urine per day)

Dietary modifications involving reasonable restrictions of dietary calcium, oxalate, meat (purines) and sodium, have been useful in reducing the urinary supersaturation of calcium oxalate. This effect is more pronounced in calcium oxalate ̶ stone formers with hypercalciuria than in calcium nephrolithiasis patients who are normocalciuric.

Some have suggested that the following 3 criteria need to be fulfilled for any dietary factor to be implicated in kidney stone disease:

  • Intake of the dietary constituent should be increased in patients with stones compared with controls

  • Restriction of the dietary factor should decrease stone formation rates

  • The reason the dietary factor causes stones needs to be understood

The main dietary contributions of calcium, sodium, potassium, animal protein, fiber, alcohol, caffeine, water, oxalate, and carbohydrates are reviewed individually below. No relationship between dietary fat and hypercalciuria has been found.


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