Abstract
Kidney stone disease (KSD) (alternatively nephrolithiasis or urolithiasis) is a global healthcare problem that affects almost all of developed and developing countries. Its prevalence has been continuously increasing with a high recurrence rate after stone removal. Although effective therapeutic modalities are available, preventive strategies for both new and recurrent stones are required to reduce physical and financial burdens of KSD. To prevent kidney stone formation, its etiology and risk factors should be firstly considered. Low urine output and dehydration are the common risks for all stone types, whereas hypercalciuria, hyperoxaluria and hypocitraturia are the major risks of calcium stone. In this article, up-to-date knowledge on strategies (nutrition-based mainly) to prevent KSD is provided. Important roles of fluid intake (2.5-3.0 L/day), diuresis (>2.0-2.5 L/day), lifestyle and habit modifications (e.g., maintain normal body mass index, fluid compensation for working in high-temperature environment, and avoid cigarette smoking), and dietary management (e.g., sufficient calcium at 1,000-1,200 mg/day, limit sodium at 2 g/day or 3-5 g/day of NaCl, limit oxalate-rich foods, avoid vitamin C and vitamin D supplements, limit animal proteins to 0.8-1.0 g/kg body weight/day but increase plant proteins in calcium and uric acid stone patients and those with hyperuricosuria, increase proportion of citrus fruits, and consider lime powder supplementation) are summarized. Moreover, uses of natural bioactive products (e.g., caffeine, epigallocatechin gallate, and diosmin), medications (e.g., thiazides, alkaline citrate, other alkalinizing agents, and allopurinol), bacterial eradication, and probiotics are also discussed.
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