Diets Higher in Calcium and Potassium May Help Prevent Recurrent Symptomatic Kidney Stones
Not only can kidney stones cause excruciating pain, but they also are associated with chronic kidney disease, osteoporosis, and cardiovascular disease. If you’ve experienced a kidney stone once, you have a 30% chance of having another kidney stone within five years.
Typically, doctors prescribe changes in diet to prevent recurrent symptomatic kidney stones. Unfortunately, there is little research available regarding dietary changes for those who have one incident of kidney stone formation versus those who have recurrent incidents.
A kidney stone is a solid, pebble-like piece of material that can form in one or both of your kidneys when your urine contains high levels of certain minerals.
Therefore, Mayo Clinic researchers designed a prospective study to investigate the impact of dietary changes. According to their results, enriching diets with foods high in calcium and potassium may prevent recurrent symptomatic kidney stones.
411 patients who had experienced first-time symptomatic kidney stones and a control group of 384 people participated in the study. Dietary factors were based on a questionnaire administered to the participants, all of whom were seen at Mayo Clinic in Rochester and Mayo Clinic in Florida between 2009 and 2018. The findings, which will be published today (August 1) in Mayo Clinic Proceedings, show that lower dietary calcium and potassium, as well as lower intake of fluids, caffeine, and phytate, are associated with higher odds of experiencing a first-time symptomatic kidney stone.
Lower Calcium and Potassium Intake Linked to Higher Stone Risk
Of the patients who had first-time stone formation, 73 experienced recurrent stones within a median of 4.1 years of follow-up. Further analysis revealed that lower levels of dietary calcium and potassium predicted recurrence.
“These dietary findings may have particular importance because recommendations for preventing kidney stones have been based primarily on dietary factors associated with first-time rather than recurrent stone formation,” says Andrew Rule, M.D., a Mayo Clinic nephrologist and senior author of the study. “Patients may not be likely to adjust their diet to prevent an incidence of kidney stones, but they are more likely to do so if it can help prevent recurrence.”
Fluid and Caffeine Intake
Fluid intake of less than 3,400 milliliters per day, or about nine 12-ounce glasses, is associated with first-time stone formation, along with caffeine intake and phytate, the study finds. Daily fluid intake includes intake from foods such as fruits and vegetables.
Drink plenty of water if you have kidney stones unless otherwise directed by a health care professional.
Low fluid and caffeine intake can result in low urine volume and increased urine concentration, contributing to stone formation. Phytate is an antioxidant compound found in whole grains, nuts, and other foods that can lead to increased calcium absorption and urinary calcium excretion.
“Changing your diet to prevent kidney stones can be very difficult,” says Dr. Rule. “Thus, knowing the dietary factors that are most important for preventing kidney stone recurrence can help patients and providers know what to prioritize.”
Low dietary calcium and potassium was a more important predictor than fluid intake of recurrent kidney stone formation, says Api Chewcharat, M.D., the article’s first author and a postdoctoral research fellow at Mayo Clinic at the time of the study. “This is not to say high fluid intake is not important. We just did not find benefits of increasing fluid intake among those patients with a history of kidney stone formation.”
Recommended Dietary Intakes for Calcium and Potassium
The study concludes that diets with daily intake of 1,200 milligrams of calcium may help prevent first-time and recurrent kidney stones. That daily intake is in line with the Department of Agriculture’s daily recommended nutrition.
While higher potassium intake also is recommended, the USDA does not make a recommendation for daily potassium intake. The study also doesn’t recommend an intake level.
Dr. Chewcharat says the takeaway is that patients should add more fruits and vegetables that are high in calcium and potassium to their diets. Fruits that are high in potassium include bananas, oranges, grapefruits, cantaloupes, honeydew melons, and apricots. Vegetables include potatoes, mushrooms, peas, cucumbers, and zucchini.
Reference: “Dietary Risk Factors for Incident and Recurrent Symptomatic Kidney Stones” 1 August 2022, Mayo Clinic Proceedings.
DOI: 10.1016/j.mayocp.2022.04.016
Co-authors with Drs. Rule and Chewcharat are Charat Thongprayoon, M.D.; Lisa Vaughan; Ramila Mehta; Phillip Schulte, Ph.D.; Helen O’Connor; and John Lieske, M.D. — all of Mayo Clinic — and Erin Taylor, M.D., of VA Maine Healthcare System. Dr. Schulte reports personal fees from OxThera Inc. outside the work on this study. Dr. Lieske reports grants and/or other fees from pharmaceutical and related companies identified in the article — all outside this study and all paid to Mayo Clinic. The other authors report no competing interests.
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39 Comments
‘Phytate is an antioxidant compound found in whole grains, nuts, and other foods that can lead to increased calcium absorption and urinary calcium excretion.’
I’m confused by the sentence above. You only have to look on Pubmed to find dozens of studies showing that phytate REDUCES calcium absorption.
This article mentions caffeine three times, as follows:
#1:
“The findings, which will be published today (August 1) in Mayo Clinic Proceedings, show that lower dietary calcium and potassium, as well as lower intake of fluids, caffeine, and phytate, are associated with higher odds of experiencing a first-time symptomatic kidney stone.”
#2:
“Fluid intake of less than 3,400 milliliters per day, or about nine 12-ounce glasses, is associated with first-time stone formation, along with caffeine intake and phytate, the study finds.”
#3:
“Low fluid and caffeine intake can result in low urine volume and increased urine concentration, contributing to stone formation.”
It seems clear that your article reports that higher fluid intake may minimize kidney stone recurrence.
However, because of textual ambiguities, I remain uncertain whether the article reports higher or lower intake of caffeine to be beneficial in this regard.
Yet another error laden report from the Mayo Clinic which STILL recommends margarine over butter. High calcium intake without K2 will actually cause stones and plaque build up.
What type of stones. Stones consist of different minerals. The most common is Calcium Oxalate stones. Low oxalate diet can reduce the chance of reoccurrence. This article should reference what type of stones this research applies to.
Potatoes, high in oxalate, not good.
Ralph Dratman, that’s exactly what I was thinking. Thank you for calling it out. I still don’t know if they are recommending higher or lower intake of caffeine. I thought I was going crazy for not understanding what the author was trying to say.
Coffee in and of itself has almost 0 bearing on kidney stone formation. The fact that it’s a diuretic means nothing if youre drinking at least 2 litres of water a day as you should be. Another BS article.
https://www.mayoclinicproceedings.org/article/S0025-6196(22)00382-2/fulltext
Try reading the original journal article. It answers most of your questions.
I should also add that rejecting something because you don’t understand it is foolish. Look at the data and the study’s construction before you reject it out of hand based solely on old information no longer relied on medically and on your own lack of knowledge.
Very confusing article.
Increase calcium intake ?
Isn’t calcium one of the main components of renal calculi ??
This report is very contradictory
False false false and I know since I’ve battled them my whole life. Calcium and potassium should actually be limited
After reading this article. I suppose no one read the article on increasing calcium intake with supplements may increase your risk of stroke or heart attack that eating foods enriched with calcium absorption was better on body.Otherwise damn if you do or you don’t.
Bad science.
1) It is common for multiple stones to be formed before the first one passes. Consequently the passing of a second stone is not an indication of new stone formation!
2) Given item 1, then their study relates to conditions that retains an existing stone! Retaining a stone means that it can grow over time – not good!
3) 9 12oz glassses? Too much or inactive office worker, not enough for a runner in summer. Better to monitor urine output and or color.
My brother had kidney stones and he drank lemonade as lemony as he could take it. Because of the acidic content, the stoned passed without surgery of any kind.
This article does not clearly state how to prevent
I would just like to say that I live with kidney stones and a kidney disease and I’ve had 70 plus kidney procedures like lipotripsy and mine are made out of calcium so a diet of calcium for me would be terrible I do not have the right acid s to break down calcium. And after multiple kidney perks no thanks.
I had kidney stones frequently for years. I started taking potassium citrate vitamins five years ago and haven’t had one since.
Clearly, no one proof reads the articles they write anymore.
Typical internet reporter who didn’t read or understand the original study but feels compelled to write the article anyway. Journalistic chewing gum
Drink Chanka Piedra, aka “The Stone Breaker” I have dozens in each kidney. I Passed 13 stones in 2-3 days without going through the awful spasm and pain. It is cheap, no prescription required. I also took tamulosin 0.4mg capsules for extra help. No problems since.
Misspelled it. Chanca Piedra. Life changing!
I am a kidney stone factory for 20+ years. Grapefruit was never recomended from all fruits. Why would I eat them now? What make grapefruits ok now and not before? Plus most of my stones are made of Cal ox. Why would I intake more Calcium?
I am 55 and have never had one. Yet I have been drinking coffee since I was 6 years old. Was a point when I drank a quart or more. I am part Polak, so potatoes a mainstay of diet. So are mushrooms and pepino.
I am also a chef and drink Chicken stock at work. 2 to 4 cups a day. At home I make stock and add it to my tomato sauces and just about anything else for the nutrients and to enrich the product.
I also hardly drink alcohol. No beer, but do like tequila and only drink margaritas and shots. Gave about 4 a year. Though was a kamakazie and tequila chaser in my youth.
On the other hand most of my friends and coworkers are beer drinkers, most daily, usually just an after-shift drink provided by the establishment and possibly 1-2 at a bar or home, and some heavy, till last call then more at home. Many of them have had k-stones since mid to late 20s. Most with reoccurring stones. They all generally have a coffee, eat potatoes and shrooms, but I was the only one to drink Chicken stock. I am also a chocoholic. Like I told my Lady you can use or consume anything but do not touch my chocolate. I eat only 70% to 95%, the lower one usually with sea salt or fruit or chili. Big chili fan too.
This article is constantly saying one thing than another. Typical of scientist. Please give us money to make a bomb. Ok our names are in the History books now for making it just do not use it without consulting with us first.
Cannot tell what has prevented me from having one as one paragraph says everything generally then the next says I should be mass producing them, except for the chicken stock.
In the end it all comes to who funds them as with all else.
I would never trust Mayo’s urology minions after what they did to my wife after lithotripsy. They destroyed her life and wouldn’t help solve the problem they created.
There are 5 different compositions of kidney stones; Ca Oxalate, Ca Phosphate, Triple Phosphate, uric acid,and the last being one which only occurs in people with Lesch-Nyhan Syndrome. They are addressed quite differently. This article does not say what kind of stones they’re talking about. To suggest a high calcium intake in people with Calcium stones is ludicrous.
It’s good to see I’m not losing it. I am in total agreement with Ralph, regarding caffeine. Is it Yay or nay????
I get why businesses hire English majors to convey management’s analysis.
Now I’ll tell you the truth and what no doctors wants you to know.Take a straight shot of any type of vinegar wait 15 min drink a tall glass of water.You will never get stone.Do this once a week.
My doctor suggested drinking milk or other high calcium foods IF I was eating something high in oxalate levels. The thought is that the calcium and oxalate will bind in the stomach and pass through the kidneys rather than the oxalate building up in the kidney. Reducing calcium too much could cause bone issues from my understanding. I’m only 3 years into kidney stones and man they suck! Science isn’t perfect and I agree parts of the article are confusing. One thing I really dislike is amounts are never suggested, just “reduce your oxalate levels” but what is considered reduced or low enough to make a difference?
how to provent kidneys stones
This information would be disaster for me a multiple calcium stone patient. I changed my diet and doctor added Allopurinol. Have not had a problem for years. To much calcium is the worst for me.
“A kidney stone is a round pebble stone”. WTF!!!
Whoever wrote that sentence has obviously NEVER experienced the utter torment of a hard jagged, all over jagged, little hateful piece of warfare that is made in our bodies. And it waits, so patient. Them BAM, S*** WTF IS THAT TERRIBLE PAIN?
You’re maybe alone. YIKES!! How can I get myself to the ER?
Doesn’t matter anyway. If you are lucky it will pass soon. Maybe the same day of your first kidney stone attack. That’s what I call them.
Mine have taken over a year to pass. Yeah, I saw the x-ray. The ureter without the stone looks like a typical drinking straw. The one with the stone looks like one of those tiny little straws you get in like a gin and tonic.
I don’t think anyone will ever be able to discover how to do much in the way of preventing them. It’d be nice though.
Gó fk yourself ! My dad was no1 in TN for stones . In 80s early 90s. Y’all gave him a free air ride there and back. All I got out of it is he told You People where to stick a pin ina map displaying where along the comberlain lime was. Don’t drink city water remotely close to trail. These people are still dumbass !!
I had kidney stones 20yrs ago,a friend who had them on multiple occaisions told me he started taking Cranberry pills daily (not concentrate) he has no more stones and neither do I.
Hello JG, What is the exact brand of Chanca Piedra you used if you don’t mind me asking?
I believe this is crap because nobody can figure out why my wife has had over 40 Stones at. Time and the keep adding up, they say her kidneys just keep producing them.Here we are 40 years later and still nothing
Need calcium for my bones I have been told I am developing osteoporosis. I get kidney stones quite often. I read that you need to take vitamin k to help the calcium absorb. Is that the truth. I was given calcium caltrate by my arthritis doctor. 3 months later my urology office called and said don’t take that anymore It causes, it causes kidney stones. They gave me calcium citrate. I really don’t know how to stop these stones because do the doctors even look after records to see that you get kidney stones. My arthritis doctor told me I needed calcium for my bones I don’t want to break bones but I don’t want kidney stones I’m at a loss what to do anymore
Kidney stones about killed me..After bariatric surgery I started having hundreds of them. Surgeons thought they didn’t cut of enough
Jejunem, so they went in again and cut off more.Stones increased so much that I was passing hundreds a day from flaked to 9mm ones..after months of watching every morsel that went into my mouth, taking blood daily, going
over my vitamins…they found that eating my calcium chew daily was the culprit…they stopped the calcium chews, the stones stopped, they started the chews again, stones poured out of me. The bariatric and genetic surgeon and Specialist had no explanation..but I have not eaten any more calcium vitamins, nor stones, thank God!
Richard S–Where have you been all my life? Your comment is not only the most astute of all the comments (a relatively low bar, sorry guys:), but more informative than the article itself (another low bar:). I know I am not alone in wondering how to find out more about the different types of stones and how one might avoid each–hopefully without getting a degree in Nephrology! Thanks for any help you might offer us!
I had a 20 M.M stone composit of Cal Oxyalyte plus 2 other compounds, In me for 5 months. Largest stone on record. two stone crusher procedures failed. Urologists said it was impossible to pass it. But I passed it after trying many options , Herbal stone breakers, other liquids & other methods. I finally passed it by helping it to move by using a deep gym Hydro Massage bed . On highest pressure & slow speed . I passed it like a bullet shooting out of me. I should have tried this earlier. I dont hydrate well. Hate water. makes me gag. Plus I never get thirsty, etc. I’m very active & work out a lot. Time to drink more water. or more agony. I also take herbal breakers & stop eating certain foods like Spinach & Beet Root powder , kale & other high Oxyalite foods.