(HealthDay News) -- Greater dietary intake of fiber, fruits, and vegetables is associated with a reduced risk of incident kidney stones in postmenopausal women, according to research published in the December issue of The Journal of Urology. Mathew D. Sorensen, M.D., from the University of Washington in Seattle, and colleagues analyzed prospective data from 83,922 postmenopausal women (mean age, 64 years; 85 percent white) participating in the Women's Health Initiative. The associations between total dietary fiber, fruit, and vegetable intake and the risk of incident kidney stone formation were evaluated, adjusting for nephrolithiasis risk factors. The researchers found that 3.5 percent of women experienced a kidney stone during a median follow-up of eight years. In adjusted models of women without a stone history, higher total dietary fiber (6 to 26 percent decreased risk; P < 0.001), greater fruit intake (12 to 25 percent decreased risk; P < 0.001), and greater vegetable intake (9 to 22 percent decreased risk; P = 0.002) were associated with a decreased risk of incident kidney stone formation. There were no significant protective effects noted for fiber, fruit, or vegetable intake on the risk of kidney stone recurrence in women with a history of stones. "The protective effects were independent of other known risk factors for kidney stones," the authors write. Several authors disclosed financial ties to the pharmaceutical industry.
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The American College of Physicians (ACP) has unveiled a new guideline for preventing recurrent kidney stones in adults. For patients who have had 1 or more prior kidney stone episodes, the guideline recommends increased fluid intake spread throughout the day to achieve at least 2 liters of urine per day. The guideline also recommends pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol to prevent nephrolithiasis in patients with active disease in which increased fluid intake fails to reduce stone formation. In addition, according to the guideline, which was published in Annals of Internal Medicine(2014;161:659–667), evidence shows that patients who decreased intake of soda acidified by phosphoric acid had decreased kidney stone recurrence. “Clinicians should encourage patients to avoid colas as opposed to fruit-flavored soft drinks, which are often acidified by citric acid,” the guideline stated. The guideline, developed by the ACP's Clinical Guidelines Committee, is based on a systemic evidence review and an evidence report sponsored by the U.S. Agency for Healthcare Research and Quality. |
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