Table 1 ∣.
Dietary risk factor | Mechanism | Urinary aberrationa | Specific stone risk |
---|---|---|---|
Fluid intake insufficient to maintain suitably low urine supersaturation | Concentrated urine | Increased urine supersaturation for crystal formation | All types of stones |
Intake of bicarbonate precursors insufficient to compensate for acidogenic foods in diet | High dietary acid load inducing bone resorption and increased renal citrate reabsorption | Hypercalciuria Hypocitraturia Overly acidic urine |
CaOx, CaPhos, uric acid |
Excessive intake of salt (as NaCl) | Expansion of extracellular volume and decreased renal calcium reabsorption in nephron | Hypercalciuria | CaOx, CaPhos |
Excessive calcium supplementation (above the DRI)b | Increased intestinal calcium absorption | Hypercalciuria | CaOx, CaPhos |
Excessive vitamin D supplementation (above the DRI)c | Increased intestinal calcium absorption | Hypercalciuria | CaOx, CaPhos |
Vitamin D intake insufficient to maintain normal limits | Secondary hyperparathyroidism and bone resorption | Hypercalciuria | CaOx, CaPhos |
Calcium intake insufficient to meet needs for bone, especially in the context of increased dietary protein intake | Rise in calcitriol production | Hypercalciuria | CaOx, CaPhos |
Calcium intake insufficient to compensate for oxalate load in the diet, especially in the context of malabsorption | Increased intestinal absorption of dietary oxalate | Hyperoxaluria | CaOx |
Excessive vitamin C supplementation (>2,000 mg/day) | Increased biosynthesis of oxalate | ||
Excessive intake of animal-derived purines | Increased uric acid biosynthesis | Hyperuricosuria | Uric acid |
CaOx, calcium oxalate; CaPhos, calcium phosphate; DRI, dietary reference intake. aAssessed using 24-h urine collection. bDRI for calcium is 1,200 mg/day for adults >19 years of age. cDRI for vitamin D is 600 International Units (15 mcg)/day for adults.