To prevent nephrolithiasis (kidney stones), attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Diet
- Dehydration – dehydration of the body due to fluid loss or lack of fluid intake.
- Malnutrition
- High-protein (high-protein) diet (animal protein).
- High intake of oxalic acid-containing foods (chard, cocoa powder, spinach, rhubarb).
- High intake of calcium
- High purine intake (offal, herring, mackerel).
- High consumption of table salt (eg, canned and convenience foods).
- Fructose-containing beverages lead to an increase in uric acid serum levels in approximately 5% of patients – due to the presence of a gene variant of the fructose transporter gene SLC2A9 – this leads to disruption of renal excretion of uric acid.
- Micronutrient deficiency (vital substances) – see prevention with micronutrients.
- Consumption of stimulants
- Alcohol
- Physical activity
- Immobility
- Overweight (BMI ≥ 25; obesity).
Medication
- Chronic antibiotic therapy – medications used to treat bacterial infections; three to twelve months after prescription, the risk of kidney stones increases by 30-130%:
- Sulfonamides (e.g., sulfamethoxazole) (odds ratio, OR 2.3).
- Cephalosporins (OR 1.9).
- Fluoroquinolones (OR 1.7)
- Nitrofurantoin (OR 1.7)
- Broad-spectrum penicillins (OR 1.3)
- Laxative abuse – dependence on laxatives.
- Vitamin D intoxication (e.g. due torickets prophylaxis/prevention of bone softening in children).
Prevention factors (protective factors)
- More than half of all stone events can be influenced by lifestyle factors:
- <2 liters of fluid intake per day (26% of all cases).
- Overweight (18.9-21.8%)
- Diet significantly different from the DASH diet (DASH diet: eat a lot of fruits and vegetables and low-fat dairy products).
- High calcium intake (in the top quintile).
- > 4 sweetened drinks per week
- In patients without a history of kidney stone disease who were taking a statin for hyperlipidemia (dyslipidemia), the incidence of neprolithiasis was 20% lower.
