Dietary strategies in kidney stone prevention: From hydration to probiotics

This comprehensive review addresses the various strategies to prevent kidney stone disease (KSD), a prevalent condition with increasing global incidence. The review highlights the multifactorial nature of KSD, emphasizing that prevention requires a combination of lifestyle modifications, dietary adjustments, and possibly medication. One of the primary recommendations is increased fluid intake, with guidelines suggesting 2.5–3.0 liters per day to ensure a urine output of 2.0–2.5 liters per day, which helps dilute urinary constituents that contribute to stone formation.
In addition to hydration, the review covers the role of dietary management, particularly focusing on the intake of calcium, sodium, oxalate, and animal proteins. Sufficient calcium intake (1000–1200 mg/day) is recommended to bind dietary oxalate in the gut, reducing its absorption and subsequent excretion in urine. Conversely, sodium intake should be limited to reduce urinary calcium excretion, and oxalate-rich foods should be minimized. The review also emphasizes the need to limit animal protein consumption, which is associated with increased risk of calcium and uric acid stones.
The role of natural bioactive compounds such as caffeine and epigallocatechin gallate (EGCG) from green tea is discussed, with evidence suggesting they may offer protective effects against KSD. Additionally, probiotics like Oxalobacter formigenes show potential in reducing urinary oxalate levels, offering a novel approach to stone prevention. The review concludes that while many strategies show promise, personalized approaches considering individual risk factors are crucial for effective prevention of kidney stones.