284 research outputs found
Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones
No full textPrevious studies of vitamin C and kidney stones were conducted mostly in men and either reported disparate results for supplemental and dietary vitamin C or did not examine dietary vitamin C
Vitamin D Intake and the Risk of Incident Kidney Stones
No full textPurpose Kidney stones are a common and painful condition. Longitudinal prospective studies on the association between the intake of vitamin D and the risk of incident kidney stones are lacking. Materials and Methods We performed a prospective analysis of 193,551 participants in the Health Professionals Follow-up Study and Nurses’ Health Study I and II. Participants were divided into categories of total (less than 100, 100 to 199, 200 to 399, 400 to 599, 600 to 999, 1,000 IU per day or greater) and supplemental (none, less than 400, 400 to 599, 600 to 999, 1,000 IU per day or greater) vitamin D intake. During a followup of 3,316,846 person-years there were 6,576 incident kidney stone events. Cox proportional hazards regression models were adjusted for age, body mass index, comorbidities, use of medications and intake of other nutrients. Results After multivariate adjustment there was no statistically significant association between vitamin D intake and risk of stones in the HPFS (HR for 1,000 or greater vs less than 100 IU per day 1.08, 95% CI 0.80, 1.47, p for trend = 0.92) and the NHS I (HR 0.99, 95% CI 0.73, 1.35, p for trend = 0.70), whereas there was a suggestion of a higher risk in the NHS II (HR 1.18, 95% CI 0.94, 1.48, p for trend = 0.02). Similar results were found for supplemental vitamin D intake. Conclusions Vitamin D intake in typical amounts was not statistically associated with risk of kidney stone formation, although higher risk with higher doses than those studied here cannot be excluded
Dietary and Lifestyle Risk Factors Associated with Incident Kidney Stones in Men and Women
No full textPurpose Several dietary and lifestyle factors are associated with a higher risk of kidney stones. We estimated the population attributable fraction and the number needed to prevent for modifiable risk factors, including body mass index, fluid intake, DASH (Dietary Approaches to Stop Hypertension) style diet, dietary calcium intake and sugar sweetened beverage intake. Materials and Methods We used data on the HPFS (Health Professionals Follow-Up Study) cohort and the NHS (Nursesâ Health Study) I and II cohorts. Information was obtained from validated questionnaires. Poisson regression models adjusted for potential confounders were used to estimate the association of each risk factor with the development of incident kidney stones and calculate the population attributable fraction and the number needed to prevent. Results The study included 192,126 participants who contributed a total of 3,259,313 person-years of followup, during which an incident kidney stone developed in 6,449 participants. All modifiable risk factors were independently associated with incident stones in each cohort. The population attributable fraction ranged from 4.4% for a higher intake of sugar sweetened beverages to 26.0% for a lower fluid intake. The population attributable fraction for all 5 risk factors combined was 57.0% in HPFS, 55.2% in NHS I and 55.1% in NHS II. The number needed to prevent during 10 years ranged from 67 for lower fluid intake to 556 for lower dietary calcium intake. Conclusions Five modifiable risk factors accounted for more than 50% of incident kidney stones in 3 large prospective cohorts. Assuming a causal relation, our estimates suggest that preventive measures aimed at reducing those factors could substantially decrease the burden of kidney stones in the general population
Risk of recurrence of idiopathic calcium kidney stones: analysis of data from the literature
No full textBACKGROUND:
Nephrolithiasis is a frequent condition. While it is generally accepted that such condition carries a risk of recurrence over time, the exact risk and its predictors have been rarely quantitated. We aimed to estimate recurrence of kidney stones, overall and in specific subgroups, from randomized controlled trials (RCTs) of calcium stone formers.
METHODS:
Systematic review of RCTs of adult patients with idiopathic calcium kidney stones. Recurrence rates analyzed in subgroups based on type of intervention and other characteristics, using Poisson regression models.
RESULTS:
The analysis included 21 RCTs with 2168 participants over a median follow-up of 3.2 years (range 0.5-9.7). The median recurrence of kidney stones was 15 per 100 person-years (range 0-110). Recurrence was higher in those with two or more previous stone episodes compared to those with a single episode at enrolment (16 vs. 6 per 100 person-years, p < 0.001) and in those untreated or treated with dietary changes compared to those treated with drugs (26 vs. 23 vs. 9 per 100 person-years, p < 0.001). The effect of drugs on recurrence seemed to be beneficial only among those with two or more previous stone episodes.
CONCLUSIONS:
The overall recurrence rate of stones depends on factors such as previous stone history and type of treatment. Dietary approaches seem to be more effective among single stone formers, whereas drugs seem to be more effective among recurrent stone formers
Intake of trace metals and the risk of incident kidney stones
No full textPURPOSE:
The association between intakes of trace metals and risk of incident stones has not been longitudinally investigated.
MATERIALS AND METHODS:
We performed a prospective analysis of 193,551 participants of the Health Professionals Follow-up Study (HPFS), Nurses' Health Study (NHS) I and II. During a follow-up of 3,316,580 person-years, there were 6,576 incident stones. We used multivariate regression models to identify associations between intakes of zinc, iron, copper and manganese and risk of stones. In a subset of participants with 24-hour urine collections, we examined the association between intake of trace metals and urine composition.
RESULTS:
After multivariate adjustment, total and dietary intakes of zinc and iron were not significantly associated with incident stones. Higher intake of manganese was associated with lower risk of stones; the pooled hazard ratio (HR) for the highest quintile of total manganese intake compared with the lowest was 0.82 (95% confidence interval [CI] 0.68, 0.98; p=0.02). Total but not dietary copper intake was marginally associated with higher risk of stones (pooled HR 1.14, 95% CI 1.02, 1.28; p=0.01). There were no statistically significant associations between total intakes of manganese and copper and urinary supersaturations.
CONCLUSIONS:
Intakes of zinc and iron were not associated with risk of stones. Copper intake may be associated with higher risk in some individuals. Higher total manganese intake was associated with lower risk of stones but not with traditional 24h urinary composite markers of stone risk. Further research is needed to elucidate mechanisms whereby manganese may reduce kidney stone formation
Insulin Resistance and Risk of Incident Hypertension among Men
No full textThe independent association between insulin resistance and the development of hypertension remains in doubt because insulin resistance correlates with other metabolic factors also proposed to be associated with hypertension. The authors examined the association between the insulin sensitivity index and incident hypertension in a prospective nested case-control study among 1453 men (mean age, 61 years) who participated in the Health Professionals' Follow- up Study. The authors computed the insulin sensitivity index for each man in the study based on fasting insulin and triglyceride levels. Logistic regression was performed conditioned on age and adjusted for standard hypertension risk factors as well as renal function, cholesterol, and uric acid. The insulin sensitivity index was 6% lower in the cases compared with the controls (P <.001). The multivariable odds ratio for hypertension comparing the lowest with highest quartile of insulin sensitivity index was 1.09 (0.71-1.65) among the entire sample. However, the association between the insulin sensitivity index and incident hypertension differed significantly by age (P interaction <.001). Among men younger than 60 years, the multivariable odds ratio for the lowest compared with highest quartile was 1.93 (1.01-3. 71) but was 0.67 (0.37-1. 24) among older men. Insulin resistance is independently associated with incident hypertension among younger men
Mediterranean diet adherence and risk of incident kidney stones
No full textBackground: Diet plays an important role in kidney stone formation. Several individual components have been associated with the risk of kidney stone formation, but there is limited evidence regarding the role of healthful dietary patterns.
Objective: To prospectively study the association between adherence to the Mediterranean diet and the risk of incident kidney stones.
Methods: We conducted a longitudinal study using 3 different cohorts: the Health Professionals Follow-up Study (n = 42,902 men), the Nurses' Health Study I (n = 59,994 women), and the Nurses' Health Study II (n = 90,631 women). We assessed diet every 4 y using an FFQ and calculated adherence to a Mediterranean diet using the alternate Mediterranean diet score (aMED). A subgroup of 6077 participants provided ≥1 24-h urine sample, and urinary solute excretion was analyzed. We used Cox proportional hazards regression to examine the independent association between the aMED and incidence of kidney stones, adjusting for potential confounders. We used adjusted linear regression models to study the relation between aMED and urine composition.
Results: During 3,316,633 person-years of follow-up, 6576 cases of incident kidney stones were identified. For participants in the highest aMED score category, the risk of developing a kidney stone was between 13% and 41% lower compared with participants in the lowest score (pooled HR: 0.72, 95% CI: 0.59, 0.87; P value for trend <0.001). A higher aMED score was associated with higher urinary citrate, magnesium, oxalate, phosphate, uric acid, volume, and pH, and lower urinary sodium, resulting in lower supersaturation for calcium oxalate, calcium phosphate, and uric acid.
Conclusion: Adherence to a Mediterranean diet is associated with a lower risk of developing a kidney stone
Vitamin D Intake and the Risk of Incident Kidney Stones
No full textPurpose Kidney stones are a common and painful condition. Longitudinal prospective studies on the association between the intake of vitamin D and the risk of incident kidney stones are lacking. Materials and Methods We performed a prospective analysis of 193,551 participants in the Health Professionals Follow-up Study and Nurses’ Health Study I and II. Participants were divided into categories of total (less than 100, 100 to 199, 200 to 399, 400 to 599, 600 to 999, 1,000 IU per day or greater) and supplemental (none, less than 400, 400 to 599, 600 to 999, 1,000 IU per day or greater) vitamin D intake. During a followup of 3,316,846 person-years there were 6,576 incident kidney stone events. Cox proportional hazards regression models were adjusted for age, body mass index, comorbidities, use of medications and intake of other nutrients. Results After multivariate adjustment there was no statistically significant association between vitamin D intake and risk of stones in the HPFS (HR for 1,000 or greater vs less than 100 IU per day 1.08, 95% CI 0.80, 1.47, p for trend = 0.92) and the NHS I (HR 0.99, 95% CI 0.73, 1.35, p for trend = 0.70), whereas there was a suggestion of a higher risk in the NHS II (HR 1.18, 95% CI 0.94, 1.48, p for trend = 0.02). Similar results were found for supplemental vitamin D intake. Conclusions Vitamin D intake in typical amounts was not statistically associated with risk of kidney stone formation, although higher risk with higher doses than those studied here cannot be excluded
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