title: Urinary lithogenic risk profile in recurrent stone formers with hyperoxaluria: a randomized controlled trial comparing DASH (Dietary Approaches to Stop Hypertension)-style and low-oxalate diets.
abstract: BACKGROUND
  Patients with nephrolithiasis and hyperoxaluria generally are advised to follow a low-oxalate diet. However, most people do not eat isolated nutrients, but meals consisting of a variety of foods with complex combinations of nutrients. A more rational approach to nephrolithiasis prevention would be to base dietary advice on the cumulative effects of foods and different dietary patterns rather than single nutrients.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Recurrent stone formers with hyperoxaluria (urine oxalate > 40 mg/d).
  
  
  METHODS
  The intervention group was asked to follow a calorie-controlled Dietary Approaches to Stop Hypertension (DASH)-style diet (a diet high in fruit, vegetables, whole grains, and low-fat dairy products and low in saturated fat, total fat, cholesterol, refined grains, sweets, and meat), whereas the control group was prescribed a low-oxalate diet. Study length was 8 weeks.
  
  
  RESULTS
  Primary: change in urinary calcium oxalate supersaturation.
  Changes in 24-hour urinary composition.
  
  
  RESULTS
  57 participants were randomly assigned (DASH group, 29; low-oxalate group, 28). 41 participants completed the trial (DASH group, 21; low-oxalate group, 20). As-treated analysis showed a trend for urinary oxalate excretion to increase in the DASH versus the low-oxalate group (point estimate of difference, 9.0mg/d; 95% CI, -1.1 to 19.1mg/d; P=0.08). However, there was a trend for calcium oxalate supersaturation to decrease in the DASH versus the low-oxalate group (point estimate of difference, -1.24; 95% CI, -2.80 to 0.32; P=0.08) in association with an increase in magnesium and citrate excretion and urine pH in the DASH versus low-oxalate group.
  
  
  CONCLUSIONS
  Limited sample size, as-treated analysis, nonsignificant results.
  
  
  CONCLUSIONS
  The DASH diet might be an effective alternative to the low-oxalate diet in reducing calcium oxalate supersaturation and should be studied more.
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nazanin
authors.initials: N
authors.lastname: Noori
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Honarkar
authors.affiliation: Nephrology Section, New York Harbor VA Healthcare System, New York, NY; Nephrology Division, New York University School of Medicine, New York, NY.
authors.forename: David S
authors.initials: DS
authors.lastname: Goldfarb
authors.affiliation: Harold Simmons Center for Kidney Disease Research & Epidemiology, Division of Nephrology and Hypertension, School of Medicine, University of California, Irvine, Irvine, CA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Taheri
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nasser
authors.initials: N
authors.lastname: Shakhssalim
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Parvin
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: basiri@unrc.ir.
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
mesh_terms: D002129:Calcium Oxalate / Q000652:urine*; D004039:Diet, Sodium-Restricted / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006959:Hyperoxaluria / Q000150:complications / Q000178:diet therapy* / Q000652:urine; D006973:Hypertension / Q000150:complications / Q000178:diet therapy* / Q000517:prevention & control; D007669:Kidney Calculi / Q000517:prevention & control / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D002129:Calcium Oxalate
keywords: Dietary Approaches to Stop Hypertension (DASH) diet; calcium oxalate supersaturation; clinical trial; hyperoxaluria; kidney stone; nephrolithiasis; oxalate