DASH Diet for Kidney Stones
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Alabama at Birmingham
Must not be taking: Acetazolamide, Topiramate, Zonisamide
Disqualifiers: Dialysis, Kidney transplant, eGFR <60, others
No Placebo Group
Trial Summary
What is the purpose of this trial?The true capacity for a healthy diet to improve urinary stone risk factors is not well-defined. The objective of this study is to measure the effect of adopting a healthy dietary pattern on kidney stone disease (KSD) risk. The working hypothesis is that a Dietary Approaches to Stop Hypertension (DASH)-style diet will improve 24-hour urine stone risk parameters. The approach to testing this hypothesis will be to randomize participants with KSD to a standardized DASH-style vs. Western-style diet for one week. The Bionutrition Unit of the Center for Clinical and Translational Science will provide all meals to participants. The rationale for this study is that by measuring the effect of a DASH-style diet on urinary stone risk parameters, a benchmark for future real-world, implementation studies will be established. Based on available evidence, this will be the first controlled diet study to assess the DASH dietary pattern for improving urinary stone risk parameters.
Will I have to stop taking my current medications?
The trial requires participants to stop taking multivitamins and dietary supplements, including calcium and vitamin C, for 7 days before and during the study. Other medications are not specifically mentioned, so it's best to discuss with the trial coordinators.
What data supports the effectiveness of the DASH-Style Diet treatment for kidney stones?
Research shows that following a DASH-style diet, which is rich in fruits, vegetables, nuts, and low-fat dairy, and low in sodium and red meats, is linked to a significantly lower risk of developing kidney stones. This diet was associated with a 40-45% reduced risk of kidney stones in both men and women over several years of study.
12345Is the DASH diet safe for humans?
The DASH diet, which includes lots of fruits, vegetables, nuts, low-fat dairy, and whole grains, is generally considered safe for humans. It has been associated with a reduced risk of kidney stones and chronic kidney disease, suggesting it is beneficial for kidney health.
13467How does the DASH-style diet treatment differ from other treatments for kidney stones?
The DASH-style diet is unique because it focuses on high intake of fruits, vegetables, nuts, legumes, low-fat dairy, and whole grains, while reducing sodium, sweetened beverages, and red and processed meats. This dietary approach is associated with a significant reduction in the risk of kidney stones, unlike other treatments that may not address dietary patterns.
13489Eligibility Criteria
This trial is for individuals with Kidney Stone Disease (KSD) who are interested in seeing if diet changes can affect their condition. Participants will be provided all meals and must follow either a DASH-style or Western-style diet strictly for one week.Inclusion Criteria
Willing to consume meals prepared by Bionutrition Unit
I have had kidney stones before.
Willing to stop dietary supplements including calcium and vitamin C for 14 days before and during study
+3 more
Exclusion Criteria
I have nephrotic syndrome.
Urinary diversion
I have an overactive thyroid.
+14 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
Treatment
Participants are randomized to a DASH-style or Western-style diet for one week
1 week
Daily visits for meal provision
Follow-up
Participants are monitored for changes in urinary stone risk factors after the dietary intervention
1 week
Participant Groups
The study aims to compare the effects of a healthy DASH-style diet versus a typical Western-style diet on factors in the urine that contribute to kidney stones. Participants will be randomly assigned to one of these diets, which they'll eat exclusively for the duration of the trial.
2Treatment groups
Experimental Treatment
Group I: Western-Style DietExperimental Treatment1 Intervention
For seven days, participants will consume a diet characterized by characterized by higher intake of red meat, sweets, and items containing added sugar, processed starches, and seed oils, in addition to lower intake of fruits, vegetables, and low-fat dairy.
Group II: DASH-Style DietExperimental Treatment1 Intervention
For seven days, participants will consume a diet characterized by higher intake of fruits, vegetables, and low-fat dairy, in addition to whole grains, poultry, fish, and nuts, but smaller amounts of red meat, sweets, and sugar-containing beverages.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Alabama at BirminghamBirmingham, AL
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Who Is Running the Clinical Trial?
University of Alabama at BirminghamLead Sponsor
References
DASH-style diet associates with reduced risk for kidney stones. [2022]The impact of the Dietary Approaches to Stop Hypertension (DASH) diet on kidney stone formation is unknown. We prospectively examined the relation between a DASH-style diet and incident kidney stones in the Health Professionals Follow-up Study (n = 45,821 men; 18 yr of follow-up), Nurses' Health Study I (n = 94,108 older women; 18 yr of follow-up), and Nurses' Health Study II (n = 101,837 younger women; 14 yr of follow-up). We constructed a DASH score based on eight components: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains and low intake of sodium, sweetened beverages, and red and processed meats. We used Cox hazards regression to adjust for factors that included age, BMI, and fluid intake. Over a combined 50 yr of follow-up, we documented 5645 incident kidney stones. Participants with higher DASH scores had higher intakes of calcium, potassium, magnesium, oxalate, and vitamin C and had lower intakes of sodium. For participants in the highest compared with the lowest quintile of DASH score, the multivariate relative risks for kidney stones were 0.55 (95% CI, 0.46 to 0.65) for men, 0.58 (95% CI, 0.49 to 0.68) for older women, and 0.60 (95% CI, 0.52 to 0.70) for younger women. Higher DASH scores were associated with reduced risk even in participants with lower calcium intake. Exclusion of participants with hypertension did not change the results. In conclusion, consumption of a DASH-style diet is associated with a marked decrease in kidney stone risk.
The role of diet in the pathogenesis and therapy of nephrolithiasis. [2013]The epidemic of nephrolithiasis in the developed world in the twentieth century is in part the result of the diet consumed in these affluent nations. High protein intake is probably the most important factor. The patients who develop nephrolithiasis may have an increased calciuric response to diet protein and perhaps to diet sodium. The benefits of dietary modification include not only a tendency to reduce urinary calcium excretion but also increased urinary citrate and reduced urinary oxalate excretion. High fluid intake is also an important component of the therapeutic armamentarium of the physician treating patients with recurrent stone formation. The benefit of dietary therapy in patients with recurrent stone formation has not as yet been rigorously tested in controlled studies. Furthermore, there are few valid clinical studies of various pharmacologic agents such as thiazides, phosphates, allopurinol, and citrate. In the absence of clear-cut advantage of any specific pharmacologic agent, it appears that many patients may benefit from dietary modification rather than embarking on a life-long use of medications to prevent stone recurrences.
DASH-style diet and 24-hour urine composition. [2022]We previously observed associations between a Dietary Approaches to Stop Hypertension (DASH)-style diet and large reductions in kidney stone risk. This study examined associations between a DASH-style diet and 24-hour excretions of urinary lithogenic factors.
The association of Dietary Approaches to Stop Hypertension-style diet with urinary risk factors of kidney stones formation in men with nephrolithiasis. [2021]The relation of the Dietary Approaches to Stop Hypertension (DASH)-style diet to urinary lithogenic factors is unclear. This study aimed to assess the association between adherence to the DASH diet and urinary risk factors of kidney stones formation.
Diet to reduce mild hyperoxaluria in patients with idiopathic calcium oxalate stone formation: a pilot study. [2022]To assess whether a normal-calcium, low-animal protein, low-salt diet is effective in reducing hyperoxaluria in idiopathic calcium oxalate nephrolithiasis compared with a traditional low-oxalate diet, routinely recommended by clinicians
Adherence to the dietary approaches to stop hypertension-style diet is inversely associated with chronic kidney disease: a systematic review and meta-analysis of prospective cohort studies. [2020]No conclusive information is available about the association between the Dietary Approaches to Stop Hypertension (DASH)-style diet and chronic kidney disease (CKD). Hence, we aimed to summarize the findings of prospective cohort studies on the relationship between adherence to the DASH-style diet and risk of CKD. A systematic search was done using relevant keywords in the online databases for relevant publications up through July 2018. In total, we included 6 studies in the current systematic review and meta-analysis, with a total sample size of 568 156 individuals and 9249 cases of CKD. Combining 6 effect sizes from 6 studies revealed a significant inverse association between adherence to the DASH diet and risk of CKD (Combined effect size: 0.72, 95% CI: 0.61-0.85, P
Dietary and Lifestyle Risk Factors Associated with Incident Kidney Stones in Men and Women. [2019]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.
Dietary pattern analysis among stone formers: resemblance to a DASH-style diet. [2021]Recent epidemiological studies have shown that dietary patterns may have a more persistent impact on the risk of stone formation than single nutrients of the diet. Dietary Approaches to Stop Hypertension (DASH), a low-sodium and fruits/vegetables-rich diet, has been associated with a lower risk of nephrolithiasis, due to altered urinary biochemistry. This observational study aimed to investigate whether the dietary pattern of stone formers (SF) resembled a DASH-diet and its influence on urinary lithogenic parameters. Anthropometric data, fasting serum sample, 24-h urine samples, and a 3-day food intake record under an unrestricted diet were obtained from 222 SF and compared with 136 non-SF subjects (controls). The DASH-diet food portions were determined from the food records whereas intakes of sodium chloride (NaCl) and protein (protein equivalent of nitrogen appearance, PNA) were estimated from 24-hr urinary sodium and urea. A dietary profile close to a DASH-diet was not observed in any of the groups. NaCl intake and PNA were significantly higher in SF versus non-SF (12.0 ± 5.2 v.s. 10.1 ± 3.4 g/day, p = 0.01 and 1.8 ± 0.1 v.s. 1.4 ± 0.1 g/kg/day, p = 0.03). SF exhibited a positive correlation of NaCl intake and PNA with urinary calcium, oxalate and uric acid, and of PNA with urinary sodium. SF consumed more vegetables and legumes, but less fruits and low-fat dairy items than non-SF. The present series presented a dietary profile characterized by low calcium and high salt and protein contents, not reflecting an ideal DASH-style diet pattern.
The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. [2020]Objective To prospectively examine the relation between the Dietary Approaches to Stop Hypertension (DASH) and Western diets and risk of gout (ie, the clinical endpoint of hyperuricemia) in men.Design Prospective cohort study.Setting The Health Professionals Follow-up Study.Participants 44 444 men with no history of gout at baseline. Using validated food frequency questionnaires, each participant was assigned a DASH dietary pattern score (based on high intake of fruits, vegetables, nuts and legumes, low fat dairy products, and whole grains, and low intake of sodium, sweetened beverages, and red and processed meats) and a Western dietary pattern score (based on high intake of red and processed meats, French fries, refined grains, sweets, and desserts).Main outcome measure Risk of incident gout meeting the preliminary American College of Rheumatology survey criteria for gout, adjusting for potential confounders, including age, body mass index, hypertension, diuretic use, and alcohol intake.Results During 26 years of follow-up, 1731 confirmed cases of incident gout were documented. A higher DASH dietary pattern score was associated with a lower risk for gout (adjusted relative risk for extreme fifths 0.68, 95% confidence interval 0.57 to 0.80, P value for trend <0.001). In contrast, a higher Western dietary pattern score was associated with an increased risk for gout (1.42, 1.16 to 1.74, P=0.005).Conclusion The DASH diet is associated with a lower risk of gout, suggesting that its effect of lowering uric acid levels in individuals with hyperuricemia translates to a lower risk of gout. Conversely, the Western diet is associated with a higher risk of gout. The DASH diet may provide an attractive preventive dietary approach for men at risk of gout.