DASH Diet for Kidney Stones

Overseen By Joseph Crivelli, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama at Birmingham

Must not be taking: Acetazolamide, Topiramate, Zonisamide

Disqualifiers: Dialysis, Kidney transplant, eGFR <60, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 1 week

48 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assess how different diets affect kidney stone risk. Participants will follow either a DASH-style diet (Dietary Approaches to Stop Hypertension), rich in fruits, vegetables, and low-fat dairy, or a Western-style diet, high in red meat and sweets, for one week. The trial will measure changes in urine that indicate kidney stone risk. It seeks individuals in the Birmingham, AL area with a history of kidney stones who can adhere to a specific diet and collect urine for testing. As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance dietary recommendations for kidney stone prevention.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Studies have shown that the DASH diet, which includes plenty of fruits, vegetables, and low-fat dairy, is generally safe and easy to follow. Research indicates that this diet can help control high blood pressure and support kidney health. In the reviewed studies, no major negative effects have been reported from following this diet. It may also slightly lower the risk of kidney stones by improving certain factors in urine.

Although the Western-style diet isn't being tested for safety in this trial, it is known to contain more red meat and sugars, which can increase some health risks. This trial, however, focuses on the potential benefits of the DASH diet for reducing the risk of kidney stones. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the DASH-Style Diet for managing kidney stones because it offers a holistic, dietary approach that contrasts with the standard treatments like medications or surgical procedures. While typical treatments often focus on breaking down or removing stones, the DASH diet emphasizes prevention by promoting a higher intake of fruits, vegetables, and low-fat dairy, which are known to help reduce stone formation. This diet also reduces the consumption of red meat and sweets, which are linked to kidney stone development, potentially offering a natural and non-invasive alternative to traditional methods.

What evidence suggests that this trial's dietary approaches could be effective for kidney stone disease?

Research has shown that a DASH-style diet, which participants in this trial may receive, can lower the risk of kidney stones. This diet includes plenty of fruits, vegetables, and low-fat dairy products. Studies have found that it reduces substances in the urine that lead to stone formation. One study found that people on a DASH-style diet had a significant decrease in their risk of developing kidney stones. Another study suggested that this diet could effectively prevent new stones from forming. The DASH diet might also help reduce the amount of calcium oxalate, a major component of many kidney stones, in the urine. Meanwhile, participants in another arm of this trial will follow a Western-style diet, characterized by higher intake of red meat, sweets, and items containing added sugar, processed starches, and seed oils. ^{2 5 6 7 8}

Are You a Good Fit for This Trial?

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

Exclusion Criteria

I have nephrotic syndrome.

Urinary diversion

I have an overactive thyroid.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

• DASH-Style Diet
• Western-Style Diet

Trial Overview 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.

How Is the Trial Designed?

Group I: Western-Style Diet Experimental Treatment 1 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 Diet Experimental Treatment 1 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.

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials

1,677

Recruited

2,458,000+

Published Research Related to This Trial

A DASH-style diet, which emphasizes fruits, vegetables, and low intake of processed foods, is associated with increased urinary citrate and volume, potentially reducing the risk of kidney stones in a study of 3426 participants.

Higher DASH scores correlated with lower relative supersaturations of calcium oxalate and uric acid, suggesting that components of the diet may contain unidentified stone inhibitors, particularly from dairy and plant sources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

DASH-style diet and 24-hour urine composition. Taylor, EN., Stampfer, MJ., Mount, DB., et al.[2022]

A normal-calcium, low-animal protein, low-salt diet significantly reduced oxalate excretion in patients with idiopathic calcium oxalate nephrolithiasis, decreasing mean oxaluria from 50.2 to 35.5 mg/d over 3 months.

In comparison, a traditional low-oxalate diet only reduced oxaluria from 45.9 to 40.2 mg/d, indicating that the new diet may be more effective in managing hyperoxaluria.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diet to reduce mild hyperoxaluria in patients with idiopathic calcium oxalate stone formation: a pilot study. Nouvenne, A., Meschi, T., Guerra, A., et al.[2022]

In a study of 44,444 men over 26 years, a higher DASH diet score was linked to a 32% lower risk of developing gout, indicating its potential effectiveness in preventing this condition.

Conversely, a higher Western diet score was associated with a 42% increased risk of gout, highlighting the negative impact of this dietary pattern on uric acid levels and gout risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. Rai, SK., Fung, TT., Lu, N., et al.[2020]

High protein intake is a significant factor contributing to the rise of kidney stones (nephrolithiasis) in developed countries, as it may increase urinary calcium excretion in susceptible individuals.

Dietary modifications, including increased fluid intake, can help reduce the risk of recurrent kidney stones by lowering urinary calcium and oxalate levels while increasing urinary citrate, suggesting that lifestyle changes may be more beneficial than long-term medication use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of diet in the pathogenesis and therapy of nephrolithiasis. Goldfarb, S.[2013]

A DASH-style diet, which emphasizes fruits, vegetables, and low-fat dairy while reducing sodium and processed foods, is linked to a significant reduction in the risk of developing kidney stones, as shown in a study involving over 240,000 participants across three large health studies over up to 18 years.

Men and women with the highest DASH scores had relative risks of kidney stones that were 45-40% lower compared to those with the lowest scores, indicating that this diet may be particularly effective in preventing kidney stone formation, regardless of calcium intake.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

DASH-style diet associates with reduced risk for kidney stones. Taylor, EN., Fung, TT., Curhan, GC.[2022]

A systematic review and meta-analysis of 6 studies involving over 568,000 individuals found a significant inverse relationship between adherence to the DASH-style diet and the risk of chronic kidney disease (CKD), suggesting that following this diet may help prevent CKD.

The DASH diet was also associated with a reduced risk of rapid decline in kidney function and microalbuminuria, indicating its potential benefits for maintaining kidney health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Taghavi, M., Sadeghi, A., Maleki, V., et al.[2020]

In a study of 264 men with kidney stone issues, high adherence to the DASH diet was linked to significantly lower odds of urinary factors that contribute to kidney stone formation, such as hypercreatininuria, hypocitraturia, and hypercalciuria.

The research suggests that following the DASH diet can be an effective preventive strategy against kidney stones, as most components of the diet were associated with reduced urinary lithogenic factors, except for nuts, legumes, and sodium.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The association of Dietary Approaches to Stop Hypertension-style diet with urinary risk factors of kidney stones formation in men with nephrolithiasis. Maddahi, N., Aghamir, SMK., Moddaresi, SS., et al.[2021]

In a study involving 192,126 participants over 3,259,313 person-years, five modifiable risk factors (body mass index, fluid intake, DASH diet, dietary calcium intake, and sugar-sweetened beverage intake) were found to account for over 50% of kidney stone incidents, highlighting their significant role in prevention.

The most impactful risk factor was lower fluid intake, which had a population attributable fraction of 26.0%, suggesting that increasing fluid consumption could substantially reduce the occurrence of kidney stones in the general population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary and Lifestyle Risk Factors Associated with Incident Kidney Stones in Men and Women. Ferraro, PM., Taylor, EN., Gambaro, G., et al.[2019]

The study of 222 stone formers (SF) and 136 non-stone formers (controls) revealed that SF had significantly higher sodium and protein intake compared to controls, indicating dietary patterns that may contribute to stone formation.

Despite consuming more vegetables and legumes, SF did not follow a DASH-style diet, as their overall dietary profile was characterized by low calcium and high salt and protein, which are not ideal for preventing kidney stones.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary pattern analysis among stone formers: resemblance to a DASH-style diet. Rodrigues, FG., Lima, TM., Zambrano, L., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2754098/

DASH-Style Diet Associates with Reduced Risk for Kidney ... In conclusion, consumption of a DASH-style diet is associated with a marked decrease in kidney stone risk. Diet plays a major role in the development of kidney ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S2405457720301376

The association of Dietary Approaches to Stop ... This study indicated that the DASH diet might represent a novel strong preventive strategy to decrease urinary risk factors of kidney stone formation. Further ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7353736/

Dietary and lifestyle factors for primary prevention of ... Another RCT showed that a DASH-style diet nonsignificantly decreased urine calcium oxalate supersaturation among stone formers with ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT06210009

Effect of a DASH-Style Diet on Urinary Risk Factors for ... The working hypothesis is that a Dietary Approaches to Stop Hypertension (DASH)-style diet will improve 24-hour urine stone risk parameters.

5. ajkd.org ajkd.org/article/S0272-6386(13)01567-9/abstract

Urinary Lithogenic Risk Profile in Recurrent Stone Formers ... Conclusions. The DASH diet might be an effective alternative to the low-oxalate diet in reducing calcium oxalate supersaturation and should be studied more.

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/32859313/

The association of Dietary Approaches to Stop ... This study aimed to assess the association between adherence to the DASH diet and urinary risk factors of kidney stones formation.

7. sciencedirect.com sciencedirect.com/science/article/pii/S0085253819301681

The Dietary Approaches to Stop Hypertension (DASH) diet ... found that those with poor accordance to a DASH diet had 16% higher risk of incident CKD over a median follow-up of 23 years. In the Nurses' Health Study, those ...

8. kidney.org kidney.org/kidney-topics/dash-diet

The Dash Diet for Kidney Disease Treatment The DASH Diet helps manage high blood pressure and kidney disease with fruits, veggies, whole grains, and low-fat dairy. Discover more about its benefits.