Dietary style and acid load in an Italian population of calcium kidney stone formers

G. Vezzoli, E. Dogliotti, A. Terranegra, T. Arcidiacono, L. Macrina, M. Tavecchia, F. Pivari, A. Mingione, C. Brasacchio, A. Nouvenne, T. Meschi, D. Cusi, D. Spotti, E. Montanari, L. Soldati

Research output: Contribution to journalArticlepeer-review


Background and aims: Animal protein intake may cause an acid load that predisposes individuals to stones by influencing calcium and citrate excretion. These associations were not confirmed in recent studies. Therefore the present study was aimed to compare acid load of diet in stone formers and controls. Methods and results: Participants to the study were 157 consecutive calcium stone formers and 144 controls. Diet was analyzed in these subjects using a software that evaluated nutrient intake from a three-day food intake diary. This software also estimated the potential renal acid load (PRAL, mEq/day). Twenty-four-hour urine excretion of ions and citrate was measured in stone formers.Stone former diet had lower intake of glucose, fructose, potassium and fiber and higher PRAL in comparison with controls. The multinomial logistic regression analysis showed that stone risk decreased in association with the middle and the highest tertiles of fiber intake and increased in association with the highest tertile of PRAL. The linear multiple regression analysis showed that calcium excretion was associated with the sodium excretion and that citrate excretion was associated with the PRAL and animal protein intake in stone formers. Conclusion: Our findings suggest that stone formers may undergo a greater dietary acid load sustained by a low vegetable intake and base provision. Dietary acid load does not appear as the main determinant of calcium excretion, but may promote stone risk by decreasing citrate excretion. Sodium intake may predispose to stones by stimulating calcium excretion.

Original languageEnglish
Pages (from-to)588-593
Number of pages6
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number6
Publication statusPublished - Jun 1 2015


  • Acid load
  • Calcium excretion
  • Citrate excretion
  • Kidney stones
  • PRAL
  • Vegetable intake

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Dietary style and acid load in an Italian population of calcium kidney stone formers'. Together they form a unique fingerprint.

Cite this