Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism

N. A. Breslau, L. Brinkley, K. D. Hill, C. Y C Pak

Research output: Contribution to journalArticle

331 Citations (Scopus)

Abstract

We wished to determine whether different types of dietary protein might have different effects on calcium metabolism and on the propensity for renal stone formation. Fifteen young normal subjects were studied during three 12-day dietary periods during which their diet contained vegetable protein, vegetable and egg protein, or animal protein. While these three diets were constant with respect to NA, K, Ca, P, Mg, and quantity of protein, they had progressively higher sulfur contents. As the fixed acid content of the diets increased, urinary calcium excretion increased from 103 ± 15 (±SEM) mg/day (2.6 ± 0.4 mmol/day) on the vegetarian diet to 150 ± 13 mg/day (3.7 ± 0.3 mmol/day) on the animal protein diet (P < 0.02). Despite the increased urinary calcium excretion, there was a modest reduction of urinary cAMP excretion and serum PTH and 1,25-dihydroxyvitamin D levels consistent with acid-induced bone dissolution. There was no change in fractional intestinal 47Ca absorption. The inability to compensate for the animal protein-induced calciuric response may be a risk factor for the development of osteoporosis. The animal protein-rich diet was associated with the highest excretion of undissociated uric acid due to the reduction in urinary pH. Moreover, citrate excretion was reduced because of the acid load. However, oxalate excretion was lower than during the vegetarian diet [26 ± 1 mg/day (290 ± 10 μmol/day) vs. 39 ± 2 mg/day (430 ± 20 μmol/day); P < 0.02]. Urinary crystallization studies revealed that the animal protein diet, when its electrolyte composition and quantity of protein were kept the same as for the vegetarian diet, conferred an increased risk for uric acid stones, but, because of opposing factors, not for calcium oxalate or calcium phosphate stones.

Original languageEnglish (US)
Pages (from-to)140-146
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume66
Issue number1
StatePublished - 1988

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Kidney Calculi
Nutrition
Metabolism
Animals
Diet
Calcium
Vegetarian Diet
Vegetable Proteins
Proteins
Uric Acid
Acids
Egg Proteins
Calcium Oxalate
Oxalates
Dietary Proteins
Intestinal Absorption
Crystallization
Sulfur
Citric Acid
Electrolytes

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. / Breslau, N. A.; Brinkley, L.; Hill, K. D.; Pak, C. Y C.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 66, No. 1, 1988, p. 140-146.

Research output: Contribution to journalArticle

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