Dietary calcium and prevention of calcium stones: More or less?
Prevention of stone disease is the key to breaking the cycle of recurrence, patient suffering, and mounting costs. Dietary modifications are an attractive means to prevent stone formation because they are generally well tolerated and inexpensive. Although urinary calcium is thought to play an important role in stone formation, since hypercalciuria comprises the most common metabolic abnormality identified in stone formers and approximately 70-80∈% of stones contain calcium (Ca), the impact of dietary Ca on urinary Ca levels and risk of urinary stones remains controversial. Moreover, the effect of altering dietary Ca potentially impacts not only stone formation but also bone health. In this chapter we review the evidence regarding dietary Ca and its effects on urinary Ca and stone risk.