Editing Stones: Evaluation and Medical Management (section)

=== Increase intake of fruits and vegetables ===

* '''<span style="color:#ff0000">Recommended in patients with calcium stones and relatively low urinary citrate</span>'''

*'''Dietary citrate increases urinary citrate excretion'''
**Although a number of fruits and juices have been evaluated for their effect on urinary stone risk factors, none have been prospectively evaluated in an RCT assessing actual stone formation.
*'''Urinary citrate excretion is determined by acid-base status; conditions such as metabolic acidosis, renal tubular acidosis and chronic diarrhea, and some medications, such as carbonic anhydrase inhibitors, may promote hypocitraturia'''
**Acidosis can arise from a diet that is inordinately rich in foods with a high potential renal acid load such as meats, fish, poultry, cheese, eggs, and to a lesser extent, grains.