Editing Stones: Evaluation and Medical Management (section)

=== Limit intake of non-dairy animal protein ===

* '''<span style="color:#ff0000">Recommended in patients with calcium stones and relatively low urinary citrate</span>'''
* '''<span style="color:#ff0000">May help reduce stone recurrence in patients with uric acid stones or calcium stones and relatively high urinary uric acid</span>'''

*'''Protein intake increases urinary calcium, oxalate, and uric acid excretion'''
**'''Urinary uric acid is derived from both endogenous and exogenous sources'''
***Diet-derived purines account for an ≈30% of urinary uric acid
* '''If diet assessment suggests that purine intake is contributory to high urinary uric acid, patients may benefit from limiting high- and moderately high purine containing foods.'''
**'''"High purine" foods are generally considered specific fish and seafood (anchovies, sardines,''' herring, mackerel, '''scallops and mussels)''', water fowl, '''organ meats,''' glandular tissue, gravies and meat extracts.
**'''"Moderately-high" sources of purines include other shellfish and fish,''' game meats, mutton, '''beef, pork, poultry''' and meat-based soups and broths
*RCTs have demonstrated a benefit of a diet with reduced animal protein (meat) intake