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Stones: Diet and Pharmacologic Management
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===Limit intake of oxalate-rich foods=== *'''<span style="color:#ff0000">Limiting intake of oxalate-rich foods and maintaining normal calcium consumption is recommended in patients with calcium oxalate stones and relatively high urinary oxalate</span>''' *'''Urinary oxalate is also modulated by calcium intake, which influences intestinal oxalate absorption''' *'''Other factors that may contribute to higher urinary oxalate include vitamin C''' (ascorbic acid is metabolized to oxalate) '''and other over-the-counter nutrition supplements.''' *Although dietary oxalate clearly plays a role in increased urinary oxalate, it is difficult to restrict its intake because oxalate is ubiquitous and found in most vegetable matter. However, it is important to avoid large portions of '''foodstuffs that are rich in oxalate, such as spinach, beets, chocolate, nuts, and tea.''' *Whereas general advice on a restricted-oxalate intake might be given to patients with recurrent nephrolithiasis, '''a low-oxalate diet would be most useful in patients with enteric hyperoxaluria, such as those with underlying bowel abnormalities or previous gastric bypass surgery'''
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