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Stones: Diet and Pharmacologic Management
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===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 β30% 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
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