加载中…
Place · Level 3 · Condition
草酸钙 70% · 反直觉膳食钙保护 · 水 3 L + 柠檬酸 + DASH · 4 种类型区分 · 急性绞痛处理 · 24h 尿代谢
synergy · 2
Counterintuitive: high *dietary* calcium (800-1200 mg/d) binds oxalate in the gut → oxalate absorption ↓ → calcium-oxalate stone risk ↓ 35-50% (Curhan 1993/1997). But high *supplemental* calcium taken without food raises risk. The distinction: food-calcium-with-meals.
One diet doing two jobs: bring sodium down and urinary calcium follows (the same path by which DASH lowers blood pressure), plus the citrate that fruit and vegetables bring — which makes DASH read almost like a stone-prevention protocol.
regulates · 4
Kidney stones: calcium oxalate (~75%), uric acid, calcium phosphate, struvite, cystine. Drivers: urine volume (<2 L/d markedly raises risk) + oxalate + calcium + citrate + pH + purines. Diet = first-line; recurrent / bilateral / familial → full metabolic workup.
Uric-acid stones make up 10-15% of kidney stones; gout patients have 10-30× elevated risk. Low urine pH + high uric acid are shared mechanisms. Allopurinol/febuxostat treat both gout and prevent uric-acid stones + some CaOx stones (urate-seeding theory).
High-dose vitamin C (>2000 mg/day) metabolises to oxalate → ↑urinary oxalate → ↑CaOx stone risk. Thomas 2013 JAMA Intern Med (N=23,355 Swedish men): ≥1000 mg/day supplement → 70% higher stone risk. Food-level doses (≤200 mg) carry no such risk. Stone formers should cap C supplements at 500 mg/day.
Urate stones are 10-15% of all kidney stones and behave differently from calcium oxalate: they crystallise below urine pH 5.5 and are near-invisible on plain X-ray, which is why flank pain with haematuria and a negative film gets misread for a long time.