Potential renal acid load and the risk of renal stone formation in a case-control study

Eur J Clin Nutr. 2013 Oct;67(10):1077-80. doi: 10.1038/ejcn.2013.155. Epub 2013 Sep 4.


Objective: The potential renal acid load (PRAL) in diet may have a key role in renal stone formation through its effect on calcium and citrate metabolism. We examined the association between calcium renal stone formation and the PRAL in a population-based case-control study.

Methods: A group of 123 calcium renal stone formers was compared with an equal number of age- and sex-matched controls. Dietary history was obtained by 24-h recall. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated across quartiles of dietary intakes of PRAL.

Results: Compared with those in the lowest quartiles of PRAL, we found an increased risk of renal stone formation for those in the highest quartile (Q4 OR=2.51, 95% CI 1.218-5.172). Regarding individual food patterns, we found a significant protection for a high consumption of vegetables (two or more servings/day; OR=0.526, 95% CI 0.288-0.962).

Conclusions: A PRAL in diet and a reduced consumption of vegetables are associated with an increased risk of calcium renal stone formation. In renal stone formers consumption of plant foods should be encouraged in order to counterbalance the acid load derived from animal-derived foods.

MeSH terms

  • Acids / metabolism*
  • Adult
  • Calcium, Dietary / metabolism*
  • Case-Control Studies
  • Diet Records
  • Diet*
  • Feeding Behavior*
  • Female
  • Humans
  • Kidney / metabolism*
  • Kidney Calculi / etiology*
  • Kidney Calculi / metabolism
  • Kidney Calculi / prevention & control
  • Male
  • Mental Recall
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Vegetables*


  • Acids
  • Calcium, Dietary