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Question 1 : ANSWER REVIEW

A patient presents with recurrent nephrolithiasis. A 24-hour urine analysis shows hypercalciuria. The nurse practitioner suspects the most common kidney stone. Which dietary modification is most beneficial to reduce the recurrence of this type of stone?



Rationale


AANP Domain Level: Plan
ANCC Domain Level: Planning
Focus Area: Genitourinary Health

The most common type of kidney stone is calcium oxalate. Oxalate-rich foods, such as spinach, nuts, beets, rhubarb, tea, and chocolate, increase urinary oxalate levels, promoting stone formation. Studies show that staying hydrated and reducing the intake of these foods helps decrease the risk. High-dose vitamin C supplementation can increase the levels of certain compounds in the urine, promoting stone formation. Decreasing dairy intake is not recommended—adequate dietary calcium helps prevent kidney stones by binding to specific compounds in the gut and reducing their absorption. Patients at risk for oxalate stones should not restrict their dairy intake.  And high sodium intake increases calcium excretion in urine, worsening stone formation.


Study Tip:

The most common kidney stone is calcium oxalate. To reduce recurrence, patients should stay hydrated and limit high-oxalate foods such as spinach, nuts, beets, tea, and chocolate. Encourage adequate calcium intake (e.g., dairy) since dietary calcium binds to oxalates in the gut, preventing absorption.

 



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