Despite high level evidence supporting the use of pharmacotherapy therapy for the prevention of kidney stones, adherence to medications is often poor because of side effects, inconvenience and cost. Furthermore, with a desire for more "natural" products, patients seek dietary and herbal remedies over pharmacotherapy. However, patients are often unaware of the potential side effects, lack of evidence and cost of these remedies. Therefore, in this review we examine the evidence for a few of the commonly espoused non-prescription agents or dietary recommendations that are thought to prevent stone formation, including lemonade, fish oil (omega fatty acids), Phyllanthus niruri (P. niruri) and the Dietary Approaches to Stop Hypertension (DASH) diet. While this review includes only a few of the stone modulating recommendations available to the lay community, we focused on these four due to their prevalent use. Our goal is not to only dispel commonly held notions about stone disease, but also to highlight the lack of high level evidence for many commonly utilized treatments.
BJU international. 2021 Jun 30 [Epub ahead of print]
Alaina Garbens, Margaret S Pearle
Department of Urology, UT Southwestern Medical Center, Dallas Texas.