Risk of Kidney stones - Influence of Dietary factors especially Vegan diets

Dear all,

The incidence of Urinary calculi in is probably second to none when compared with Incidence of Renal calculi. The numbers of surgical procedures that we in India perform make us the leading exponents in the field globally.

There have been sporadic studies available on the causation of Kidney stone formation, we do lack in scientific data concerning this. The metabolic factors associated with Stone formation appear to vary across the country. In the West, It has been found that the main metabolic abnormality appear to be Hypocitraturia with Hyperuricosuria. But majority of the stones encountered in the west are radiopaque and this is construed to be due to epitaxy with ca Oxalate. Raman from Nadiad had presented a paper in CKP Menon award concerning use of Lime juice in the prevention of Urinary calculi (Nadiad can correct me if I am wrong). But in Southern part of Eastern India, it is said that Hypercalciuria predominate.

In many parts of the country, more probably Gujarat, has more Vegans than most of the other parts of the country. Kerala is well known for its Non Veg diet. But if you look at the incidence of Urinary stone disease across both these regions, Gujarat and its surrounding states abound with Urinary calculi than Kerala (It is only a presumption).

I am providing an article published on March 15th, 2020 on Risk of Kidney Stone along with Role Vegetarian Diets mention that based on the available evidence; a balanced vegetarian diet with dairy products seems to be the most protective diet for kidney stone patients.

https://www.mdpi.com/2072-6643/12/3/779 (PDF available) (this is a good article worth reading)

I wonder why this disparity. I would like to know from our learned members (all are), if Vegan Diet leads to reduced incidence of stones, why then states with more Vegans suffer from Kidney Stones. Can we attribute this to Climatic factors and not really dietary factors?

Incidentally, I would like to bring to your notice that we use Potassium Citrate for the treatment of Kidney Stones as it is purported to correct Hypocitraturia. Studies are now ongoing on the value of Hydroxycitrate (Presented at AUA 2016 and published in ‘Nature’ 2016) state that Hydroxycitrate is more potent in elevating the lowered citrate level. It has been demonstrated that Kudampuli (Garcinia cambogia, used mainly in southern Kerala for Tamarind)) has abundance of Hydroxycitrate. Inspite of using this for regular cooking, there is not much reduction in the incidence of stone disease, a point Rimer (since 2016) is attempting to propagate that all these could be beneficial only when adhered to Vegan diet essentially.

I would like to know from our esteemed members what percent of the stone disease they encounter are in Vegans who have never taken non Veg food of any sorts.

With warm Regards,




  • Ravindra Sabnis
    Ravindra Sabnis
    25 Mar 2020 11:36:37 PM

    Wonderful articles sir. Etiology of stone disease is so complex, very difficult to understand. 

    In Gujarat majority are vegetarian, many are jains & still gujarat is endemic in stone formation. 
    Many patients who are repeated stone formers,(all metabolic work up normal), in their house, others are eating same diet but do not form stones. All are in same environment, & climate but still do not form stones.
    SO my analysis is - stone formation is multifactorial. Climate, diet, occupation, body tendency & so many other factors contribute stone formation. All factors put in together will determine stone formation. Of course I am talking all those who do not have metabolic cause for stone formation. 

  • Tanuj Paul Bhatia
    Tanuj Paul Bhatia
    17 Apr 2020 11:21:26 PM

    Sir in Haryana also majority of population is vegetarian, but stones are extremely common. I have many families with multiple members having kidney stone disease. I send stone analysis of all recurrent stone formers and encourage them for a 24 hr urine metabolic evaluation(urolab). Most commonly we can identify low volumes, or hypocitraturia , or hypomagnesuria. Then we end up prescribing pottasium magnesium citrate which we were going to anyways prescribe. 

  • Dr. Roy Chally
    Dr. Roy Chally
    18 Apr 2020 08:36:44 AM

     Present work habits and life style change more than diet is the cause for stones in Kerala. In endemic areas there must be an added reason which remains elusive. 

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