Rosh Internal Medicine Boost Practice Exam

Which dietary change is most beneficial for reducing the risk of kidney stone formation?

1. Increasing citrate intake

2. Increasing oxalate intake

3. Increasing sodium intake

4. Increasing sucrose intake

The correct answer is: Increasing citrate intake

Increasing citrate intake is indeed the most beneficial dietary change for reducing the risk of kidney stone formation. Citrate acts as a natural inhibitor of stone formation, particularly calcium stones, which are the most common type of kidney stones. The presence of citrate in urine can help prevent the crystallization of calcium salts, making it less likely for stones to form. In addition to its inhibitory effects, citrate may also increase urine pH, creating a more alkaline environment that is less conducive to stone formation. This property of citrate can be particularly helpful for individuals who are predisposed to forming calcium-based stones, as it directly counteracts the factors that contribute to stone development. In contrast, increasing oxalate intake can actually raise the risk of stone formation, especially in individuals who are susceptible to calcium oxalate stones. Similarly, increasing sodium intake is not helpful and can worsen the situation, as higher sodium levels can lead to higher calcium excretion in urine, promoting stone formation. Increasing sucrose intake does not have a positive impact on kidney stone prevention and may contribute to obesity and other metabolic issues that can indirectly affect kidney health. Therefore, focusing on increasing citrate intake is a significant dietary change that can effectively reduce the risk of kidney stones.