Kidney stones impact 7 per cent to 15 per cent of the population in North America, 5 per cent to 9 per cent of the population in Europe, and 1 per cent to 5 per cent of the population in Asia. Common symptoms include severe pain, nausea, vomiting, fever, chills, and bloody urine.
However, kidney stones can cause infections, swelling of the kidneys (hydronephrosis), renal insufficiency, and end-stage renal disease in addition to lowering quality of life. Obesity, chronic diarrhoea, dehydration, and inflammatory bowel disease, diabetes, or gout are all known risk factors for kidney stones.
A new study published in Frontiers in Nutrition suggests that increased consumption of added sugars should be added to the list of risk factors for kidney stones for the first time. Added sugars can be found in a variety of processed foods, but they are particularly prevalent in sugar-sweetened sodas, fruit drinks, candies, ice cream, cakes, and cookies.
“Ours is the first study to report an association between added sugar consumption and kidney stones,” said lead author Dr Shan Yin, a researcher at the Affiliated Hospital of North Sichuan Medical College, Nanchong, China. “It suggests that limiting added sugar intake may help to prevent the formation of kidney stones.”
Yin et al. analyzed epidemiological data on 28,303 adult women and men, collected between 2007 to 2018 within the US National Health and Nutrition Examination Survey (NHANES). Participants self-reported if they had a history of kidney stones. Each participant’s daily intake of added sugars was estimated from their recall of their most recent consumption of food and drinks, given twice: once in a face-to-face interview, and once in a telephone interview between three and 10 days later. For example, participants were asked if they had eaten syrups, honey, dextrose, fructose, or pure sugar during the past 24 hours.
Each participant also received a healthy eating index score (HEI-2015), which summarizes their diet in terms of the adequacy of beneficial diet components such as fruits, vegetables, and whole grains, and moderation of potentially harmful foods, for example, refined grains, sodium, and saturated fats.
The researchers adjusted the odds of developing kidney stones per year during the trial for a range of explanatory factors. These included gender, age, race or ethnicity, relative income, BMI, HEI-2015 score, smoking status, and whether the participants had a history of diabetes.
At the start of the study, participants with a higher intake of added sugar tended to have a higher current prevalence of kidney stones, a lower HEI score, and a lower education level. The overall mean intake of added sugars was 272.1 calories per day, which corresponds to 13.2% of the total daily energy intake.
The researchers showed that after adjusting for these factors, the percentage of energy intake from added sugars was positively and consistently correlated with kidney stones. For example, participants whose intake of added sugars was among the 25% highest in the population had 39% greater odds of developing kidney stones over the course of the study.
Similarly, participants who derived more than 25 per cent of their total energy from added sugars had 88 per cent greater odds than those who derived less than 5 per cent of their total energy from added sugars.
The results also indicated that participants from ‘Other’ ethnicities – for example, Native American or Asian people – had higher odds of developing kidney stones when exposed to greater-than-average amounts of added sugars than Mexican American, other Hispanic, non-Hispanic White, and non-Hispanic Black people. People with a greater Poverty-Income Ratio (PIR; ie, the ratio between their income and the federal poverty level) had greater odds of developing kidney stones when exposed to more added sugars than people at or slightly above the poverty level.
The mechanisms of the relation between consuming more added sugars and a greater risk of developing kidney stones is not yet known. Because this was an uncontrolled observational trial, it can’t yet be ruled out that unknown confounding factors might drive this association.
“Further studies are needed to explore the association between added sugar and various diseases or pathological conditions in detail,” cautioned Yin. “For example, what types of kidney stones are most associated with added sugar intake? How much should we reduce our consumption of added sugars to lower the risk of kidney stone formation? Nevertheless, our findings already offer valuable insights for decision-makers.”
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