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Nefrolitiasis: Una perspectiva paleolítica y un enfoque fisiológico para la prevención
Calyani Ganesan1, Lynda Frassetto2, Alan C Pao1,3,4
1Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA;
Annual review of medicine
|January 27, 2026
Resumen
La dieta humana moderna, alta en sodio y precursores de ácido, aumentó significativamente el riesgo de nefrolitiasis (cálculos renales) en comparación con la dieta paleolítica. La adopción de patrones dietéticos antiguos puede reducir el riesgo de cálculos.
Sus antecedentes:
- La nefrolitiasis (cálculos renales) es una afección prevalente con etiologías complejas.
- La dieta humana ha experimentado cambios drásticos a lo largo de la historia evolutiva, particularmente en los últimos 10.000 años.
Objetivo del estudio:
- Explorar la influencia de la dieta paleolítica en el riesgo de nefrolitiasis.
- Investigar el impacto de las revoluciones agrícola e industrial en la producción de alimentos en la formación de cálculos renales.
Principales métodos:
- Revisión de evidencia dietética evolutiva e histórica.
- Análisis del cambio de una dieta paleolítica rica en potasio, baja en sodio y rica en álcali a una dieta moderna.
Principales resultados:
- La dieta paleolítica se caracterizaba por un alto contenido de potasio, bajo contenido de sodio y altos precursores de álcali.
- Las dietas modernas, influenciadas por la agricultura y la industrialización, son ricas en sodio y precursores de ácido, lo que aumenta el riesgo de cálculos.
- El cambio abrupto en la dieta desafió la homeostasia renal, elevando el riesgo de formación de cálculos.
Conclusiones:
- El regreso a patrones dietéticos similares a los de la dieta paleolítica puede mitigar el riesgo de cálculos renales.
- Si bien medicamentos como las tiazidas, los álcalis y la empagliflozina muestran potencial, se necesitan ensayos clínicos adicionales para confirmar su eficacia en la prevención de la recurrencia de cálculos.
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