{"id":"9f3fca62-3c20-5d38-9f35-84463f760c06","stable_key":"434e1e27-eb90-583a-956b-62472726ffba:cal-borghi-stone-recurrence","predicate":"has_reported_effect_on","statement":"A normal-calcium diet with less animal protein and salt reduced stone recurrence compared with a low-calcium diet.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"negative","is_public":true,"mechanism_event_id":"d96609a0-bc5c-5c4b-b874-300b88aca989","mechanism_event_label":"Restricting calcium was not the better strategy in this particular dietary trial.","subject":{"id":"8e2a5a1f-cd49-5f28-8611-325266fb78a6","slug":"calcium","display_name":"Calcium","entity_type_key":"nutrient_element"},"object":{"id":"10407418-0efd-5f92-a032-1ee3dc734bd3","slug":"recurrent-calcium-oxalate-stones","display_name":"Calcium oxalate stone recurrence","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"d96609a0-bc5c-5c4b-b874-300b88aca989","stable_key":"434e1e27-eb90-583a-956b-62472726ffba:cal-borghi-stone-recurrence-event","event_type":"observed_intervention","label":"Restricting calcium was not the better strategy in this particular dietary trial.","description":"A normal-calcium diet with less animal protein and salt reduced stone recurrence compared with a low-calcium diet.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"8e2a5a1f-cd49-5f28-8611-325266fb78a6","slug":"calcium","display_name":"Calcium","entity_type_key":"nutrient_element"},"role":"tested_input","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"10407418-0efd-5f92-a032-1ee3dc734bd3","slug":"recurrent-calcium-oxalate-stones","display_name":"Calcium oxalate stone recurrence","entity_type_key":"cellular_process"},"role":"measured_outcome","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""}]},"contexts":[{"dimension":"experimental_model","value_text":"120 hypercalciuric male recurrent stone formers; five-year randomized comparison.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Recurrences 12/60 versus 23/60; RR 0.49, 95% CI 0.24-0.98. Calcium 30 versus 10 mmol/day; intervention also reduced animal protein and salt.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Multiple dietary components changed together, preventing isolated calcium attribution.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Calcium research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"calcium","display_name":"Calcium","entity_type_key":"nutrient_element"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"Restricting calcium was not the better strategy in this particular dietary trial.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[cal-clin-borghi2002] Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria (2002). https://pubmed.ncbi.nlm.nih.gov/11784873/ DOI: 10.1056/NEJMoa010369","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Human clinical or absorption endpoint","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"a4661074-47ef-5101-b510-419013014177","evidence_kind":"source_excerpt","locator":"Lines 1235-1245","start_line":1235,"end_line":1245,"excerpt":"### cal-borghi-stone-recurrence\nA normal-calcium diet with less animal protein and salt reduced stone recurrence compared with a low-calcium diet.\nCondition category: normal\nnutrient_topic: Calcium research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Restricting calcium was not the better strategy in this particular dietary trial.\norganism: Homo sapiens\ntissue_or_cell_type: Human clinical or absorption endpoint\nexperimental_model: 120 hypercalciuric male recurrent stone formers; five-year randomized comparison.\nlimitations: Multiple dietary components changed together, preventing isolated calcium attribution.\nexposure: Recurrences 12/60 versus 23/60; RR 0.49, 95% CI 0.24-0.98. Calcium 30 versus 10 mmol/day; intervention also reduced animal protein and salt.\n[cal-clin-borghi2002] Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria (2002). https://pubmed.ncbi.nlm.nih.gov/11784873/ DOI: 10.1056/NEJMoa010369","model_system":"120 hypercalciuric male recurrent stone formers; five-year randomized comparison.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [cal-clin-borghi2002] Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria (2002). https://pubmed.ncbi.nlm.nih.gov/11784873/ DOI: 10.1056/NEJMoa010369","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"3c083fa0-59c6-50e9-af42-678d0e3c1006","stable_key":"import-434e1e27-eb90-583a-956b-62472726ffba","title":"Calcium: mechanism-first literature curation (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"965c934d6b147f2b62f8d45ce6d7a87681a600bfe5c46a585b4704889afd3fc1","revision_id":"543ec48b-4f70-5197-9d76-f5a3c443664c","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[{"id":"f16e9dc0-acf9-59fd-8924-83f8d90687c6","title":"Dietary calcium context and combined supplements have different stone findings","kind":"context_difference","status":"open","why":"The dietary trial changed protein and salt as well as calcium and enrolled male recurrent stone formers; WHI tested calcium plus vitamin D in postmenopausal women. Luminal oxalate binding is plausible but cannot by itself reconcile all clinical differences.","resolution":"Unresolved; needs review.","created_at":"2026-09-17 08:08:54","record_type":"conflict","display_label":"Recorded conflict","record_url":"/conflicts/f16e9dc0-acf9-59fd-8924-83f8d90687c6","sides":[{"conflict_id":"f16e9dc0-acf9-59fd-8924-83f8d90687c6","ordinal":0,"label":"Restricting calcium was not the better strategy in this particular dietary trial.","revision_id":"543ec48b-4f70-5197-9d76-f5a3c443664c","start_line":1235,"end_line":1245,"quote":"### cal-borghi-stone-recurrence\nA normal-calcium diet with less animal protein and salt reduced stone recurrence compared with a low-calcium diet.\nCondition category: normal\nnutrient_topic: Calcium research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Restricting calcium was not the better strategy in this particular dietary trial.\norganism: Homo sapiens\ntissue_or_cell_type: Human clinical or absorption endpoint\nexperimental_model: 120 hypercalciuric male recurrent stone formers; five-year randomized comparison.\nlimitations: Multiple dietary components changed together, preventing isolated calcium attribution.\nexposure: Recurrences 12/60 versus 23/60; RR 0.49, 95% CI 0.24-0.98. Calcium 30 versus 10 mmol/day; intervention also reduced animal protein and salt.\n[cal-clin-borghi2002] Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria (2002). https://pubmed.ncbi.nlm.nih.gov/11784873/ DOI: 10.1056/NEJMoa010369","source_key":"import-434e1e27-eb90-583a-956b-62472726ffba","source_title":"Calcium: mechanism-first literature curation (2026-09-17)","claim_ids":["9f3fca62-3c20-5d38-9f35-84463f760c06"]},{"conflict_id":"f16e9dc0-acf9-59fd-8924-83f8d90687c6","ordinal":1,"label":"The same trial recorded more kidney-stone events with the combined supplements.","revision_id":"543ec48b-4f70-5197-9d76-f5a3c443664c","start_line":1223,"end_line":1233,"quote":"### cal-whi-urinary-stones\nWHI assigned calcium plus vitamin D increased reported renal-calculus events relative to placebo.\nCondition category: normal\nnutrient_topic: Calcium research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: The same trial recorded more kidney-stone events with the combined supplements.\norganism: Homo sapiens\ntissue_or_cell_type: Human clinical or absorption endpoint\nexperimental_model: Randomized WHI safety outcome.\nlimitations: Combined intervention; cannot attribute the whole effect to calcium or identify every stone composition.\nexposure: Renal-calculus HR 1.17, 95% CI 1.02-1.34; same assigned regimen as the fracture analysis.\n[cal-clin-jackson2006] Calcium plus vitamin D supplementation and the risk of fractures (2006). https://pubmed.ncbi.nlm.nih.gov/16481635/ DOI: 10.1056/NEJMoa055218","source_key":"import-434e1e27-eb90-583a-956b-62472726ffba","source_title":"Calcium: mechanism-first literature curation (2026-09-17)","claim_ids":["19a81f98-abde-5c2a-827e-e6e56a1ca427"]}]}],"corrections":[],"research":null}