Do you routinely recommend decreasing dietary animal protein intake in patients with recurrent calcium oxalate nephrolithiasis who are found to have hyperoxaluria on 24 hour urine studies?

This is an interesting question. I focus more on total protein intake rather than which type in my initial assessment and make sure that the patients are meeting guidelines there first (0.8-1g protein/Kg of lean body weight). I address hyperoxaluria in my review primarily through addressing the usua...

I do not. The link between prospective new stone onset and red meat is very weak and surely is due to the increase of urine calcium from protein amino acids that signal TAHL cell CaSR. Effects of diet protein on urine oxalate are meager to none.