Dietary pattern analysis among stone formers: resemblance to a DASH-style diet

Abstract

Recent epidemiological studies have shown that dietary patterns may have a more persistent impact on the risk of stone formation than single nutrients of the diet. Dietary Approaches to Stop Hypertension (DASH), a low-sodium and fruits/vegetables-rich diet, has been associated with a lower risk of nephrolithiasis, due to altered urinary biochemistry. This observational study aimed to investigate whether the dietary pattern of stone formers (SF) resembled a DASH-diet and its influence on urinary lithogenic parameters. Anthropometric data, fasting serum sample, 24-h urine samples, and a 3-day food intake record under an unrestricted diet were obtained from 222 SF and compared with 136 non-SF subjects (controls). The DASH-diet food portions were determined from the food records whereas intakes of sodium chloride (NaCl) and protein (protein equivalent of nitrogen appearance, PNA) were estimated from 24-hr urinary sodium and urea. A dietary profile close to a DASH-diet was not observed in any of the groups. NaCl intake and PNA were significantly higher in SF versus non-SF (12.0 ± 5.2 v.s. 10.1 ± 3.4 g/day, p = 0.01 and 1.8 ± 0.1 v.s. 1.4 ± 0.1 g/kg/day, p = 0.03). SF exhibited a positive correlation of NaCl intake and PNA with urinary calcium, oxalate and uric acid, and of PNA with urinary sodium. SF consumed more vegetables and legumes, but less fruits and low-fat dairy items than non-SF. The present series presented a dietary profile characterized by low calcium and high salt and protein contents, not reflecting an ideal DASH-style diet pattern.

24-hour sodium and potassium excretion in the Americas: a systematic review and meta-analysis

“…Date of data collection was assumed to be 3 years before publication when authors left unanswered (n=15) (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Response was not received from studies with missing SD: three reporting sodium (32)(33)(34), three reporting potassium (26,34,35), two reporting creatinine (26,35). Therefore, missing data were imputed: estimating the mean SD from studies with full data provided carried out in the same country ( )…”

“…If the period of data collection covered more than a year, the midpoint was used. When both baseline and end-of-trial measurements were reported, only the former (n=15) (19,21,22,24,25,30,33,(37)(38)(39)(40)(41)(42)(43)(44), or the control group were included (n=4) (28,35,45,46).…”

Metabolic and dietary features in kidney stone formers: nutritional approach

“…Rodrigues et al reported also that the diet of kidney stone formers showed a higher amount of protein and salt but lower calcium than in controls 1 . Probably, the higher percentage of diabetes in their group could have influenced patient’s food choices.…”

“…Kidney stone disease is not only a pathology of the urinary tract, but it is also closely associated to metabolic abnormalities and incorrect dietary habits. Rodrigues et al 1 reported the results of an observational study about the metabolic and dietary features of a Brazilian population of kidney stone patients. They found that kidney stone formers had a higher prevalence of obesity, diabetes, and hypertension together with higher serum levels of glucose and triglycerides than non-stone formers.…”

Vascular Calcification Is Associated with Fetuin-A and Cortical Bone Porosity in Stone Formers

“…Nephrolithiasis represents a common disorder with a lifetime cumulative incidence of 5–10% and a progressively increasing prevalence worldwide [ 1 , 2 ], affecting all ages, sexes, and races, but frequently occurring between the 2nd and 4th decades of life [ 3 ]. Lithogenesis is characterized by an imbalance between the solubility and precipitation of minerals in the urine influenced by several factors, including climate, social-economic status, eating habits, obesity, genetic inheritance, and metabolic disorders [ 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. It is well established that stone formers (SF) exhibit a reduction of bone mineral density (BMD) [ 12 , 13 ], which may be exacerbated under low calcium intake [ 14 ], and histomorphometric studies have reported low bone formation and increased bone resorption [ 15 , 16 , 17 ].…”