Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
J Endourol. 2011 Mar;25(3):535-40. doi: 10.1089/end.2010.0241. Epub 2011 Mar 1.
The aim of this study was to investigate the current impact of dietary counseling on the risk for urolithiasis.
A retrospective cohort study of the patients treated in our stone clinics from July 2007 to February 2009 was carried out. Patients' urinary risk factors for stone disease were evaluated with pre- and postintervention 24-hour urine collections. All patients received dietary recommendations from a registered dietician at each visit.
One hundred thirty-seven subjects were identified and managed initially with only dietary interventions to address their urinary stone risk parameters. Average follow-up for this group was 15.19 ± 13.7 months. Subjects showed significant changes in urine volume (71.1%, 1.68 ± 0.68 to 2.59 ± 0.80 L/day, p < 0.0001), urine sodium (58.1%, 229.68 ± 72.51 to 144.65 ± 52.70 mmol/day, p < 0.0001), urine calcium (43.8%, 314.33 ± 95.75 to 216.81 ± 80.90 mg/day, p < 0.0001), urinary uric acid (50%, 0.821 ± 0.210 to 0.622 ± 0.128 g/day, p < 0.0001), urinary citrate (50.7%, 583.19 ± 330.86 to 797.36 ± 412.31, p < 0.0001), and urine oxalate (55.5%, 46.28 ± 10.31 to 32.56 ± 9.02 mg/day, p < 0.0001). The supersaturation for calcium oxalate also decreased significantly from baseline (9.34-5.03, p < 0.0001).
Urolithiasis is a multifactorial disease requiring a multidisciplinary approach. Our results support the use of dietary counseling by a registered dietician in the management of urolithiasis.
本研究旨在探讨饮食咨询对尿石症风险的当前影响。
对 2007 年 7 月至 2009 年 2 月在我院结石门诊治疗的患者进行回顾性队列研究。通过干预前后 24 小时尿液收集评估患者结石病的尿危险因素。每位患者在每次就诊时都接受注册营养师的饮食建议。
共确定并初步管理了 137 例患者，仅通过饮食干预来解决其尿石症风险参数。该组的平均随访时间为 15.19 ± 13.7 个月。患者的尿液量（71.1%，1.68 ± 0.68 至 2.59 ± 0.80 L/天，p < 0.0001）、尿钠（58.1%，229.68 ± 72.51 至 144.65 ± 52.70 mmol/天，p < 0.0001）、尿钙（43.8%，314.33 ± 95.75 至 216.81 ± 80.90 mg/天，p < 0.0001）、尿尿酸（50%，0.821 ± 0.210 至 0.622 ± 0.128 g/天，p < 0.0001）、尿枸橼酸盐（50.7%，583.19 ± 330.86 至 797.36 ± 412.31，p < 0.0001）和尿草酸盐（55.5%，46.28 ± 10.31 至 32.56 ± 9.02 mg/天，p < 0.0001）均显著增加。钙草酸的过饱和度也从基线显著降低（9.34-5.03，p < 0.0001）。
尿石症是一种多因素疾病，需要多学科方法。我们的结果支持注册营养师在尿石症管理中使用饮食咨询。
