Dietary habits in women with recurrent idiopathic calcium nephrolithiasis

Journal of Translational Medicine

Loris Borghi⁶  Marcello Maggio⁴  Fulvio Lauretani⁵  Giovanni Gambaro²  Giuseppe Vezzoli¹  Laura Soldati³  Federica Pigna⁶  Franca Allegri⁶  Angela Guerra⁶  Beatrice Prati⁶  Andrea Ticinesi⁶  Antonio Nouvenne⁶  Tiziana Meschi⁶ 

[1]Nephrology Unit, S. Raffaele Hospital, Milan, Italy

[2]Department of Internal Medicine and Medical Specialties, Renal Program, Columbus-Gemelli University Hospital, Catholic University, Rome, Italy

[3]Department of Medicine, Surgery and Dentistry, University of Milan, Milan, Italy

[4]Department of Internal Medicine and Biomedical Sciences, University of Parma, Parma, Italy

[5]Geriatric Unit, Parma University Hospital, Parma, Italy

[6]Department of Clinical Sciences, University of Parma, Via A. Gramsci 14, 43126 Parma, Italy

关键词: Food frequency;    Kidney stones;    Diet;    Idiopathic calcium nephrolithiasis;   

Others  :  1206018
DOI  :  10.1186/1479-5876-10-63

 received in 2011-11-15, accepted in 2012-03-28,  发布年份 2012

【 摘 要 】

Background

Nutrition has been widely recognized to influence the risk of kidney stone formation. Therefore the aim of our study was to assess: a) whether usual diet of women with idiopathic calcium nephrolithiasis (ICN) living in Parma (Northern-Italy) is different compared to healthy controls, b) how their diet differs from Italian National guidelines and c) whether it is related to nephrolithiasis clinical course.

Methods

143 women with recurrent ICN (mean age 43 ± 13 ys) and 170 healthy women (mean age 42 ± 11 ys) were enrolled. All women completed a food frequency questionnaire for the last 60-days and a 3-day dietary diary analysed with a dedicated software.

Results

Stone formers showed a higher consumption of sausages, ham, meat and sweets than healthy controls (43.1% vs 11.1%, 29.4% vs 13.9%, 21.6% vs 4.2%, 66.7% vs 18.1%, p < 0.001). The 3-day diary analysis showed an intake of calories, carbohydrates, lipids and non-discretionary sodium about 10% higher than healthy controls (p < 0.001). Finally, after dividing the population into 3 age groups (≤30, 31-40, > 40 years), the differences described above were amplified in the class ≤30 years, where nephrolithiasis presented a more serious course (shorter recurrence interval, greater stone-rate). In this age group the intake of fruit and vegetables was notably lower than guideline recommendations.

Conclusions

We conclude that the usual diet of women with recurrent ICN is different from controls and characterized by low intake of fruits and vegetables and higher consumption of simple sugars and foods with high protein and salt content. This dietary imbalance could play a role in the ICN pathogenesis, especially in younger women.

This work was financed by grants from Italian Ministry of University and Research as part of a larger project about the prevention of kidney stones (PRIN 2005063822) and by Fondazione per la Ricerca Scientifica Termale (FoRST). No potential conflict of interest relevant to this paper was reported.

【 授权许可】

   
2012 Meschi et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Taylor EN, Stampfer MJ, Curhan GC: Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow up. J Am Soc Nephrol 2004, 15:3225-3232.
• [2]Taylor EN, Curhan GC: Diet and fluid prescription in stone disease. Kidney Int 2006, 70:835-839.
• [3]Hess B: Nutritional aspects of stone disease. Endocrinol Metab Clin N Am 2002, 31:1017-1030.
• [4]Siener R: Impact of dietary habits on stone incidence. Urol Res 2006, 34:131-133.
• [5]Saint-Elie DT, Patel PV, Healy KA, Solomon T, Pattaras JG, Qian J, Master VA, Ogan K: The impact of income and education on dietary habits in stone formers. J Urol 2010, 76:307-313.
• [6]Borghi L, Meschi T, Maggiore U, Prati B: Dietary therapy in idiopathic nephrolithiasis. Nutr Rev 2006, 64:301-312.
• [7]Robertson WG, Heyburn PJ, Peacock M, Hanes FA, Swaminathan R: The effect of high animal protein intake on the risk of calcium-stone formation in the urinary tract. Clin Sci 1979, 57:285-288.
• [8]Kerstetter JE, O'Brien KO, Insogna K: Low protein intake: the impact on calcium and bone homeostasis in humans. J Nutr 2003, S1:855-861.
• [9]Nguyen QV, Kalin A, Drouve U, Casez JP, Jaeger P: Sensitivity to meat protein intake and hyperoxaluria in idiopathic calcium stone formers. Kidney Int 2001, 59:2273-2281.
• [10]Holl MG, Allen LH: Sucrose ingestion, insulin response and mineral metabolism in humans. J Nutr 1987, 117:1229-1233.
• [11]Garg A, Bonanome A, Grundy SM, Unger RH, Breslau NA, Pak CYC: Effect of dietary carbohydrates on metabolism of calcium and other minerals in normal subjects and patients with noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1990, 70:1007-1013.
• [12]Taylor EN, Stampfer MJ, Curhan GC: Obesity, weight gain, and the risk of kidney stones. Am Med Association 2005, 293:455-462.
• [13]Sakhaee K, Harvey JA, Padalino PK, Whitson P, Pak CYC: The potential role of salt abuse on the risk for kidney stone formation. J Urol 1993, 160:310-312.
• [14]Kok DJ, Iestra JA, Doorenbos CJ, Papapoulos SE: The effects of dietary excesses in animal protein and in sodium on the composition and the crystallization kinetics of calcium oxalate monohydrate in urines of healthy men. J Clin Endocrinol Metab 1990, 71:861-867.
• [15]Frassetto LA, Curtis Morris RJ, Sellmeyer DE, Sebastian A: Adverse effects of sodium chloride on bone in the aging human population resulting from habitual consumption of typical American diets. J Nutr 2008, 138:419S-422S.
• [16]Lemann J Jr, Pleuss JA, Gray RW: Increased dietary calcium intake reduces urinary oxalate excretion in healthy adults. In Urolithiasis. Edited by Walker VR, Sutton RAL, Cameron ECB, Pak CYC, Robertson WG. New York and London: Plenum Press; 1989:435-438.
• [17]Martini LA, Heilberg IP: Stop dietary calcium restriction in kidney stone-forming patients. Nutr Rev 2002, 60:212-214.
• [18]Curhan GC, Willett WC, Knight EL, Stampfer MJ: Dietary factors and the risk of incident kidney stones in younger women. Arch Intern Med 2004, 164:885-891.
• [19]Meschi T, Maggiore U, Fiaccadori E, Schianchi T, Bosi S, Adorni G, Ridolo E, Guerra A, Allegri F, et al.: The effect of fruits and vegetables on urinary stone risk factors. Kidney Int 2004, 66:2402-2410.
• [20]Curhan GC, Willett WC, Rimm EB, Stampfer MJ: A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 1993, 328:833-838.
• [21]Taylor EN, Curhan GC: Determinants of 24-hour urinary oxalate excretion. Clin J Am Soc Nephrol 2008, 3:1453-1460.
• [22]Pak CYC, Skurla C, Harvey J: Graphic display of urinary risk factors for renal stone formation. J Urol 1985, 134:867-870.
• [23]Guerra A, Allegri F, Meschi T, Adorni G, Prati B, Nouvenne A, Novarini A, Maggiore U, Fiaccadori E, Borghi L: Effects of urine diluition on quantity, size and aggregation of calcium oxalate crystals induced in vitro by an oxalate load. Clin Chem Lab Med 2005, 43:585-589.
• [24]Curhan GC, Willett WC, Speizer FE, Stampfer MJ: Beverage use and risk for kidney stones in women. Ann Intern Med 1998, 128:534-540.
• [25]Taylor EN, Curhan GC: Fructose consumption and the risk of kidney stones. Kidney Int 2008, 73:207-212.
• [26]Goodman JW, Asplin JR, Goldfarb DS: Effect of two sports drinks on urinary lithogenicity. Urol Res 2009, 37:41-46.
• [27]Griffith HM, O'Shea B, Kevany JP, McCormick JS: A control study of dietary factors in renal stone formation. Br J Urol 1981, 53(5):416-420.
• [28]Power C, Baker DJ, Nelson M, Winter PD: Diet and renal stones: a case-control study. Br J Urol 1984, 56(5):456-459.
• [29]Griffith HM, O'Shea B, Maguire M, Koegh B, Kevany JP: A case-control study of dietary intake of renal stone patients. II. Urine biochemistry and stone analysis. Urol Res 1986, 14(2):75-82.
• [30]Wasserstein AG, Stolley PD, Soper KA, Goldfarb S, Maislin G, Agus Z: Case-control study of risk factors for idiopathic calcium nephrolithiasis. Mineral Electrolyte Metab 1987, 13(2):85-95.
• [31]Fellstrom B, Danielson BG, Karlstrom B, Lithell H, Ljunghall S, Vessby B: Dietary habits in renal stone patients compared with healthy subjects. Br J Urol 1989, 63:575-580.
• [32]Trinchieri A, Mandressi A, Luongo P, Longo G, Pisani E: The influence of diet on urinary risk factors for stones in healthy subjects and idiopathic renal calcium stone formers. Br J Urol 1991, 67:230-236.
• [33]Leonetti F, Dussol B, Berthezene P, Thirion X, Berland Y: Dietary and urinary risk factors for stones in indiopathic calcium stone formers compared with healthy subjects. Nephrol Dial Transplant 1998, 13:617-622.
• [34]Al Zahrani H, Norman RW, Thompson C, Weerasinge S: The dietary habits of idiopathic calcium stone-formers and normal control subjects. BJU Int 2000, 85:616-620.
• [35]Guidelines for a healthy Italian diet. Italian National Institute for Research on Food and Nutrition (Linee Guida per una sana alimentazione italiana. Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione) [http://www.inran.it/648/linee_guida.html] webcite Visited on November 2nd 2011
• [36]Committee G: 2003 European Society of Hypertension - European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003, 21(6):1011-1053.
• [37]Taylor EN, Fung TT, Curhan GC: DASH-style diet associates with reduced risk for kidney stones. J An Soc Nephrol 2009, 20:2253-2259.
• [38]Nouvenne A, Meschi T, Prati B, et al.: Effect of a low-salt diet on idiopathic hypercalciuria in calcium-oxalate stone formers: a 3-mo randomized controlled trial. Am J Clin Nutr 2010, 91:565-570.
• [39]Borghi L, Schianchi T, Meschi T, et al.: Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 2002, 346(2):77-84.
• [40]Siener R, Schade N, Nicolay C, Von Unruh GE, Hesse A: The efficacy of dietary intervention on urinary risk factors for stone formation in recurrent calcium oxalate stone patients. J Urol 2005, 173:1601-1605.
• [41]Nouvenne A, Meschi T, Guerra A, Allegri F, Prati B, Fiaccadori E, Maggiore U, Borghi L: Diet to reduce mild hyperoxaluria in patients with idiopathic calcium oxalate stone formation: a pilot study. J Urol 2009, 73:725-730.
• [42]Jaeger Ph, Robertson WG: Role of dietary intake and intestinal absorption of oxalate in calcium stone formation. Nephron Physiol 2004, 98:64-71.
• [43]Dussol B, Iovanna C, Rotily M, Morange S, Leonetti F, Dupuy P, Vazi A, Saveanu A, Loundou A, Berland Y: A randomized trial of low-animal-protein or high-fiber diets for secondary prevention of calcium nephrolithiasis. Nephron Clin Pract 2008, 110:c185-c194.
• [44]Burkhardt P: The effect of the alkali load of mineral water on bone metabolism: interventional studies. J Nutr 2008, 138:435S-437S.
• [45]Arnett TR: Extracellular pH regulates bone cell function. J Nutr 2008, 138:415S-418S.
• [46]Prentice RL, Mossavar-Rahmani Y, Huang Y, Van Horn L, Beresford SA, Caan B, Tinker L, Schoeller D, Bingham S, Eaton CB, Thomson C, Johnson KC, Ockene J, Sarto G, Heiss G, Neuhouser ML: Evaluation and comparison of food records, recalls, and frequencies for energy and protein assessment by using recovery biomarkers. Am J Epidemiol 2011, 174:591-603.