Influence of clinical therapy and nutritional counseling on the recurrence of urolithiasis.

Autor:	Damasio PC; Medical School of Botucatu, Sao Paulo State University, Botucatu, SP, Brazil., Amaro CR; Medical School of Botucatu, UNESP, Botucatu, SP, Brazil., Padovani CR; Department of Biostatistics, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil., Leitão VA; Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil., Yamamoto H; Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil., Amaro JL; Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Acta cirurgica brasileira [Acta Cir Bras] 2014 Jun; Vol. 29 (6), pp. 400-4.
DOI:	10.1590/s0102-86502014000600009
Abstrakt:	Purpose: To evaluate the influence of combined clinical therapy and nutritional guidance on the recurrence of urolithiasis. Methods: From our registry of patients with recurrent urolithiasis we selected 57 who had at least 5-years of follow-up. We collected 24h urine samples in order to analyze Ca, Na, uric acid, citrate, oxalate, and Mg concentrations and to assess urine volume. Patients filled out a clinical questionnaire before treatment, and abdominal radiographs and/or ultrasound were performed both before treatment and during the follow-up period. During follow-up, specific and individualized dietary advice was given based on the individual's metabolic disorders. Patients also received specific pharmacological treatment for their metabolic alterations. Outcome measures were metabolites in urine and the urolith recurrence rate. Pre- and post- intervention values were compared using tests as appropriate. Results: Fifty six of the patients were male and the majority of patients were overweight. The mean BMI was 27 kg/m(2). Urinary excretion of calcium, uric acid and sodium decreased significantly over the five year follow-up period. The number of uroliths that formed during the 5-year follow-up also decreased significantly compared to pre-treatment values. Conclusion: Individualized dietary advice combined with pharmacological treatment significantly reduces long-term urolithiasis recurrence.
Databáze:	MEDLINE
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