요석 환자에서 일반적인 식이요법의 효과에 대한 평가 = Evaluation for Effect of Standard Diet Therapy in Patients with Urolithiasis

다국어 초록 (Multilingual Abstract)

PURPOSE: In the treatment of urolithiasis, the prevention of recurrence is an essential goal. For this reason, a constant effort has been made to find risk factors for urolithiasis through full metabolic evaluations and to recommend a dietary therapy on the basis of the risk factors as a primary preventive modality. In this study, the effect of dietary therapy in patients with urolithiasis was evaluated by comparing the change of metabolic parameters before and after they followed standard diet recommendations.
MATERIAL and METHODS: A total of 40 stone formers who have no any metabolic disorders such as renal tubular acidosis, gout, or hyperparathyroidism were included. They were consisted of 26 males (mean age: 38.0±12.9) and 14 females (mean age: 44.5±11.7). Among them, 16 were first-time stone formers and 24 were recurrent formers with two or more episodes in their history. Blood and urinary metabolic evaluations were performed before and after dietary therapy with the mean duration of 5.4 months ranging from 3 to 13 months. The recommended diet regimen was as follows; large amount of water intake (more than 3L/day), drinking fruit juice, restriction of animal protein and salt and low consumption of oxalate-rich foods. In case of having abnormalities in first metabolic study, special attentions to that abnormalities was instructed primarily. Two corresponding metabolic parameters were compared using Wilcoxon signed rank test and McNemar test.
RESULTS: There was no significant change in blood chemistry before and after diet therapy. Among the urinary parameters, the excretion of citrate was significantly increased after diet therapy but the rest such as calcium, oxalate, uric acid, magnesium, sodium, 24-hour urine volume, or patassium remained unchanged. As compared the urinary metabolic abnormalities such as the hypercalciuria, hyperoxaluria, hypocitraturia, and hyperuricosuria, the frequencies were as follow; 10 cases of hypercalciuria, 9 of hyperoxaluria, 7 of hyperuricosuria, and 19 of hypocitraturia on the first metabolic evaluation, and 19, 13, 8, and 11 cases respectively on second test. There were the significant changes in the frequencies of hypercalciuria and hypocitraturia (p=0.049, p=0.039).
CONCLUSIONS: The standard diet therapy applied to patients with urolithiasis did not showed the significant effect in the view of changes of metabolic parameters except for urinary citrate excretion. Therefore, I think that the more detailed guidelines about the dietary recommendations and follow-up need to be developed.

목차 (Table of Contents)

• 서론 1
• 대상 및 방법 4
• 결과 8
• 고찰 18
• 결론 21
• 참고문헌 22