Nutritional aspects in primary hypercalciuria: part 2
At the end of the screening, all of the results were shown to the patient and he was given detailed information concerning the meaning of the urinary stone risk profile. He was given an in- depth “lesson” on the importance of diet for the prevention of his kidney stones and more in general for his health, and he was given a written dietary prescription, whose nutritional composition is shown in Table II. cad-pharmacy.com 1 internet online drugstore
After a week of this diet, the urinary stone risk profile risk was repeated, the results are shown in Table I. Significant changes in the excretion of many substances may be seen, all of which are positive in the “antilithogenic” sense. In particular, there is a normalization of urinary calcium, a reduction in oxalate and uric acid, an increase in citrate and, above all, a net reduction in the saturation levels for calcium oxalate and calcium phosphate. In terms of nutritional markers, there was a drastic reduction in sodium, chloride, urea and sulphate and an increase in potassium. The patient was impressed by these changes. Among other things, he refers to the almost “euphoria-inducing” effect of the diet: he had lost 2 kg in weight, his arterial blood pressure was almost in the normal range (145/90 mmHg) and he said that he felt “lighter”. He left the outpatients clinic convinced of what he had been recommended, with the undertaking to continue with the diet and to return every year for the check-up which formed part of our follow-up, and which included the renal echography and the urinary stone risk profile. This he did for the five years that followed.
Table II – Composition of the “antilithogenic” diet prescribed for the patient.
|
Daily Intake |
Value* |
|
Total calories (Kcal) |
2540 |
|
Total protein (g) |
93 |
|
|
(372 Kcal, or approximately |
|
|
15% of total calories) |
|
From meat or fish |
21 |
|
From milk and derivatives |
31 |
|
From bread, pasta, and vegetables |
41 |
|
Lipids (g) |
93 |
|
|
(837 Kcal, or approximately |
|
|
33% of total calories) |
|
Carbohydrates (g) |
333 |
|
|
(1332 Kcal, or approximately |
|
|
52% of total calories) |
|
Fiber (g) |
40 |
|
Sodium chloride (mEq) |
50 |
|
Potassium (mEq) |
120 |
|
Calcium (mg) |
1200 |
|
Phosphorus (mg) |
1512 |
|
Magnesium (mg) |
348 |
|
Oxalate (mg) |
Approximately 200 |
|
Water in foods (ml) |
1550 |
In the 5 years of follow-up he no longer experienced renal colic, the echography was always negative, the calciuria was always less than 300 mg/day, oscillating between 230 and 270 mg/day, the urinary sodium, urea and sulphate showed values of 100 mEq/day, 25 g/day and 23 mmol/day respectively, thus showing a fair adherence to the diet. His arterial blood pressure remained stable between the values 140-150/80-90 mmHg and his body weight fell still further to about 80 kg.
