1
|
Balawender K, Łuszczki E, Mazur A, Wyszyńska J. The Multidisciplinary Approach in the Management of Patients with Kidney Stone Disease-A State-of-the-Art Review. Nutrients 2024; 16:1932. [PMID: 38931286 PMCID: PMC11206918 DOI: 10.3390/nu16121932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/15/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Kidney stone disease has a multifactorial etiology, and evolving dietary habits necessitate continuous updates on the impact of dietary components on lithogenesis. The relationship between diseases influenced by lifestyle, such as obesity and diabetes, and kidney stone risk underscores the need for comprehensive lifestyle analysis. Effective management of kidney stones requires a multidisciplinary approach, involving collaboration among nutritionists, urologists, nephrologists, and other healthcare professionals to address the complex interactions between diet, lifestyle, and individual susceptibility. Personalized dietary therapy, based on each patient's unique biochemical and dietary profile, is essential and necessitates comprehensive nutritional assessments. Accurate dietary intake evaluation is best achieved through seven-day, real-time dietary records. Key factors influencing urinary risk include fluid intake, dietary protein, carbohydrates, oxalate, calcium, and sodium chloride. Personalized interventions, such as customized dietary changes based on gut microbiota, may improve stone prevention and recurrence. Current research suggests individualized guidance on alcohol intake and indicates that tea and coffee consumption might protect against urolithiasis. There is potential evidence linking tobacco use and secondhand smoke to increased kidney stone risk. The effects of vitamins and physical activity on kidney stone risk remain unresolved due to mixed evidence. For diseases influenced by lifestyle, conclusive evidence on targeted interventions for nephrolithiasis prevention is lacking, though preliminary research suggests potential benefits. Management strategies emphasize lifestyle modifications to reduce recurrence risks, support rapid recovery, and identify predisposing conditions, highlighting the importance of these changes despite inconclusive data.
Collapse
Affiliation(s)
- Krzysztof Balawender
- Institute of Medical Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland;
- Clinical Department of Urology and Urological Oncology, Municipal Hospital, Rycerska 4, 35-241 Rzeszow, Poland
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland; (E.Ł.); (J.W.)
| | - Artur Mazur
- Institute of Medical Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland;
| | - Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszow University, Al. mjr. W. Kopisto 2a, 35-959 Rzeszow, Poland; (E.Ł.); (J.W.)
| |
Collapse
|
2
|
Siener R, Stein J, Ritter M. [Prevention of recurrence of urolithiasis]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:387-395. [PMID: 38466398 DOI: 10.1007/s00120-024-02312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
Urolithiasis is one of the most frequent urological diseases. Identifying the causes of stone formation forms the basis for successful prevention of recurrence. Metabolic diagnostics and measures for prevention of recurrence are based on the assignment of the patient to a low-risk or high-risk group. Analysis of the urinary calculi is an essential prerequisite for identifying patients at risk. The general recommendations on diet and lifestyle are considered to be the basis of treatment. Depending on the type of stone and the individual biochemical risk profile of a patient, these general measures should be supplemented by targeted medical nutrition therapy and pharmacological treatment. Mixed stones can pose a challenge for the treatment and prevention of recurrence. A personalized treatment decision that takes the various components of mixed stones into account could further improve the prevention of recurrence of urolithiasis.
Collapse
Affiliation(s)
- Roswitha Siener
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Johannes Stein
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Manuel Ritter
- Universitäres Steinzentrum, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| |
Collapse
|
4
|
Ellinger S, Amini AM, Haardt J, Lehmann A, Schmidt A, Bischoff-Ferrari HA, Buyken AE, Kroke A, Kühn T, Louis S, Lorkowski S, Nimptsch K, Schulze MB, Schwingshackl L, Siener R, Stangl GI, Volkert D, Zittermann A, Watzl B, Egert S. Protein intake and body weight, fat mass and waist circumference: an umbrella review of systematic reviews for the evidence-based guideline on protein intake of the German Nutrition Society. Eur J Nutr 2024; 63:3-32. [PMID: 37794213 PMCID: PMC10799103 DOI: 10.1007/s00394-023-03220-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/18/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE This umbrella review aimed to assess whether dietary protein intake with regard to quantitative (higher vs. lower dietary protein intake) and qualitative considerations (total, plant-based or animal-based protein intake) affects body weight (BW), fat mass (FM) and waist circumference (WC). METHODS A systematic literature search was conducted in PubMed, Embase and Cochrane Database of Systematic Reviews for systematic reviews (SRs) with and without meta-analyses of prospective studies published between 04 October 2007 and 04 January 2022. Methodological quality and outcome-specific certainty of evidence of the retrieved SRs were assessed by using AMSTAR 2 and NutriGrade, respectively, in order to rate the overall certainty of evidence using predefined criteria. RESULTS Thirty-three SRs were included in this umbrella review; 29 were based on randomised controlled trials, a few included cohort studies. In studies without energy restriction, a high-protein diet did not modulate BW, FM and WC in adults in general (all "possible" evidence); for older adults, overall certainty of evidence was "insufficient" for all parameters. Under hypoenergetic diets, a high-protein diet mostly decreased BW and FM, but evidence was "insufficient" due to low methodological quality. Evidence regarding an influence of the protein type on BW, FM and WC was "insufficient". CONCLUSION "Possible" evidence exists that the amount of protein does not affect BW, FM and WC in adults under isoenergetic conditions. Its impact on the reduction in BW and FM under hypoenergetic conditions remains unclear; evidence for an influence of protein type on BW, FM and WC is "insufficient".
Collapse
Affiliation(s)
- Sabine Ellinger
- Institute of Nutritional and Food Science, Human Nutrition, University of Bonn, Meckenheimer Allee 166a, 53115, Bonn, Germany.
| | | | | | | | | | - Heike A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland
- City Hospital Zurich, Zurich, Switzerland
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Paderborn, Germany
| | - Anja Kroke
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Tilman Kühn
- The Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg, Germany
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Sandrine Louis
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Stefan Lorkowski
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
- Competence Cluster for Nutrition, Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine (MDC), Helmholtz Association, Berlin, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, Bonn, Germany
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Bernhard Watzl
- Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Sarah Egert
- Institute of Nutritional and Food Science, Nutritional Physiology, University of Bonn, Bonn, Germany
| |
Collapse
|
5
|
Barzilay JI, Farag YMK, Durthaler J. Albuminuria: An Underappreciated Risk Factor for Cardiovascular Disease. J Am Heart Assoc 2024; 13:e030131. [PMID: 38214258 PMCID: PMC10926810 DOI: 10.1161/jaha.123.030131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Albuminuria, an established biomarker of the progression of chronic kidney disease, is also recognized as a biomarker for the risk of cardiovascular disease. Elevated urinary albumin excretion indicates kidney damage and systemic vascular disease, including myocardial capillary disease and arterial stiffness. Albuminuria is associated with an increased risk of coronary artery disease, stroke, heart failure, arrhythmias, and microvascular disease. There are now several therapeutic agents that can lead to albuminuria lowering and a reduction in cardiovascular risk. However, screening for albuminuria is still low. Considering the importance of multidisciplinary management of patients with cardiovascular disease, it is crucial that health care professionals managing such patients are aware of the benefits of albuminuria surveillance and management.
Collapse
|