Descriptive analysis of clinical and nutritional status of patients with Nephrolithiasis.

摘要

Introduction: Nephrolithiasis is a high incidence and high recurrence condition and, if untreated, it progresses with high rate of complications. To motivate this population to adhere to dietary treatment is a major challenge for health professionals. Objective: To describe the nutritional and feeding status in these patients, their' degree of motivation to change eating habits through the transtheoretical model of feeding behavior (TMFB) in patients with Nephrolithiasis diagnostic image. Methods: 30 adult patients in regular follow-up in the RenalClass outpatient clinic were followed. Data evaluated were gender age, time since diagnosis, anthropometry (weight, height, waist circumference) and dietary survey (Food Frequency Questionnaire - FFQ adapted to highlight food sources of oxalate, calcium, sodium and purines). Results: Mean age was 46.6 ± 13 years, predominantly female (51.7%). Most patients had less than 5 years lithiasis history. About 41.4% of the patients underwent metabolic investigation. Main disorders detected were hypercalciuria, hypocitraturia, hyperoxaluria and hyperu-ricosuria. Most patients showed overweight (25.9%) and obesity (41.8%). 81.8% had very high risk of developing cardiovascular diseases. Of these, 61.1% were female. According to the FFQ, about three times a week, 35% of patients ingested foods with excessive oxalate content (> 99 mg oxalate per serving) while 59.4% of the patients consumed foods with high oxalate content (26 to 99 mg). Regarding purines, on a weekly basis, 20% of patients consumed food with excessive amount of purines (150-1000 mg of purines in 100 g of food) while 75.8% of patients ingested foods with high amount of purines (75-150 mg of purines per 100 g of food). Daily consumption of high sodium content foods proved to be elevated in 70% of patients. 96.7% of patients consumed food which were calcium sources, while fluid intake was inadequate (<2.5 L/day) in 93.3% of them. With regard to the questionnaire TMFB, 50% of the subjects were in the maintenance phase, followed by 20% in action phase, 16.7% in relapse and 6.7% in decision. In pre-contemplation and contemplation, there was 3.3% each. Conclusion: Most patients were overweight or obese. In spite of calcium intake proved to be appropriate, there were factors that contribute to kidney stone forrnation such as alarming frequency of foods with high levels of oxalate, purine and sodium in the diet, associated with an inadequate fluid intake. However some of the patients had been motivated to assume a positive feeding behavior, since the majority were in phase and maintenance of action.