Electronic nutritional intake assessment in patients with urolithiasis: A decision impact analysis

Abstract

PurposeTo evaluate a physician's impression of a urinary stone patient's dietary intake and whether it was dependent on the medium through which the nutritional data were obtained. Furthermore, we sought to determine if using an electronic food frequency questionnaire (FFQ) impacted dietary recommendations for these patients.Materials and MethodsSeventy-six patients attended the Stone Clinic over a period of 6 weeks. Seventy-five gave consent for enrollment in our study. Patients completed an office-based interview with a fellowship-trained endourologist, and a FFQ administered on an iPad. The FFQ assessed intake of various dietary components related to stone development, such as oxalate and calcium. The urologists were blinded to the identity of patients' FFQ results. Based on the office-based interview and the FFQ results, the urologists provided separate assessments of the impact of nutrition and hydration on the patient's stone disease (nutrition impact score and hydration impact score, respectively) and treatment recommendations. Multivariate logistic regressions were used to compare pre-FFQ data to post-FFQ data.ResultsHigher FFQ scores for sodium (odds ratio [OR], 1.02; p=0.02) and fluids (OR, 1.03, p=0.04) were associated with a higher nutritional impact score. None of the FFQ parameters impacted hydration impact score. A higher FFQ score for oxalate (OR, 1.07; p=0.02) was associated with the addition of at least one treatment recommendation.ConclusionsInformation derived from a FFQ can yield a significant impact on a physician's assessment of stone risks and decision for management of stone disease.

Knowledge, Awareness and Practice on Dietary Management Among Patients with Urolithiasis: A Scoping Review

“…Men are more prone to experienced urolithiasis in comparison to women as commonly reported in several studies [6][7][8]15,18]. The results from previous studies showed that the prevalence of urinary stone was higher in male than in female by the ratio of 2:1 [7,8].…”

“…Eating habit was the main factors contributing towards the formation of stones in the urinary tract. Various studies have shown a link between high animal protein diets and increased incidence of kidney disease [7,15,18]. Thus, it was recommended to adopt an animal-free vegetarian diet which lower the risk of urolithiasis [7,15,18].…”

“…Various studies have shown a link between high animal protein diets and increased incidence of kidney disease [7,15,18]. Thus, it was recommended to adopt an animal-free vegetarian diet which lower the risk of urolithiasis [7,15,18]. Moreover, food with high sodium content increased urinary calcium and phosphate that facilitated the formation of uric acid crystals and reduced urinary citrate which caused stone formation [7,15,18].…”

“…For calcium stone prevention, oral calcium restriction has traditionally been the main dietary recommendation similarly addressed to limit the oxalate diet for those at risk for oxalate stone formation [7,15,18]. On the other hand, purine banned was recommended to reduce the risk of stones for patients with uric acidstones [7,18].…”

“…Increasing the knowledge on urolithiasis will enable patient to identify of sign and symptoms as well as risk factors of urolithiasis [8,[10][11][12][13]]. An improvement in knowledge will affect changes in the dietary and lifestyle practice in prevention of incidence or recurrent episode [9,[14][15][16][17][18][19][20][21]. Further explanation and health education are very important to ensure that the patients practice the dietary recommendation correctly.…”