title: Impact of dietary counseling on urinary stone risk parameters in recurrent stone formers.
abstract: OBJECTIVE
  The aim of this study was to investigate the current impact of dietary counseling on the risk for urolithiasis.
  
  
  METHODS
  A retrospective cohort study of the patients treated in our stone clinics from July 2007 to February 2009 was carried out. Patients' urinary risk factors for stone disease were evaluated with pre- and postintervention 24-hour urine collections. All patients received dietary recommendations from a registered dietician at each visit.
  
  
  RESULTS
  One hundred thirty-seven subjects were identified and managed initially with only dietary interventions to address their urinary stone risk parameters. Average follow-up for this group was 15.19 ± 13.7 months. Subjects showed significant changes in urine volume (71.1%, 1.68 ± 0.68 to 2.59 ± 0.80 L/day, p < 0.0001), urine sodium (58.1%, 229.68 ± 72.51 to 144.65 ± 52.70 mmol/day, p < 0.0001), urine calcium (43.8%, 314.33 ± 95.75 to 216.81 ± 80.90 mg/day, p < 0.0001), urinary uric acid (50%, 0.821 ± 0.210 to 0.622 ± 0.128 g/day, p < 0.0001), urinary citrate (50.7%, 583.19 ± 330.86 to 797.36 ± 412.31, p < 0.0001), and urine oxalate (55.5%, 46.28 ± 10.31 to 32.56 ± 9.02 mg/day, p < 0.0001). The supersaturation for calcium oxalate also decreased significantly from baseline (9.34-5.03, p < 0.0001).
  
  
  CONCLUSIONS
  Urolithiasis is a multifactorial disease requiring a multidisciplinary approach. Our results support the use of dietary counseling by a registered dietician in the management of urolithiasis.
authors.affiliation: Glickman Urological and Kidney Institute, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Ortiz-Alvarado
authors.forename: Ricardo
authors.initials: R
authors.lastname: Miyaoka
authors.forename: Carly
authors.initials: C
authors.lastname: Kriedberg
authors.forename: Angela
authors.initials: A
authors.lastname: Moeding
authors.forename: Michelle
authors.initials: M
authors.lastname: Stessman
authors.forename: James K
authors.initials: JK
authors.lastname: Anderson
authors.forename: Manoj
authors.initials: M
authors.lastname: Monga
mesh_terms: D002118:Calcium / Q000652:urine; D019343:Citric Acid / Q000652:urine; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010070:Oxalates / Q000652:urine; D012008:Recurrence; D012307:Risk Factors; D012964:Sodium / Q000652:urine; D014527:Uric Acid / Q000652:urine; D014545:Urinary Calculi / Q000178:diet therapy* / Q000652:urine
chemical_list: D010070:Oxalates; D014527:Uric Acid; D019343:Citric Acid; D012964:Sodium; D002118:Calcium