title: Influence of clinical therapy and nutritional counseling on the recurrence of urolithiasis.
abstract: OBJECTIVE
  To evaluate the influence of combined clinical therapy and nutritional guidance on the recurrence of urolithiasis.
  
  
  METHODS
  From our registry of patients with recurrent urolithiasis we selected 57 who had at least 5-years of follow-up. We collected 24h urine samples in order to analyze Ca, Na, uric acid, citrate, oxalate, and Mg concentrations and to assess urine volume. Patients filled out a clinical questionnaire before treatment, and abdominal radiographs and/or ultrasound were performed both before treatment and during the follow-up period. During follow-up, specific and individualized dietary advice was given based on the individual's metabolic disorders. Patients also received specific pharmacological treatment for their metabolic alterations. Outcome measures were metabolites in urine and the urolith recurrence rate. Pre- and post- intervention values were compared using tests as appropriate.
  
  
  RESULTS
  Fifty six of the patients were male and the majority of patients were overweight. The mean BMI was 27 kg/m(2). Urinary excretion of calcium, uric acid and sodium decreased significantly over the five year follow-up period. The number of uroliths that formed during the 5-year follow-up also decreased significantly compared to pre-treatment values.
  
  
  CONCLUSIONS
  Individualized dietary advice combined with pharmacological treatment significantly reduces long-term urolithiasis recurrence.
authors.affiliation: Medical School of Botucatu, Sao Paulo State University, Botucatu, SP, Brazil.
authors.forename: Patrícia Capuzzo
authors.initials: PC
authors.lastname: Damasio
authors.affiliation: Medical School of Botucatu, UNESP, Botucatu, SP, Brazil.
authors.forename: Carmen Regina
authors.initials: CR
authors.lastname: Amaro
authors.affiliation: Department of Biostatistics, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil.
authors.forename: Carlos Roberto
authors.initials: CR
authors.lastname: Padovani
authors.affiliation: Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil.
authors.forename: Victor Augusto
authors.initials: VA
authors.lastname: Leitão
authors.affiliation: Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil.
authors.forename: Hamilto
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Medical School of Botucatu, UNESP, Botucatu, SP, Brazil.
authors.forename: João Luiz
authors.initials: JL
authors.lastname: Amaro
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002118:Calcium / Q000652:urine; D003131:Combined Modality Therapy; D003376:Counseling; D004032:Diet; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012008:Recurrence; D012964:Sodium / Q000652:urine; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000652:urine; D052878:Urolithiasis / Q000178:diet therapy* / Q000188:drug therapy* / Q000652:urine; D055815:Young Adult
chemical_list: D014527:Uric Acid; D012964:Sodium; D002118:Calcium