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Which Diet for Calcium Stone Patients: A Real-World Approach to Preventive Care

机译:哪种钙饮食患者饮食:现实世界中的预防保健方法

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Kidney stone disease should be viewed as a systemic disorder, associated with or predictive of hypertension, insulin resistance, chronic kidney disease and cardiovascular damage. Dietary and lifestyle changes represent an important strategy for the prevention of kidney stone recurrences and cardiovascular damage. A full screening of risk factors for kidney stones and for cardiovascular damage should be recommended in all cases of calcium kidney stone disease, yet it is rarely performed outside of stone specialist clinics. Many patients have a history of kidney stone disease while lacking a satisfactory metabolic profile. Nonetheless, in a real-world clinical practice a rational management of kidney stone patients is still possible. Different scenarios, with different types of dietary approaches based on diagnosis accuracy level can be envisaged. The aim of this review is to give patient-tailored dietary suggestions whatever the level of clinical and biochemistry evaluation. This can help to deliver a useful recommendation, while avoiding excessive dietary restrictions especially when they are not based on a specific diagnosis, and therefore potentially useless or even harmful. We focused our attention on calcium stones and the different scenarios we may find in the daily clinical practice, including the case of patients who reported renal colic episodes and/or passed stones with no information on stone composition, urinary risk factors or metabolic cardiovascular risk factors; or the case of patients with partial and incomplete information; or the case of patients with full information on stone composition, urinary risk factors and metabolic cardiovascular profile.
机译:肾结石疾病应被视为系统性疾病,与高血压,胰岛素抵抗,慢性肾脏疾病和心血管损害相关或可预见。饮食和生活方式的改变代表了预防肾结石复发和心血管损害的重要策略。在所有钙-肾结石疾病病例中,均应建议全面筛查肾结石和心血管损害的危险因素,但很少在结石专科诊所以外进行。许多患者都有肾结石病史,但缺乏令人满意的新陈代谢。尽管如此,在现实世界的临床实践中,仍然有可能对肾结石患者进行合理的管理。可以设想基于诊断准确度水平的具有不同类型饮食方法的不同情况。这篇综述的目的是为患者量身定制饮食建议,无论其临床和生化评估水平如何。这有助于提供有用的建议,同时避免过多的饮食限制,尤其是当这些饮食限制不是基于特定的诊断,因此可能无用甚至有害时。我们将注意力集中在钙结石和我们在日常临床实践中可能发现的不同情况,包括那些报告肾绞痛发作和/或通过结石的患者,但没有结石成分,泌尿危险因素或代谢性心血管危险因素的信息;或患者的信息不完整或不完整的情况;或患者具有有关结石成分,泌尿危险因素和代谢性心血管状况的完整信息的情况。

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