Abstract
Our purpose was to study the relationship of adherence to the Mediterranean diet (MedDiet) with urinary factors that favor the formation of renal calcium and uric acid stones in overweight and obese participants who had metabolic syndrome. This cross-sectional study examined 267 participants. A well-known MedDiet score (range 0–9) was calculated for each patient, and patients were then categorized has having low (≤3), medium (4–5), or high (≥6) adherence to the MedDiet. Baseline characteristics and urinary parameters were also analyzed. High calcium salt urinary crystallization risk (CaUCR) and high uric acid urinary crystallization risk (UrUCR) were calculated from urinary parameters using pre-defined criteria. More than half of patients with MedDiet scores ≤3 had high UrUCR (55.4%) and high CaUCR (53.8%). In contrast, fewer patients with high adherence (≥6) to the MedDiet had high UrUCR (41.2%) and high CaUCR (29.4%). Relative to those with low adherence, individuals with high adherence had a prevalence ratio (PR) of 0.77 for a high UrUCR (95% CI: 0.46–1.12; p for trend: 0.069) and a PR of 0.51 for a high CaUCR (95% CI: 0.26–0.87; p for trend: 0.012) after adjusting for age, sex, body mass index, type 2 diabetes, and total energy intake. Our findings indicate that greater adherence to the MedDiet was associated with a reduced CaUCR and a reduced UrUCR. This suggests that adequate dietary management using the MedDiet patterns may prevent or reduce the incidence and recurrence of calcium salt and uric acid renal stones.
Highlights
70–80% of renal calculi are composed of calcium oxalate or calcium phosphate, about 10–15% are uric acid, 5–10% are struvite, and
Individuals with low adherence were younger and had a higher concentration of urinary uric acid, but the other measured parameters were similar among the three groups
The major result of our study of participants who were overweight/obese and had the metabolic syndrome is that high adherence to the Mediterranean diet (MedDiet) was associated with lower prevalence of high calcium salt urinary crystallization risk (CaUCR) and high uric acid urinary crystallization risk (UrUCR)
Summary
Urine composition is a key factor affecting urine crystal formation, because urine is a metastable liquid containing multiple solutes that can potentially. A disruption in the balance between urinary promoters and inhibitors of crystallization within the urinary tract, and certain renal macro- and micro-anatomical features can affect crystallization. The structure and composition of renal calculi vary greatly. They may consist of pure uric acid, pure hydroxyapatite, calcium oxalate with different compositions, and various mixtures of these different compounds. 70–80% of renal calculi are composed of calcium oxalate or calcium phosphate, about 10–15% are uric acid, 5–10% are struvite, and
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