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. 2020 May-Jun;96(3):333-340.
doi: 10.1016/j.jped.2018.11.008. Epub 2019 Feb 5.

Association between dietary pattern and metabolic disorders in children and adolescents with urolithiasis

Mariana S Vieira  1 , Priscila de C Francisco  2 , Ana Luiza L C Hallal  3 , Maria Goretti M G Penido  4 , Nilzete L Bresolin  5
Affiliations

Association between dietary pattern and metabolic disorders in children and adolescents with urolithiasis

Mariana S Vieira et al. J Pediatr (Rio J). 2020 May-Jun.

Abstract
in English, Portuguese

Objective: To describe the dietary patterns and occurrence of metabolic disorders in children and adolescents with urolithiasis treatment at a referral hospital in southern Brazil in order to learn the features of urolithiasis in this population to better develop preventive actions.

Methods: Descriptive study conducted between 2016 and 2017 in a tertiary care referral hospital. Fourty patients aged 2-19 years old with urolithiasis proven by imaging were included. Clinical and dietary data were obtained through interviews and medical records. For statistical analyses, the chi-squared test was performed.

Results: 40 individuals were analyzed. Mean age at diagnosis was 7.2±4 years. 25% were overweight or obese. 95% had metabolic disorders, hypocitraturia being the predominant type. Protein intake was adequate in all participants and carbohydrate intake, in 70% of them; 37.5% had lipid intake above recommended and 65% had low fiber intake. The mean daily sodium intake was 2.64g (±1.74), with 55% of participants ingesting more than the recommended amount. A total of 52.5% had low potassium intake, with a mean of 4.79g/day (±2.49). Calcium intake was adequate in 27.5%. No significant differences were identified in relation to mean daily consumption among participants with or without the various metabolic disorders.

Conclusion: Pediatric urolithiasis is often accompanied by metabolic disorders; therefore, metabolic evaluation should be part of the diagnostic process and subsequent analysis of these patients' dietary patterns, helping to optimize treatment and prevent recurrences and complications.

Objetivo: Descrever o padrão alimentar e ocorrência de distúrbios metabólicos em crianças e adolescentes portadoras de urolitíase acompanhadas em hospital de referências no sul do Brasil a fim de conhecer as particularidades da urolitíase nessa população para melhor desenvolver ações de prevenção.

Métodos: Estudo observacional descritivo realizado entre 2016 e 2017 em centro de referência em atenção terciária. Foram selecionados 40 pacientes de 2 a 19 anos com urolitíase comprovada por exame de imagem. Dados clínicos e alimentares foram obtidos através de prontuário e entrevista. Para análise estatística, utilizou-se o teste qui-quadrado.

Resultados: Foram analisados 40 indivíduos, 55% masculinos. Idade média ao diagnóstico 7,2±4 anos. 25% tinham sobrepeso ou obesidade. 95% tinham distúrbios metabólicos, predominando a hipocitratúria. O consumo proteico e de carboidratos foi adequado em 100% e 70% dos participantes, respectivamente. 37,5% apresentaram ingestão de lipídeos acima do recomendado e 65% apresentaram ingestão de fibras alimentares abaixo do recomendado. O consumo diário médio de sódio foi de 2,64 g (±1,74), com 55% acima do recomendado. 52,5% apresentaram baixa ingestão de potássio com média de 4,79 g/dia (±2,49). O consumo de cálcio foi adequado em 27,5%. Não foram identificadas diferenças significativas em relação ao consumo médio diário dos nutrientes entre os participantes com ou sem os diversos distúrbios metabólicos.

Conclusões: A urolitíase pediátrica é frequentemente acompanhada de distúrbios metabólicos, o que confirma a necessidade de avaliação metabólica adequada ao diagnóstico e análise do padrão alimentar a fim de identificar erros alimentares e otimizar o tratamento destes distúrbios, prevenindo recorrências e complicações.

Keywords: Cálculo renal; Diet; Dieta; Hipercalciúria; Hypercalciuria; Kidney calculi; Pediatrics; Pediátrica; Urolithiasis; Urolitíase.

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Figures

Figure 1
Figure 1
Dietary adjustment of macro- and micronutrients for children and adolescents with urolithiasis with or without the three most frequent metabolic disorders in the population studied: hypocitraturia (A and B), hypercalciuria (C and D), and hypernatriuria (E and F).
See this image and copyright information in PMC

Comment in

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