Abstract
The nutrient intake of 69 stone formers (SFs) from three subsets of the local population (urban 22, rural tribal 22 and rural nontribal 25) and 69 age, sex, weight and socioeconomically matched control subjects (NSs) (urban 20, rural tribal 22 and rural nontribal 27) was studied. Simultaneously their timed 24-h urine samples collected over a similar period were analyzed. In general caloric and protein intake was low in all the groups but was strikingly low in the rural subjects. Intake of all nutrients was lowest in the tribal group. Although no difference was observed in diet between NSs and SFs in the same population subjects, SFs had higher urinary excretion of oxalic acid and calcium and lower excretion of citric acid and excreted more saturated urine. Notably magnesium intake was normal in both NSs and SFs, but mean excretion of magnesium was lower than normal in all the groups, suggesting its defective absorption. The influence of dietary intake of protein, carbohydrate, fat, fiber, calcium and oxalic acid on urinary excretion of calcium, oxalic acid, uric acid, inorganic phosphorus, magnesium and citric acid was examined using the chi-square test. No association was observed, thus suggesting that this low nutrient intake did not influence the lithogenic process. Thus, the overall observations suggest: (a) poor nutrition, (b) no effect of diet on urinary stone disease, (c) no difference in the nutrient intake between NSs and SFs and (d) a higher excretion of promoters and a lower excretion of inhibitors in SFs than in NSs.
Similar content being viewed by others
References
Ahlstrand C, Larsson L, Tiselius H (1984) Variation in urine composition during the day in patients with calcium oxalate stone disease. J Urol 131:77
Anderson DA (1973) Environmental factors in the aetiology of urolithiasis. In: Cifuentes, Delatte L, Rapado A, Hodgkinson A (eds) Urinary calculi. Karger, Basel, p 130
Blacklock NJ (1976) Dietary content of refined carbohydrate: an explanation for the ‘stone wave’ and apparent immunity to renal stone. In: Fleisch H, Robertson WG, Smith LH, Vahlensieck W (eds) Urolithiasis research. Plenum Press, New York, p 413
Breslau NA, Brinkley L, Hill KD, Pak CYC (1988) Relationship of animal protein-rich diet to kidney stone formation and calcium metabolism. J Clin Endocr Metab 66:140
Brockis JG, Levitt AJ, Cruthers SM (1982) The effect of vegetable and animal protein diets on calcium, urate and oxalate excretion. Br J Urol 54:590
Caraway WT (1955) Determination of uric acid in serum by carbonate method. Am J Clin Nutr 25:840
Chaudhary M, Rajvanshi K, Pendse AK, Singh PP (1987) Food habits, socio-economic status and clinical profile of stone formers in Udaipur region. In: Singh PP, Pendse AK (eds) Multidimensional approach to urolithiasis. Himanshu Publications, Udaipur, p 111
Fellstrom B, Danielson BG, Karlstrom B, Lithell H, Ljunghall S, Vessby B (1985) Dietary history and dietary records in renal stone patients and controls In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York, p 73
Fellstrom B, Danielson BG, Karlstrom B (1989) Effects of high intake of dietary animal protein on mineral metabolism and urinary supersaturation of calcium oxalate in renal stone formers. Br J Urol 56:263
Ghosh R (1991) Effect of some indigenous drugs on course of bladder stone disease. PhD Thesis, Sukhadia University, Udaipur
Gindler EM, King JD (1972) Rapid colorimetric determination of calcium in biological fluids with methylthymol blue. Am J Clin Path 58:376
Gopalan C (1991) The changing profile of undernutrition in India. NFI Bulletin. Bull Nutrit Found India 12:1
Gopalan C, Rama Sastri BV, Balasubramanian SC (1984) Nutritive value of Indian foods. National Institute of Nutrition, Indian Council of Medical Research, Hyderabad
Griffith HM, O'Shea B, Keogh B (1986) A case control study of dietary intake of renal stone patients. I. Preliminary analysis, Urol Res 14:67
Hodgkinson A (1977) Oxalic acid in biology and medicine. Academic Press, London
Hodgkinson A, Williams A (1972) An improved colorimetric procedure for urine oxalate. Clin Chim Acta 36:127
Iguchi M, Umekawa Y, Ishikawa Y, Kodama M, Takada M, Kotoh Y, Kohri K, Kurila T (1990) Dietary intake and habits of Japanese renal stone patients. J Urol 143:1093
Joshi S, Mane S, Agte V (1991) Analysis of insoluble fiber components in common Indian foods and habitual diets. Indian J Clin Biochem 6:97
Kabra SG, Gaur SK, Sharma SS, Patni MK, Banerji R (1972) Urolithiasis: incidence of urinary calculi in south eastern Rajasthan. Indian J Surg 34:261
Laminski NA, Meyers AM, Kruger M, Sonnekus MI, Margolius LF (1991) Hyperoxaluria in patients with recurrent calcium oxalate calculi. Dietary and other risk factors. Br J Urol 68:454
Ljunghall S (1985) Incidence of renal stones in western countries. In: Schwill PO, Smith LH, Rebertson WG, Vehlensieck W (eds) Urolithiasis and clinical research. Plenum Press, New York, p 31
Lonsdale K (1968) Human stones. Science 159:199
Marangella M, Bianco O, Marteni M, Petrarule C, Vitale C, Linari F (1989) Effect of animal and vegetable protein intake on oxalate excretion in idiopathic calcium stone disease. Br J Urol 63:348
Meyer JL (1990) Physicochemistry of stone formation. In: Resnick MT, Pak CYC (eds) Urolithiasis — a medical and surgical reference. WB Saunders, Philadelphia, p 11
Natelson S (1971) Techniques of clinical chemistry. Charles C Thomas, Springfield, Illinois, USA, pp 286, 576, 371
Pak CYC (1978) Calcium urolithiasis, pathogenesis diagnosis and management. Plenum Medical, New York, p 37
Pendse AK, Singh PP (1986) The etiology of urolithiasis in Udaipur (western part of India). Urol Res 14:59
Pendse AK, Singh PP, Rathore V (1978) Urinary calculous disease in Jodhpur (North-Western India). In: Singh PP, Pendse AK (eds) Multidimensional approach to urolithiasis. Himanshu Publications, Udaipur, p 367
Pendse AK, Srivastava AK, Kumawat JL, Goyal A, Ghosh R, Sharma HS, Singh PP (1984) Urolithiasis in Udaipur (Rajasthan) J Indian Med Assoc 82:151
Raghuramulu N, Madhavan K, Kalyansundaram S (1983) A manual of laboratory technique (1983) National Institute, Hyderabad, Indian Council of Medical Research, p 31
Rajagopal G (1984) A simple colorimetric procedure for estimation of citric acid in urine. Indian J Exp Biol 22:391
Robertson WG (1985) Dietary factors important in calcium stone formation. In: Schwille PO, Smith LH, Robertson WG, Vahlensieck W (eds) Urolithiasis and related clinical research. Plenum Press, New York, p 61
Robertson WG, Peacock M, Heyburn PJ, Hanes FA, Rutherford A, Clementson E, Swaminathan R, Clark PB (1979) Should recurrent calcium oxalate stone formers become vegetarians? Br J Urol 51:427
Robertson WG, Peacock M, Hodgkinson A (1979) Dietary changes and the incidence of urinary calculi in the UK between 1958 and 1976. J Chron Disease 32:469
Singh PP, Kothari LK, Sharma DC, Saxena SN (1972) Nutritional value of Indian foods in relation to their oxalic acid content. Am J Clin Nutr 25:1147
Singh PP, Singh LBK, Prasad SN, Singh MG (1978) Urolithiasis in Manipur (north-east region of India): incidence and chemical composition of stones. Am J Clin Nutr 31:1519
Singh PP, Pendse AK, Jain AK (1985) Urolithiasis in southern Rajasthan. Contribution of dietary oxalate to urinary oxalate. In: Schwille PO, Smith LH, Robertson WG, Vahlensteck W (eds) Urolithiasis and related clinical research, Plenum Press, New York, p 77
Singh PP, Rathore V, Singh LBK (1986) A possible role of fish preparation, “Hentak” in urolithiasis in Manipur — an experimental study. Indian J Expt Biol 24:88
Singh PP, Pendse AK, Rathore V, Vishnoi A, Sharma M (1987) Hyperoxaluria and urolithiasis. In: Singh PP, Pendse AK (eds) Multidimensional approach to urolithiasis. Himanshu Publications, Udaipur, p 279
Singh PP, Pendse AK, Rathore V, Dashora PK (1988) Urinary biochemical profile of patients with ureteric calculi in Jodhpur region (north western India). Urol Res 16:105
Singh PP, Pendse AK, Mathur HN, Rajkiran (1990) A clinicoepidemiological study of urinary tract stone disease in the Udaipur region of Rajasthan. Project Report, Indian Council of Medical Research, New Delhi
Smith LH (1989) The medical aspects of urolithiasis. A overview. J Urol 141:707
Snedecor GW, Cochran WG (1967) Statistical methods, 6th edn. IBH Publishing Co., Oxford, p 228
Sur BK, Pandey HN, Kumar P (1987) An improved method for assay of urinary inhibitor of calcium oxalate crystallization. In: Singh PP, Pendse AK (eds) Multidimensional approach to urolithiasis Himanshu Publications, Udaipur, p 265
Trichieri A, Mandressi A, Luongo P, Longo G, Pisoni E (1991) The influence of diet on urinary risk factors for stones in healthy subjects and idiopathic renal calcium stone formation. Br J Urol 67:230
Van Reen R (1976) Idiopathic bladder stone disease. Urol Res 4:569
Wainer L, Resnick VA, Resnick MI (1987) Nutritional aspects of stone disease. In: Pak CYC (ed) Renal stone disease. Martinus Nighoff Publishing, Boston, p 85
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rajkiran, Pendse, A.K., Ghosh, R. et al. Nutrition and urinary calcium stone formation in northwestern India: a case control study. Urol. Res. 24, 141–147 (1996). https://doi.org/10.1007/BF00304077
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00304077