上部尿路結石症の再発予防のための食事指導の意義－特に食事指導の限界について－

Abstract

一般的に薬物治療の対象とされる過カルシウム尿症や過尿酸尿症のある患者の多くに, 食事指導によって再発率の有意な減少がみられ, その効果は患者が通院を中止した後も持続することから, 食事指導は再発予防のためにまず行われるべき方策であり, 予防医学の観点からも広く世間に啓蒙する必要がある

By following individual dietary guidelines which were established from analysis of the dietary intake and habits of male renal stone patients, the stone recurrence rate in 75 male calcium stone patients who had only received individual dietary instruction decreased markedly, as compared with that in 114 male calcium stone patients who had not received such instructions. Among 75 patients, recurrence was noted in 6 normocalciuric recurrent stone patients and 1 normocalciuric single stone patient during the period of outpatient visits. Investigation of the daily consumption of various nutrients and urinary excretion revealed no differences among the 6 normocalciuric recurrent stone patients, hypercalciuric recurrent stone patients, hypercalciuric single stone patients and normocalciuric single stone patients. Our findings suggest that the high recurrence rate in the normocalciuric recurrent stone patients is associated with stone lithogenic factors, such as heredity and anatomy, that could not be controlled by the daily treatment in this group.