ORIGINAL RESEARCH Adequate Dietary Intake and Nutritional Status in Patients With Nephrolithiasis: New Targets and Objectives Larissa Marques Tondin de Oliveira, ESP,* Daniela Barbieri Hauschild, ESP,* Christiane de Mesquita Barros Almeida Leite, MS,* Deise Regina Baptista, MS,* and Mauricio Carvalho, MD, PhD, FACP † Objectives: Modifiable risk factors for kidney stones, such as diet and nutritional status, are targets in the treatment and prevention of nephrolithiasis. The aim of the present study was to assess the nutritional state and energy and nutrient adequacy of patients with neph- rolithiasis via anthropometric evaluation, dietary inquiry, and urine biochemistry. Design: The present observational cross-sectional study. Setting: An outpatient, nephrolithiasis clinic of a tertiary care, university hospital. Subjects: A total of 31 patients with nephrolithiasis and 25 controls were assessed. Interventions: All patients were subjected to nutritional evaluation, including dietary inquiry and chemical tests of blood and 24-hour urine samples. Main Outcome Measure: Nutritional state and nutrient ingestion adequacy. Results: The group of patients with nephrolithiasis exhibited high body mass index, abdominal circumference, and body fat percent- age values. The protein, sodium, calcium, potassium, and oxalate intakes differed significantly from the recommended values in both the nephrolithiasis and control groups. The nephrolithiasis and control groups differed only in terms of oxalate intake (159 6 119.27 vs. 112 6 47.9, respectively, P 5 .042). Regarding urine biochemistry, 30% of the patients with nephrolithiasis exhibited hypercalciuria, versus 12% of the control group. Conclusions: The prevalence of individuals with overweight/obesity was high in both the nephrolithiasis and control groups. This finding indicates that in addition to orientation regarding nonlithogenic dietary habits, continuous education by a multidisciplinary staff must also address the prevention and treatment of obesity. Ó 2014 by the National Kidney Foundation, Inc. All rights reserved. Introduction N EPHROLITHIASIS IS A frequent cause of morbidity, with a prevalence of 2% to 20% among the general population. 1 According to estimates, approxi- mately 10% of men and 5% of women will exhibit kidney stones at some point in life. Around 80% of kidney stones contain calcium, and most are composed of calcium oxalate. Risk factors liable to modification, such as diet and nutritional status, might represent targets for the pre- vention and treatment of nephrolithiasis. 2 The risk of nephrolithiasis is believed to rise in parallel to increases in body mass index (BMI) and waist circumfer- ence (WC). 3 The frequency of kidney stones among women has increased in recent decades, possibly because of novel dietary habits, thus reducing the 3:1 prevalence ratio of men to women. 4 Obesity is associated with meta- bolic disorders that might favor kidney stone formation, like diabetes mellitus, for example. In addition, excess weight might increase the urinary excretion of uric acid and oxalate, which are the risk factors for calcium oxalate stones. 2 Appropriate fluid and potassium intake is associated with a reduced risk of nephrolithiasis, whereas diets rich in so- dium, animal protein, and sugars might increase that risk. 5 A low intake of dietary calcium favors kidney stone formation, whereas appropriate dairy-rich diets reduce the incidence of nephrolithiasis. 6 Nutritional therapy plays a crucial role in the prevention and/or reduction of lithogenesis. 7 The aim of the present study was to assess the nutritional status and the energy * Department of Clinical Nutrition, Hospital de Cl  ınicas, Universidade Federal do Paran  a (UFPR), Curitiba, PR, Brazil. † Department of Internal Medicine, Hospital de Cl  ınicas, UFPR, Curitiba, PR, Brazil; and Nephrology Section, Pontif  ıcia Universidade Cat  olica do Paran a, Curitiba, PR, Brazil. Financial Disclosure: The authors declare that they have no relevant financial interests. Address correspondence to Larissa Marques Tondin de Oliveira, ESP, Depar- tamento de Cl  ınica M edica – 10  andar, Hospital de Cl  ınicas da UFPR, Rua General Carneiro, 181 – CEP – 80060-900, Curitiba, PR, Brazil. E-mail: larissatondin@hotmail.com Ó 2014 by the National Kidney Foundation, Inc. All rights reserved. 1051-2276/$36.00 http://dx.doi.org/10.1053/j.jrn.2014.06.003 Journal of Renal Nutrition, Vol 24, No 6 (November), 2014: pp 417-422 417