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Is the "Pandemic Diet" Nonlithogenic?

Brian Shkolnik1, Kelley Zhao1, Jennifer Y Lu2

  • 1Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.

Journal of Endourology
|April 16, 2024
PubMed
Summary

The COVID-19 pandemic led to more home cooking, significantly reducing urinary sodium and calcium levels in patients with kidney stones. These improvements in stone risk factors persisted even after the lockdown, suggesting lasting benefits of dietary changes.

Keywords:
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Area of Science:

  • Nephrology
  • Urology
  • Public Health

Background:

  • The COVID-19 pandemic and associated lockdowns prompted significant lifestyle changes, including shifts in dietary habits.
  • A notable change was the reduction in restaurant dining and an increase in home-cooked meals, particularly in New York State.

Purpose of the Study:

  • To investigate the impact of COVID-19 pandemic-related lifestyle changes on the risk of kidney stone disease.
  • To analyze 24-hour urine studies of patients with a history of nephrolithiasis before, during, and after the pandemic.

Main Methods:

  • Retrospective analysis of 24-hour urine studies from 93 patients with a history of nephrolithiasis.
  • Urine samples were categorized as pre-COVID (before March 16, 2020), during-COVID (March 16–December 31, 2020), and post-COVID (January 1, 2021–October 31, 2022).
  • Paired t-tests were used to compare mean urinary sodium (uNa) and calcium (uCa) levels across the periods.

Main Results:

  • Significant reductions in mean urinary sodium (uNa) and urinary calcium (uCa) were observed during the COVID-19 period compared to pre-COVID levels (p=0.015 for uNa, p=0.010 for uCa).
  • These reductions in uNa and uCa persisted into the post-COVID period, remaining significantly lower than pre-COVID levels.
  • The observed benefits were primarily noted in patients younger than 65 years; no significant changes in urine volume, magnesium, or citrate were found.

Conclusions:

  • Home-cooked meals during the COVID-19 lockdown improved urinary parameters, reducing lithogenic risk factors like hypernatriuria and hypercalciuria.
  • The sustained improvement in urinary parameters post-lockdown suggests that dietary changes adopted during the pandemic may lead to long-term benefits in managing kidney stone risk.