Renal stones and renal cell carcinoma (RCC) are significant urological conditions with increasing global prevalence, contributing to considerable morbidity and healthcare burden. Renal stones, also known as nephrolithiasis, affect approximately 10-15% of the global population, with recurrence rates as high as 50% within five years (1). Similarly, RCC accounts for nearly 3% of all malignancies, with an increasing incidence due to advancements in imaging techniques and early detection (2). Both conditions are multifactorial, influenced by genetic predisposition, environmental factors, and dietary habits. with high intake of oxalate-rich foods, excessive sodium consumption, and inadequate hydration being key risk factors (3). Studies have shown that diets high in animal protein and processed foods increase urinary calcium and oxalate excretion, promoting stone formation (4). Conversely, diets rich in citrate, such as those containing citrus fruits, have been found to reduce stone formation by inhibiting calcium crystallization (5). Similarly, RCC risk is linked to dietary factors, with an increased incidence observed in individuals consuming high amounts of red and processed meats, saturated fats, and low-fiber diets (6). On the other hand, diets rich in fruits, vegetables, and antioxidants have been associated with a lower risk of RCC due to their protective effects against oxidative stress and inflammation (7).

Genetic susceptibility also plays a crucial role in the pathogenesis of renal stones and RCC. Mutations in genes involved in calcium metabolism, oxalate transport, and oxidative stress regulation have been linked to increased stone formation (8). Similarly, hereditary syndromes such as von Hippel-Lindau disease and mutations in the VHL gene have been identified as significant contributors to RCC development (9). A family history of kidney disease further increases the risk, emphasizing the interplay between genetic and environmental factors (10).

Despite existing knowledge, the combined impact of dietary patterns and genetic predisposition on renal stone formation and RCC development remains inadequately explored. This prospective study aims to assess the role of dietary habits and genetic susceptibility in the development of renal stones and RCC, providing insights for early identification and preventive strategies.

Study Design and Setting

This prospective study was conducted at MMIMSR, Mullana, Ambala, over a period of one year. The study aimed to evaluate the relationship between dietary habits and genetic predisposition in the development of renal stones and renal cell carcinoma (RCC).

Sample Size and Participant Selection

A total of 100 participants were included in the study, divided into two groups: patients diagnosed with renal stones (n = 50) and those diagnosed with RCC (n = 50). Participants were recruited from the urology and oncology departments of the hospital. Inclusion criteria consisted of adult patients (aged 18–65 years) with a confirmed diagnosis of renal stones or RCC based on clinical, radiological, or histopathological findings. Patients with a history of metabolic disorders, chronic kidney disease, or other malignancies were excluded.

Dietary Assessment

Dietary intake was assessed using a validated food frequency questionnaire (FFQ), which recorded participants' consumption of various food groups over the past six months. Special attention was given to the intake of oxalate-rich foods, processed meats, high-fat diets, and antioxidant-rich fruits and vegetables. The data were analyzed to determine dietary patterns associated with an increased risk of renal stones and RCC.

Genetic and Biochemical Analysis

A detailed family history was collected to assess genetic predisposition. Additionally, blood samples were obtained from all participants to analyze specific genetic markers associated with calcium metabolism, oxalate transport, and oxidative stress. Biochemical parameters, including serum calcium, oxalate, uric acid, and creatinine levels, were measured using standard laboratory techniques.

Data Collection and Statistical Analysis

All relevant demographic, clinical, and dietary data were recorded. Statistical analysis was performed using SPSS software (version XX). Continuous variables were analyzed using the Student’s t-test, while categorical variables were compared using the chi-square test. Correlation analysis was conducted to assess the association between dietary factors, genetic predisposition, and disease occurrence. A p-value of <0.05 was considered statistically significant.

Demographic Characteristics

The study included 100 participants, with 50 diagnosed with renal stones and 50 with renal cell carcinoma (RCC). The mean age of renal stone patients was 45.3 ± 10.2 years, while RCC patients had a slightly higher mean age of 50.6 ± 9.5 years. Males were predominant in both groups, accounting for 60% in the renal stone group and 70% in the RCC group. The mean BMI was also higher in the RCC group (29.1 ± 2.8) compared to the renal stone group (27.5 ± 3.2) (Table 1).

Dietary Intake and Nutritional Analysis

Dietary habits were significantly different between the two groups. Among renal stone patients, 60% reported a high intake of oxalate-rich foods, whereas only 25% of RCC patients exhibited similar dietary patterns. Processed meat consumption was significantly higher in RCC patients (55%) compared to renal stone patients (20%). Additionally, 70% of RCC patients reported a low intake of fruits and vegetables, while 35% of renal stone patients had similar dietary deficiencies. Sodium intake was higher among renal stone patients (50%) compared to RCC patients (40%) (Table 2).

Biochemical and Genetic Analysis

Serum calcium levels were slightly elevated in renal stone patients (9.8 ± 1.2 mg/dL) compared to RCC patients (9.2 ± 1.1 mg/dL). Serum oxalate levels were also higher in renal stone patients (5.2 ± 0.8 mg/L) than in RCC patients (4.6 ± 0.9 mg/L). Conversely, oxidative stress markers were significantly higher in RCC patients (50%) compared to renal stone patients (30%). A positive family history of kidney disease was observed in 30% of renal stone patients and 40% of RCC patients, indicating a genetic predisposition in both conditions (Table 3)

These findings suggest that dietary patterns play a crucial role in the pathogenesis of both renal stones and RCC, with high oxalate intake being a significant factor in stone formation, while processed food consumption and oxidative stress contribute to RCC development. ​​

Table 1: Demographic Characteristics of Study Participants

Table 2: Dietary Intake and Nutritional Analysis

Table 3: Biochemical and Genetic Markers

The findings of this study highlight the significant role of dietary patterns and genetic predisposition in the development of renal stones and renal cell carcinoma (RCC). The results indicate that individuals with high oxalate intake are more susceptible to renal stone formation, while those consuming processed meats and low-antioxidant diets have an increased risk of RCC. Furthermore, genetic susceptibility, as observed in a positive family history, also contributes to the development of both conditions.

Dietary factors play a crucial role in renal stone formation, with excessive oxalate intake being a well-documented risk factor. High dietary oxalate intake leads to increased urinary oxalate excretion, which promotes calcium oxalate crystallization, a primary component of kidney stones (1). Similar studies have reported that diets rich in animal proteins, sodium, and low in citrate further increase stone risk (2,3). Conversely, a diet rich in calcium and citrate has been found to reduce the likelihood of stone formation by inhibiting oxalate absorption and calcium crystallization (4). In this study, 60% of renal stone patients had high oxalate consumption, corroborating previous reports that dietary modifications can significantly influence stone risk (5).

In contrast, RCC is strongly associated with diets high in red and processed meats, saturated fats, and low in fruits and vegetables. Carcinogenic compounds, such as heterocyclic amines and nitrosamines, found in processed meats, have been implicated in renal carcinogenesis (6). Studies have shown that excessive consumption of red meat is linked to increased oxidative stress and chronic inflammation, which contribute to tumor initiation and progression (7). Our study found that 55% of RCC patients had high processed meat intake, which aligns with previous research indicating an association between Western dietary patterns and RCC risk (8). On the other hand, a diet rich in antioxidants, vitamins, and polyphenols has been shown to offer protective effects against RCC by neutralizing oxidative damage (9).

Genetic predisposition also plays a critical role in the development of renal stones and RCC. Mutations in genes involved in calcium metabolism, oxalate transport, and renal epithelial cell function have been implicated in stone formation (10). In our study, 30% of renal stone patients had a family history of kidney disease, suggesting a hereditary component. Similarly, RCC has been linked to genetic mutations, particularly in the von Hippel-Lindau (VHL) gene, which regulates hypoxia-inducible factor (HIF) and angiogenesis in renal tumors (11). Our study found a family history of kidney disease in 40% of RCC patients, supporting existing literature that genetic susceptibility increases the risk of renal malignancy (12).

Biochemical analysis further supports the association between dietary and genetic factors with renal stones and RCC. Elevated serum calcium and oxalate levels in renal stone patients indicate a metabolic imbalance favoring stone formation (13). Conversely, increased oxidative stress markers in RCC patients suggest that oxidative damage contributes to carcinogenesis (14). Similar studies have found that individuals with higher oxidative stress levels are at greater risk of RCC development, emphasizing the need for antioxidant-rich dietary interventions (15).

The findings of this study emphasize the importance of lifestyle modifications, particularly dietary changes, in reducing the risk of renal stones and RCC. Patients with a high oxalate diet should be advised to increase citrate intake and maintain adequate hydration, while individuals at risk of RCC should limit processed meat consumption and increase their intake of antioxidant-rich foods. Furthermore, individuals with a family history of renal disease should undergo early screening to identify and mitigate risk factors.

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