Abstract

PURPOSE: Investigations in healthy persons have shown that drinking mineral water containing HCO 3 has a positive effect on urine supersaturated with calcium-oxalate (SS CaOx ) . The present study evaluates in a common setting whether these effects are also relevant in patients with multiepisodic urinary stone formation. MATERIALS AND METHODS: A total of 34 patients with evident multiepisodic CaOx-urolithiasis were included in the study. In a cross-over design and double-blinded the patients received 1.5 l of a mineral water with 2.673 mg HCO 3 /l (test water) or the same amount of water with a low mineral content (98 mg HCO 3 /l) (control water) daily for 3 days. The main target parameter was SS CaOx in 24-hour urine. In addition, urinary pH and the most important inhibiting and promoting factors were measured in 24-hour urine (Ca, Ox, Mg, Cit). RESULTS: Both waters tested led to a highly significant increase in 24-hour urine volume without there being a difference between both waters tested. In the group drinking the water containing HCO 3 the urinary pH increased significantly and was within a range relevant for metaphylaxis of calcium-oxalate stone formation (x=6.73). These changes were highly significant when compared to the control group. In addition, significantly increased magnesium and citrate concentration were also observed. Supersaturation with calcium-oxalate decreased significantly and to a relevant extent; however, there was no difference between the waters tested. DISCUSSION: It is evident that both waters tested are able to lower significantly and to a relevant extent the risk of urinary stone formation in patients with multiepisodic CaOx-urolithiasis. In addition, the bicarbonate water increases the inhibitory factors citrate and magnesium. Thus, it can be recommended for metaphylaxis of calcium-oxalate and uric acid urinary stones.

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