Calcium oxalate kidney stone formers are invariably advised to
increase their fluid intake. In addition, magnesium therapy is often
administered. Recently, a prospective study showed that a high dietary intake
of calcium reduces the risk of symptomatic kidney stones. The present study was
performed to test whether simultaneous delivery of these factors--high fluid
intake, magnesium ingestion and increased dietary calcium--could reduce the
risk of calcium oxalate kidney stone formation.
- A French mineral water, containing calcium and magnesium (202 and 36 ppm, respectively) was selected as the dietary vehicle. Twenty calcium oxalate stone-forming patients of each sex as well as 20 healthy volunteers of each sex participated in the study.
- Each subject provided a 24-hour urine collection after ingestion of mineral water over a period of 3 days; after a suitable rest period the protocol was repeated using local tap water (Ca: 13 ppm, Mg: 1 ppm).
- In addition, 24-hour urines were collected by each subject on their free diets. The entire cycle was repeated at least twice by each subject.
Several risk factors (excretion of oxalate; relative
supersaturations of calcium oxalate, brushite and uric acid; calcium oxalate
metastable limit; oxalate:magnesium ratio and oxalate:metastable limit ratio)
were favourable altered by the mineral water and tap water regimens but the
former was more effective. In addition, the mineral water protocol produced
favourable but unique changes in the excretion of citrate and magnesium as well
as in the relative supersaturation of brushite which were not achieved by the
tap water regimen. To the contrary, tap water produced an unfavourable change
in the magnesium excretion.
Conclusion
The group which benefited most were male stone formers in whom 9
risk factors were favourably altered by the mineral water protocol. It is
concluded that mineral water containing calcium and magnesium, such as that
used in this study, deserves to be considered as a possible therapeutic or
prophylactic agent in calcium oxalate kidney stone disease.
Reference
- Rodgers AL. Effect of mineral water containing calcium and magnesium on calcium oxalate urolithiasis risk factors. Department of Chemistry, University of Cape Town, South Africa. Accessed at http://www.mgwater.com
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