Effect of L-Methionine on the Risk of Phosphate Stone Formation

Siener, Roswitha; Struwe, F.; Hesse, Albrecht

doi:10.1016/j.urology.2016.08.007

Cited by 29 publications

(24 citation statements)

References 17 publications

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“…A recent study in healthy adults showed that the administration of 1500 mg/day l -methionine clearly decreases diurnal urinary pH ( Figure 1 ) [ 31 ]. Urinary sulfate excretion, a direct marker for the metabolism of l -methionine, and ammonium excretion, which reflects the increase in net acid production, increased significantly after l -methionine administration.…”

Section: Net Acid Excretion and Urinary Phmentioning

confidence: 99%

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Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease

Siener¹

2018

Nutrients

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Chronic kidney disease and reduced glomerular filtration rate are risk factors for the development of chronic metabolic acidosis. The prevention or correction of chronic metabolic acidosis has been found to slow progression of chronic kidney disease. Dietary composition can strongly affect acid–base balance. Major determinants of net endogenous acid production are the generation of large amounts of hydrogen ions, mostly by animal-derived protein, which is counterbalanced by the metabolism of base-producing foods like fruits and vegetables. Alkali therapy of chronic metabolic acidosis can be achieved by providing an alkali-rich diet or oral administration of alkali salts. The primary goal of dietary treatment should be to increase the proportion of fruits and vegetables and to reduce the daily protein intake to 0.8–1.0 g per kg body weight. Diet modifications should begin early, i.e., even in patients with moderate kidney impairment, because usual dietary habits of many developed societies contribute an increased proportion of acid equivalents due to the high intake of protein from animal sources.

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Section: Net Acid Excretion and Urinary Phmentioning

confidence: 99%

“… Diurnal variation in urinary pH during a 24-h period in healthy individuals under controlled, standardized conditions before (control, blue line) and after receiving 1500 mg/day l -methionine (red line) (M ± SEM) (* p < 0.05) [ 31 ]. …”

Section: Figurementioning

confidence: 99%

Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease

Siener¹

2018

Nutrients

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“…The oral composition studied contains both urine acidifier and crystallization inhibitors, such us L-methionine (an essential amino acid recommended by the EAU Guidelines on Urolithiasis with acidifier properties for the treatment of infectious stones) and phytin (a phytate salt with demonstrated inhibitory properties of calcium stones) as active components. L-methionine directly reduces/acidifies urine pH [15,16], whereas crystallization inhibitors [17] decrease the risk of renal stone formation [18,19].…”

Section: Introductionmentioning

confidence: 99%

Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a multicenter, placebo controlled, double blind, randomized clinical trial

et al. 2020

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Background: Encrustation of ureteral double J stents is a common complication that may affect its removal. The aim of the proposed study is to evaluate the efficacy and safety of a new oral composition to prevent double J stent encrustation in indwelling times up to 8 weeks. Methods: A double-blinded, multicenter, placebo-controlled trial was conducted with 105 patients with indwelling double J stents enrolled across 9 public hospitals in Spain. The patients were randomly assigned (1:1) into intervention (53 patients) or placebo (52 patients) groups for 3 to 8 weeks and both groups self-monitored daily their morning urine pH levels. The primary outcome of analysis was the degree of stent ends encrustation, defined by a 4-point score (0none; 3global encrustation) using macroscopic and electron microscopy analysis of crystals, after 3 to 8-w indwelling period. Score was exponentially transformed according to calcium levels. Secondary endpoints included urine pH decrease, stent removal, and incidence of adverse events. Results: The intervention group benefits from a lower global encrustation rate of stent ends than placebo group (1% vs 8.2%; p < 0.018). Mean encrustation score was 85.12 (274.5) in the placebo group and 18.91 (102.27) in the intervention group (p < 0.025). Considering the secondary end points, treated patients reported greater urine pH decreases (p = 0.002). No differences in the incidence of adverse events were identified between the groups. Conclusions: Our data suggest that the use of this new oral composition is beneficial in the context of ureteral double J indwelling by decreasing mean, as well as global encrustation.

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“…The oral composition studied contains both urine acidifier and crystallization inhibitors, such us Lmethionine (an essential amino acid recommended by the EAU Guidelines on Urolithiasis with acidifier properties for the treatment of infectious stones) and phytin (a phytate salt with demonstrated inhibitory properties of calcium stones) as active components. L-methionine directly reduces/acidifies urine pH (15,16), whereas crystallization inhibitors (17) decrease the risk of renal stone formation (18,19).…”

Section: Introductionmentioning

confidence: 99%

Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a m ulticenter, placebo controlled, double blind, randomized clinical trial

Torrecilla

Fernández-Concha

Cansino

et al. 2020

Preprint

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Background: Encrustation of ureteral double J stents is a common complication that may affect its removal. The aim of the proposed study is to evaluate the efficacy and safety of a new oral composition to prevent double J stent encrustation in indwelling times up to 8 weeks. Participants, design and intervention: A double-blinded, multicenter, placebo-controlled trial was conducted with 105 patients with indwelling double J stents enrolled across 9 public hospitals in Spain. The patients were randomly assigned (1:1) into intervention (53 patients) or placebo (52 patients) groups for 3 to 8 weeks and both groups self-monitored daily their morning urine pH levels. Outcome measurements and statistical analysis: The primary outcome of analysis was the degree of stent ends encrustation, defined by a 4-point score (0 – none; 3 – global encrustation) using macroscopic and electron microscopy analysis of crystals, after 3 to 8-w indwelling period. Score was exponentially transformed according to calcium levels. Secondary endpoints included urine pH decrease, stent removal, and incidence of adverse events. Results: The intervention group benefits from a lower global encrustation rate of stent ends than placebo group (1% vs 8.2%; p < 0.018). Mean encrustation score was 85.12 (274.5) in the intervention group and 18.91 (102.27) in the placebo group (p < 0.025). Considering the secondary end points, treated patients reported greater urine pH decreases (p = 0.002). No differences in the incidence of adverse events were identified between the groups. Conclusions: Our data suggest that the use of this new oral composition is beneficial in the context of ureteral double J indwelling by decreasing mean, as well as global encrustation. Trial registration: This trial was registered at www.clinicaltrials.gov under the name “Combined Use of a Medical Device and a Dietary Complement in Patient Urinary pH Control in Patients With an Implanted Double J Stent” with date 2 nd November 2017, code NCT03343275, and URL: https://clinicaltrials.gov/ct2/show/record/NCT03343275?term=NCT03343275&draw=2&rank=1 Keywords: double J stent; encrustation; nutraceutical; L-methionine; phytin; pH.

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Effect of L-Methionine on the Risk of Phosphate Stone Formation

Abstract: The present findings show that L-methionine effectively decreases urinary pH and the risk of struvite and calcium phosphate stone formation in healthy subjects. Hypercalciuria is not expected to occur at physiological doses of L-methionine.

Cited by 29 publications

References 17 publications

Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease

Dietary Treatment of Metabolic Acidosis in Chronic Kidney Disease

Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a multicenter, placebo controlled, double blind, randomized clinical trial

Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a m ulticenter, placebo controlled, double blind, randomized clinical trial

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