Effect of Mineral Water Containing Calcium and Magnesium on Calcium Oxalate Urolithiasis Risk Factors

Abstract

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 favourably 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. The group which benefitted 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.

Influence of a mineral water rich in calcium, magnesium and bicarbonate on urine composition and the risk of calcium oxalate crystallization

“…No relation was established between urinary sodium and calcium excretion, neither on standardized nor on normal dietary conditions. The majority of the studies evaluating the effect of the calcium content of water on urine composition revealed significant increases in urinary calcium excretion both in normal subjects (Rodgers, 1997;Coen et al, 2001) and stone formers (Ackermann et al, 1988;Marangella et al, 1996;Rodgers, 1997;Caudarella et al, 1998) on a high as opposed to a low calcium load with water.…”

Effect of blackcurrant-, cranberry- and plum juice consumption on risk factors associated with kidney stone formation

“…Second, fluid composition has a direct influence on urine composition and crystal formation (Hesse et al, 1993). Depending on the stone composition, several fluids have been found to be suitable, eg mineral water (Hesse et al, 1993;Borghi et al, 1996;Rodgers, 1997), orange juice (Hesse et al, 1993;Wabner & Pak, 1993), apple juice, fruit and herbal teas (Vahlensieck, 1986). Care should be taken to avoid fluids containing lithogenic agents which may increase the risk of stone formation, such as coffee, black tea, alcohol (Vahlensieck, 1986) and cola (Weiss et al, 1992;Rodgers, 1999).…”

Târgu Lăpuş Region Mineral Waters Characterization

“…It is concluded that mineral water containing calcium and magnesium, deserves to be considered as a possible therapeutic or prophylactic agent in calcium oxalate kidney stone disease (Rodgers, 1997). Mineral water under study was characterized by a significant content of calcium, sodium, potassium, magnesium, being recognized as carbonated water.…”