Effi casy of a citrate-enriched mineral beverage in the prevention of calcium urolithiasis

Abstract

Background: h e aim of our study was to evaluate the ei cacy of a new citrate-enriched natural mineral beverage in the prevention of calcium stone formation in the urinary tract. Methods: h irty-four patients, 16 male and 18 female, between 23 and 71 years of age (average 50.9 years), participated in a prospective, randomized, single-blind study that lasted two years. h e patients were randomly divided into a study group (16 patients) and a control group (18 patients). All patients suf ered from recurrent urinary calcium stone disease, with at least one recurrence experienced within the previous two years. Before the start of the study, we evaluated the patients\' dietary habits and l uid intake, recorded the demographic and vital data, performed a blood count, biochemical analysis of blood and analysis of a 24-hour urine specimen, and obtained a plain x-ray i lm and/or ultrasound scan of the urinary tract to establish the presence of any urinary stones. Over the following two years, the patients of the study group drank 500 ml of the citrate-enriched mineral beverage daily, while the patients of the control group drank the same quantity of plain water. At the end of this treatment, each patient\'s health status was assessed and the initial laboratory investigations were repeated. Statistical analysis of the results was performed with the use of the chi-square test, Fischer\'s test and the Cochram-Mante-Haenszel test for qualitative variables; the two-tailed t test (comparison between groups) and the paired t test (comparisons within individual group) were used for quantitative variables. Results: At the end of the 24-month treatment period, there were no signii cant differences between the groups in any values of the blood cell count, biochemical parameters of blood or parameters of 24-hour urine. Results for the study group showed a signii cant increase in urinary magnesium (p = 0.0047), phosphate (p = 0.0103) and citrate (p = 0.0410) over the baseline values. In the control group, values for 24-hour urine showed a signii cant decrease in specii c gravity (p = 0.0137) and a signii cant increase in the levels of calcium (p = 0.0382) and magnesium (p = 0.0068). In the study group, the calcium/magnesium ratio in urine was significantly below the baseline value (p = 0.0049). h e number of stones in the urinary tract did not dif er signii cantly between the two groups either before (p = 0.7125) or at er the treatment (p = 0.2297). Eighty-eight per cent of patients in the study group and 83% of those in the control group were satisi ed or highly satisi ed with the treatment received. Two patients in the study group and one in the control group were excluded from the study because of gastrointestinal intolerance. Conclusions: On the basis of our study, we can conclude that the citrate-enriched mineral beverage might prove an ef ective inhibitor of calcium stone formation in the urinary tract. h is is supported mainly by the observed signii cant increase in urolithiasis inhibitors.