Trinchieri A, Boccafoschi C, Chisena S, De Angelis M, Seveso M
AURO Cooperative Group, Pietraligure, SV, Italia.
Arch Ital Urol Androl. 1999 Apr;71(2):121-4.
The diluition of urine decreases the risk of stone formation by lowering the concentration of calcium, oxalate and uric acid, but involves a simultaneous decrease of the concentration of the inhibitors of crystallization. On the other hand the ion content of the drinking water used for stone prevention could by itself modify urine composition. We tested the effect of the administration of a mild-calcium high-bicarbonate content water on urine composition of a group of calcium renal stone formers. A group of 40 calcium renal stone formers was instructed to drink 3 l/day of a mild-calcium (57 mg/l) and high-bicarbonate (180 mg/l) content water (Rocchetta) for a 7 day period. A 24-h collection was obtained before and after water administration for analyses of calcium, magnesium, oxalate and citrate. Urine volume was significantly increased after water administration (1601 +/- 357 vs 1878 +/- 339). Daily urinary calcium, magnesium and citrate were significantly increased, whereas daily urinary oxalate was unchanged after water administration. In conclusion the mild-calcium high-bicarbonate content water administration seems suitable for stone prevention because of the increased excretion of urinary inhibitors counterbalancing increased urinary calcium excretion.
尿液稀释通过降低钙、草酸盐和尿酸的浓度来降低结石形成的风险,但同时也会降低结晶抑制剂的浓度。另一方面,用于预防结石的饮用水中的离子含量本身可能会改变尿液成分。我们测试了饮用低钙高碳酸氢盐含量的水对一组肾钙结石患者尿液成分的影响。一组40名肾钙结石患者被要求在7天内每天饮用3升低钙(57毫克/升)高碳酸氢盐(180毫克/升)含量的水(罗凯塔水)。在饮水前后分别进行24小时尿液收集,以分析钙、镁、草酸盐和柠檬酸盐。饮水后尿量显著增加(1601±357对1878±339)。饮水后每日尿钙、镁和柠檬酸盐显著增加,而每日尿草酸盐无变化。总之,饮用低钙高碳酸氢盐含量的水似乎适合预防结石,因为尿液中抑制剂的排泄增加,抵消了尿钙排泄的增加。