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Urinary risk factors for nephrolithiasis in patients with idiopathic renal stones at the end of each week of prescription of a specific type of drinking water (mean B SEM)
Source publication
Both amount and timing of dietary calcium intake influence the recurrence of renal calcium stones. We have evaluated whether the hardness of extra meal drinking water modifies the risk for calcium stones. The urinary levels of calcium, oxalate and citrate, i.e., the main urinary risk factors for calcium stones, were measured in 18 patients with idi...
Similar publications
Nephrolithiasis remains a formidable health problem in the United States and worldwide. A very important but underaddressed area in nephrolithiasis is the accompanying bone disease. Epidemiologic studies have shown that osteoporotic fractures occur more frequently in patients with nephrolithiasis than in the general population. Decreased bone miner...
Citations
... Despite significant progress in comprehending the multifactorial pathophysiology of urinary stone formation, a comprehensive and satisfactory explanation of this process remains elusive [6,13]. Early investigations into urinary stone disease have provided insights into the composition, mineralogy, structure, formation processes, and geo-environmental factors [14,15]. Recently, there has been a growing focus on the role of the major and trace elements in lithogenesis [16,17]. ...
Background
Urolithiasis has emerged as a global affliction, recognized as one of the most excruciating medical issues. The elemental composition of stones provides crucial information, aiding in understanding the causes, mechanisms, and individual variations in stone formation. By understanding the interactions between elements in various types of stones and exploring the key role of elements in stone formation, insights are provided for the prevention and treatment of urinary stone disease.
Methods
This study collected urinary stone samples from 80 patients in Beijing. The chemical compositions of urinary stones were identified using an infrared spectrometer. The concentrations of major and trace elements in the urinary stones were determined using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS), respectively. The data were processed using correlation analysis and Principal Component Analysis (PCA) methods.
Results
Urinary stones are categorized into five types: the calcium oxalate (CO) stone, carbonate apatite (CA) stone, uric acid (UA) stone, mixed CO and CA stone, and mixed CO and UA stone. Ca is the predominant element, with an average content ranging from 2.64 to 27.68% across the five stone groups. Based on geochemical analysis, the high-content elements follow this order: Ca > Mg > Na > K > Zn > Sr. Correlation analysis and PCA suggested significant variations in the interactions between elements for different types of urinary stones. Trace elements with charges and ionic structures similar to Ca may substitute for Ca during the process of stone formation, such as Sr and Pb affecting the Ca in most stone types except mixed stone types. Moreover, the Mg, Zn and Ba can substitute for Ca in the mixed stone types, showing element behavior dependents on the stone types.
Conclusion
This study primarily reveals distinct elemental features associated with five types of urinary stones. Additionally, the analysis of these elements indicates that substitutions of trace elements with charges and ion structures similar to Ca (such as Sr and Pb) impact most stone types. This suggests a dependence of stone composition on elemental behavior. The findings of this study will enhance our ability to address the challenges posed by urinary stones to global health and improve the precision of interventions for individuals with different stone compositions.
... Calcium (Ca 2+ ) and magnesium (Mg 2+ ) are the two principal ions present in many sedimentary rocks that contribute to the total hardness of water (WHO, 2017). Several studies have highlighted the health benefits of presence of Ca 2+ in water (Bellizzi et al., 1999;Nerbrand et al., 2003;Miyake et al., 2004;Sengupta, 2013). However, very high content of Ca 2+ and Mg 2+ may lessen water acceptability due to taste and high total dissolved solids (TDS) which could lead to high risk of renal and arthritis problems (Sengupta, 2013;Frantisek, 2020). ...
Agwe, T. M., Twesigwe-omwe, M. N. and Ako, T. (2024). Performance evaluation of open air burnt sorghum and wheat straw ashes in hard water treatment. International Journal of Agricultural Technology 20(1):399-410. Abstract The average values for the physiochemical parameters of raw water samples were 1.45 NTU, 5.42, 355 µS/cm, 8 Pt-Co, 60 mg/l and 740 mg/l respectively for turbidity, pH, EC, color, TDS and hardness. This measured hardness value of 740 mg/l was higher by 140 mg/l than the recommended standard for natural potable of 600 mg/l. In the course of hardness treatment, optimum dosages were obtained to be 20.0 g/l for WSA and 22.5 g/l for SSA, with hardness removal efficiencies of 53% and 42% respectively. At optimum dosages of the ashes, other physiochemical parameters of treated water samples were measured. Studies revealed that properties such as turbidity, pH, color and TDS of the treated water increased with respect to raw water samples but still remained within the acceptable limits except for alkalinity that was initially higher than the standard while EC and hardness reduced in percentages. The pH of raw water samples initially above the acceptable standards were found to be within the standards after being treated. The study revealed that WSA and SSA were good for hardness treatment and additives for raising the pH level. The ashes are recommended for hardness treatment being abundantly available and inexpensive for small scale hardness treatments in rural communities.
... Quality of water gas gained much attention for kidney stone formation. Water hardness [38,39], calcium content [40], and beverage types [41,42] have been recently reported to infuence the incidence of kidney stones. However, controversy remains as to whether the pH of drinking water impacts the occurrence of stone formation [43]. ...
Background
Kidney stone disease induces chronic renal insufficiency by crystal-induced renal tubular epithelial cell injury. It has been reported that the prevalence of kidney stone disease is increasing, accompanied by the high recurrence rate. Alkaline mineral water has been reported to possess beneficial effects to attenuate inflammation. Here, we explored the potential protective effects and underlying mechanisms of alkaline mineral water against calcium oxalate-induced kidney injury.
Methods
We performed the mice kidney stone model by administering glyoxylate at 100 mg/kg once daily for 7 days. To assess the effects of alkaline mineral water on oxalate-induced kidney injury, mice drank different water (distilled water, natural mineral water at pH = 8.0, as well as natural mineral water at pH = 9.3) for 7 days, respectively, followed by glyoxylate exposure. After collection, crystal formation, kidney injury and cell apoptosis, fibrosis, oxidative stress, as well as inflammation were measured.
Results
Our results showed that glyoxylate treatment led to kidney crystal formation and fibrosis, which can be attenuated by drinking alkaline mineral water. Furthermore, alkaline mineral water also reduced kidney injury and cell apoptosis, oxidative stress, and inflammation.
Conclusion
Alkaline mineral water supplement prevents progression of glyoxylate-induced kidney stones through alleviating oxidative stress and inflammation.
... Hard water has been also associated with some negative health impacts, such as kidney stones [28] or the risk of eczema [29]. However, the data on kidney stones and drinking water is not clear. ...
Background:
Interest in water chemical activity, its content, and its impact on human health has greatly increased throughout the last decade. Some studies suggest that drinking water with high hardness may have preventative effects on cardiovascular diseases. This study aims to investigate the association between drinking water hardness and cardiovascular disease (CVD) mortality.
Methods:
The study selection process was designed to find the association between drinking water hardness and CVDs mortality. The search included both qualitative and quantitative research and was performed in three databases: Web of Science (Clarivate Analytics, Ann Arbor, MI, USA), PubMed (National Institute of Health, Bethesda, MA, USA), and Scopus (Elsevier, RELX Group plc, London, UK). The project was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42020213102.
Results:
Seventeen studies out of a total of twenty-five studies qualitatively analyzed indicated a significant relation between total water hardness and protection from CVD mortality. The quantitative analysis concluded that high drinking water hardness has a significantly lowering effect on mortality from CVDs, however, the heterogeneity was high.
Conclusions:
This systematic literature review shows that total water hardness could affect CVD prevention and mortality. Due to the many confounding factors in the studies, more research is needed.
... This is highly significant as every 100mmol increase in dietary sodium results in approximately 25mg rise in urinary calcium. [4] Whereas increased dietary calcium reduces urinary excretion of oxalate [13] by increasing oxalate binding capacity of intestines thereby decreasing risk of nephrolithiasis. [4] It is known that initially electrolytes and proteins inhibit crystallization in solution but the same can act as promoters when they are immobilized. ...
... It mainly included pollutions from livestock and poultry industry, aquaculture industry, planting industry, and rural domestic sewage. Thus, from the matrix, the parameters influencing significantly the level of water quality of an area are evaluated according to Kothari et al., [59]; Bhutiani et al., [60] and Bellizzi et al., [61]. Dunca [62] found that rivers in the heavily modified basin have had a moderate ecological potential as also found in this study. ...
... As far as stone formation in the human body is concerned, the quantity of water is more important than the quality of water consumed (the lower the intake, the more likely stone formation) (Marangella et al., 1996). Combined food and water habits lead to more calculus, as suggested by Bellizzi et al. (1999) and Churchill et al. (1978). Therefore, the possibility of stone disease with high calcium content in drinking water quality cannot be ruled out. ...
Sagar, a district in central India, hosts a large population of people dependent on groundwater (without further purification) for their daily needs. However, water borne diseases, primarily kidney stones, are prevalent in this district. Therefore, we collected a large number of drinking water samples (227) in both pre-monsoon and post-monsoon seasons by dividing the entire area into 6 × 6 km2 grids. A total of 19 drinking water quality parameters were assessed and analyzed for each sample and compared with the Bureau of Indian Standards BIS 2012 (IS: 10500). The correlation coefficients of total dissolved solids (TDS), electrical conductivity and salinity were found to align perfectly with the correlation coefficients of total hardness, calcium hardness and magnesium hardness. Similarly, the total alkalinity and phenolphthalein alkalinity were correlated with bicarbonate and carbonate ion concentrations, respectively. Ion Selective electrodes (ISE), UV–vis Spectrophotometer, and volumetric methods were used for the analyses. The water quality was found to be mainly influenced by geological factors, which play an important role in controlling hardness, TDS and chloride and sulfate ion concentrations. The water quality index indicates that about 89% of the samples were in good condition. However, total hardness (TH) and nitrate ion concentration were the issues at large. Geological analysis was performed using ArcGIS 10.0 to mark the spatiality of drinking water quality through distribution maps, which revealed that the predominance of permeable calcium-rich rocks is the prime reasons behind the water hardness.
... In Brazil, approximately 5% of the population is affected by urolithiasis, independent of age and geographical location (Peres et al., 2003). The lifetime risk of becoming a patient is about 10-20% for men and 5-10% for women, of which approximately 50% will experience reoccurrence of the disease (Tiselius 2011;Moe 2006;Peres et al. 2003;Bellizzi et al. 1999). ...
... Instead, most authors strongly recommend cutting foods rich in oxalate such as spinach, rhubarb, black and green tea, bread, chocolate, and others. For these authors, the stone formation is related to food intake and environmental factors, not with water hardness (Bellizzi et al., 1999). On the other hand, there are surveys suggesting that hard-water intake between meals increases calcium concentration in urine and calcium oxalate supersaturation. ...
... According to the research of Mirzazadeh et al. (2012), in patients who had nephrolithiasis, drinking hard water showed a statistically signi cant increase in urinary calcium excretion, while patients without a history of stone precipitation did not show the same result. All studies about the in uence of water hardness in stone formation concluded that magnesium in certain way inhibits the kidney stones formation mainly because magnesium is more soluble than calcium and when the amount of magnesium is low, the risk of kidney stones formation is higher (Irsay et al. 2014;Mirzazadeh et al. 2012;Siener et al. 2004;Bellizzi et al. 1999). Therefore, hardness in water can be ambiguous, presenting both negative and positive aspects, depending on its compounds. ...
Kidney stones are precipitated when abnormal conditions within the urinary tract promotes local ions supersaturation, changes in the pH, and, in some cases, a differential bacterial influence. The most common minerals in kidney stones are calcium oxalates, followed by calcium phosphates, struvite, cystine and uric acid. In this study, the morphological and mineralogical characteristics of kidney stones were registered and applied to simplify their identification and facilitate the diagnosis. Furthermore, we performed isotopic analysis to verify the likelihood of external factors influencing kidney stones formation. In total, 160 samples of kidney stones from different patients above 18 years old were analyzed. We examined the morphological characterization macroscopically, based on features such as color, fabric and relative hardness. The x-ray diffraction (XRD) applied to mineral identification indicated that whewellite was present in 64% of the samples, followed by 14% uric acid stones and 10% struvite stones. The x-ray fluorescence (XRF) revealed that the majority of the kidney stones were formed by phosphates and calcium oxides, followed by magnesium, sodium and sulfur oxides. Isotopic analysis showed δ ¹³ C values from − 23 to -8‰ and δ ¹⁸ O values between − 12 and − 6‰ in different types of kidney stones. All the results have shown that it is possible to improve the discrimination of kidney stones based on some morphological features associated with chemical and isotopic composition. Furthermore, isotopic results have suggested that kidney stone formation can be associated with different diets and water intake.
... However, researchers point to serious risks of infection in this regard. Based on a clinical study, Bellizzi et al. (1999) suggested favoring the consumption of fresh water in the preventive approach to calcium nephrolithiasis. However, opinions differ on this issue since a high content of magnesium and bicarbonate in the water is, for example, recommended for patients suffering from kidney stones ( 93 neurodegenerative diseases. ...
This paper presents, for the first time to our knowledge, some physicochemical characteristics (pH, soluble solids content (TDS, in mg/L), electrical conductivity (EC, in µS/cm), and turbidity (in NTU) of seven types of spring waters (AO, IK, TB, TNZ, TT, TZD and TZF) and well water (AZG) from the Tizi-Ouzou region. pH, TDS and EC were measured by direct reading using hand-held probes, while other characteristics, including turbidity, were determined at a certified quality control laboratory. The results show that pH, TDS and EC varied from 4.4 (case of AO) to 9.0 (case of IK), from 68 (case of TZD) to 656 mg/L (case of TT) and from 109 (case of TZD) to 1316 µS/cm (case of TT). Except for TZF, which has intolerable turbidity (˃ 5 NTU), the other samples analyzed show excellent transparency with zero turbidity except for TZD (turbidity =1.52 NTU). Knowing the practical and possible health implications of these parameters, further studies are needed.
... A number of interventional studies have demonstrated that consumption of drinking water with different mineral compositions can result in changes to excreted urinary calcium, magnesium and citrate levels as well as urinary pH, with a weak consensus in the literature favouring hard, mineral-rich water for patients at risk of KSD [6]. When compared to tap water in our study, the mineral content of different types of water included in these study protocols was, for the most part, within the ranges of total hardness, calcium and magnesium levels in tap water in the United Kingdom, although the maximum calcium concentrations in some of the studies were significantly higher, being derived from bottled mineral water [23][24][25]. It can therefore be hypothesised that variation in the mineral content of tap water in the United Kingdom may translate into variations in excreted urinary parameters of key promoting and inhibitory lithogenic factors. ...
Introduction:
The dissolved mineral content of drinking water can modify a number of excreted urinary parameters, with potential implications for kidney stone disease (KSD). The aim of this study is to investigate the variation in the mineral content of tap drinking water in the United Kingdom and discuss its implications for KSD.
Methods:
The mineral composition of tap water from cities across the United Kingdom was ascertained from publicly available water quality reports issued by local water supply companies using civic centre postcodes during 2021. Water variables, reported as 12-monthly average values, included total water hardness and concentrations of calcium, magnesium, sodium and sulphate. An unpaired t-test was undertaken to assess for regional differences in water composition across the United Kingdom.
Results:
Water composition data were available for 66 out of 76 cities in the United Kingdom: 45 in England, 8 in Scotland, 7 in Wales and 6 in Northern Ireland. The median water hardness in the United Kingdom was 120.59 mg/L CaCO3 equivalent (range 16.02-331.50), while the median concentrations of calcium, magnesium, sodium and sulphate were 30.46 mg/L (range 5.35-128.0), 3.62 mg/L (range 0.59-31.80), 14.72 mg/L (range 2.98-57.80) and 25.36 mg/L (range 2.86-112.43), respectively. Tap water in England was markedly harder than in Scotland (192.90 mg/L vs. 32.87 mg/L as CaCO3 equivalent; p < 0.001), which overall had the softest tap water with the lowest mineral content in the United Kingdom. Within England, the North West had the softest tap water, while the South East had the hardest water (70.00 mg/L vs. 285.75 mg/L as CaCO3 equivalent).
Conclusions:
Tap water mineral content varies significantly across the United Kingdom. Depending on where one lives, drinking 2-3 L of tap water can contribute over one-third of recommended daily calcium and magnesium requirements, with possible implications for KSD incidence and recurrence.
