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| Prevención de la Litogénesis y cura del agua. Agua mineral y piedras en el riñón. |
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By Dr. Gemma Revuelta
Degree in Medicine from the University of Barcelona and Master's in Scientific Communication
and
Maria Roura
Degree in Biology from the Autonomous University of Barcelona and in Journalism from the University of Pompeu Fabra
Renal lithiasis is characterised by the formation, growth and quartering or expulsion of the calculi through the urinary system. Lithiasis is one of the diseases known from antiquity and is observed frequently, with the incidence (G. del Rio) being around 2-3% of the population in developed countries. It is reported more often among men than women by 2:1 or 4:1 and is observed particularly between age 30 and 50.
The clinical symptoms of lithiasis are quite varied, ranging from completely asymptomatic lithiasis discovered by chance during an X-ray to lithiasis causing minor episodes of back pain and hematuria or lithiasis accompanied by severe renal colic or even severe renal impairment.
The formation of a calculus requires the presence of urine oversaturated with molecules or salts capable of crystallisation.
A shortage of certain crystallisation inhibitors in the urine, as well as the presence of crystallisation facilitators and in certain cases, a suitable pH for the formation or growth of crystals, is also required.
Since there are various kinds of calculi having a different composition, there is no single approach to lithiasis.
Cystine calculi account for 1-2% of all calculi where uric acid calculi account for 5-20% and also contain calcium oxalate salts.
Magnesium ammonia phosphate account for 5 to 25% of all calculi.
Calcium lithiasis is observed most frequently and represents 80-90% of calculi observed in men and 50% in women.
Calcium oxalate (70%) and calcium phosphate (50%) are potentially the most insoluble of all lithogenic salts under the normal conditions of urine.
Treatment ranges from prevention of lithogenesis, elimination of existing calculi, therapeutic treatment of renal colic and obstructive nephropathy as well as treatment of any urinary infections and kidney impairment that may result.
Water therapy has been used since antiquity and is completely consistent with the theory of urine oversaturation. The water intake level must depend on the desired amount of diuresis and should exceed 2.5-3 litres, a level implying a significant amount of additional liquids.
Numerous medications have been used to treat calcium lithiasis. The main preparations that are most advisable are the thiazides and cellulose phosphate.
Until now patients with calcium oxalate kidney calculi were advised to increase their intake of water and also given magnesium therapy.
Recently a prospective study showed that a calcium-rich diet reduces the risk of having symptomatic kidney calculi.
This study reported that a high fluid intake, as well as the intake of magnesium and increased dietary calcium, all simultaneously, could reduce the formation of calcium oxalate calculi in the kidney.
The study "which was conducted by the chemist Rodgers" was based on the intake of mineral water having a high level of calcium (202 ppm) and magnesium (36 ppm), respectively.
Twenty patients of both sexes who had had calcium oxalate calculi participated in the study along with 20 other healthy volunteers of both sexes.
The subjects were given mineral water for 3 days and the urine was collected; later the protocol was repeated with tap water.
The risk factors (oxalate excretion; oversaturation of calcium oxalate, uric acid, etc.) were favourably affected by the intake of mineral water. In contrast, tap water caused an adverse change in magnesium excretion.
The study concluded that natural mineral water containing calcium and magnesium, such as Vichy Catalan or Malávella, can be considered therapeutic as well as an prophylactic agent in calcium oxalate calculi disease in kidneys.
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