Drinking water composition and incidence of urinary calculus: introducing a new index

INTRODUCTION. We searched for a pathophysiologically based feature of major water electrolytes, which may define water quality better than the water hardness, respecting urinary calculus formation. MATERIALS AND METHODS. Utilizing a multistage stratified sampling, 2310 patients were diagnosed in the...

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Bibliographic Details
Published in:Iranian journal of kidney diseases 2011-01, Vol.5 (1), p.15-20
Main Authors: Basiri, Abbas, Shakhssalim, Nasser, Khoshdel, Ali Reza, Pakmanesh, Hamid, Radfar, Mohammad Hadi
Format: Article
Language:English
Subjects:
Bicarbonates - analysis
Calcium - analysis
Electrolytes - analysis
Humans
Incidence
Iran - epidemiology
Magnesium - analysis
Registries
Regression Analysis
Risk Factors
Urinary Calculi - epidemiology
Urinary Calculi - physiopathology
Water Supply - analysis
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Summary:INTRODUCTION. We searched for a pathophysiologically based feature of major water electrolytes, which may define water quality better than the water hardness, respecting urinary calculus formation. MATERIALS AND METHODS. Utilizing a multistage stratified sampling, 2310 patients were diagnosed in the imaging centers of the provincial capitals in Iran between 2007 and 2008. These were composed of 1755 patients who were settled residents of 24 provincial capitals. Data on the regional drinking water composition, obtained from an accredited registry, and their relationships with the region's incidence of urinary calculi were evaluated by metaregression models. The stone risk index (defined as the ratio of calcium to magnesium-bicarbonate product in drinking water) was used to assess the risk of calculus formation. RESULTS. No correlation was found between the urinary calculus incidence and the amount of calcium, bicarbonate, or the total hardness of the drinking water. In contrast, water magnesium had a marginally significant nonlinear inverse relationship with the incidence of the disease in the capitals (R(2) = 26%, P = .05 for a power model). The stone risk index was associated nonlinearly with the calculus incidence (R(2) = 28.4%, P = .04). CONCLUSIONS. Urinary calculus incidence was inversely related with drinking water magnesium content. We introduced a new index constructed on the foundation of a pathophysiologically based formula; the stone risk index had a strong positive association with calculus incidence. This index can have therapeutic and preventive applications, yet to be confirmed by clinical trials.
ISSN:1735-8582
1735-8604