Urine alkalinization can be used for the treatment of some urological diseases.
A series of cases showing the beneficial effects of urine alkalinization with potassium magnesium citrate, theobromine, zinc and vitamin A for the dissolution of uric acid stones and the treatment of other urological pathological conditions is presented.
Alkalinization was effective in the dissolution of uric acid renal stones in various clinical conditions. Two cases of bilateral renal stone, four cases of staghorn renal stone, seven patients with unilateral renal stone, and five cases of ureteral stone were described. In this group the age ranged from 46 to 91 years, the M/F ratio was 7/11, the density of the stones ranged between 300 and 528. In most cases the urinary pH ranged from 5 to 5.5. Diabetes was observed in 4 cases, obesity in 4 cases and hyperuricemia in 7. Alkalinizing treatment achieved complete dissolution of the stone in 12 cases and almost complete or partial dissolution in other 6. A combination of potassium magnesium citrate, theobromine, zinc and vitamin A was used in all the cases. In 4 cases the administration of allopurinol was associated. In one case with obstructive ureteral stones, stone dissolution was obtained with the combined administration of bicarbonate via nephrostomy and intravenous bicarbonate and oral treatment with citrates. Stone dissolution of uric acid stones has also been described in some specific clinical conditions such as Crohn's disease with ileostomy, outcome of partial nephrectomy, cross-fused renal ectopia. Alkalinization was also used to prevent encrustation of a self-expanding metallic ureteral stent. Alkalinization has also been employed during the period of Mitomycin administration for the treatment of non-muscle infiltrating bladder tumors and for the treatment of overactive bladder.
The findings of these case reports demonstrate that urinary alkalinization with frequent monitoring of urinary pH can be successfully employed in the non-surgical treatment of uric acid stones of different sizes in various locations.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2025 Mar 28 [Epub]
Celia Abad Rodriguez-Hesles, Hassan Alkhatatbeh, María Belén Alonso Bartolomé, Carmen Arai Valladares Ferreiro, Hector Ricardo Ayllón Blanco, Cristina Calzas Montalvo, Daniel Carrasco Gómez, Marta Casadevall Rubau, Elena Maria Casas Martinez, Sara Esturo Sacristan, Miguel Gómez Garberí, Blanca Gómez-Jordana Mañas, Rosa Maria Gras Martinez, Ana Morales Martínez, Pedro Hernandez-Peñalver, Silvia Juste Alvarez, Alberto López Sierra, Rafael Maria Mas Lucas, Isabel Mohedano Sánchez, Isabel Montuenga Fernandez, Baraa Nakdali Kassab, Maria Negueroles-Garcia, Leticia Ruibal Gago, Laura Sánchez, Bernat Isern, Alberto Trinchieri
Hospital Universitario Clínico San Cecilio, Grenada. ., Department of General Surgery, Hashemite University, Zarqa. ., Hospital Universitario La Paz, Madrid. ., Hospital de Valme, Endourology and Urolithiasis Section, Sevilla. ., Hospital Universitario La Paz, Madrid. ., Hospital Universitario 12 de Octubre, Madrid. ., Hospital Regional Universitario de Málaga, Malaga. ., Fundacio Puigvert, Barcelona. ., Hospital Universitario Rey Juan Carlos, Madrid. ., Hospital Universitario Galdakao-Usansolo, Galdakao. ., Department of Urology, Hospital Universitario San Juan, Alicante. ., Hospital Universitario Fundación Jiménez Díaz, Madrid. ., Hospital General Universitario de Valencia. ., Servicio de Urología, Hospital Universitario San Cecilio, Granada. ., Fundacio Puigvert, Barcelona. ., Hospital Universitario 12 de Octubre, Madrid. ., Hospital Nuestra Señora de Sonsoles, Avila. ., General Hospital of Segovia. ., Hospital Juan Ramón Jiménez, Huelva. ., Hospital Universitario Príncipe de Asturias, Alcala de Henares (Madrid). ., Hospital Universitario San Juan, Alicante. ., Hospital Clínico Universitario de Valencia. ., Complexo Hospitalario Universitario de Pontevedra. ., Hospital Universitario San Juan, Alicante. ., Devicare, Barcelona; Laboratori d'Investigació en Litiasi Renal, Universitat de les Illes Balears. ., Ambrosiana Nursing Home, Milan. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40162813