Does drinking alkaline water help people with uric acid, cystine urolithiasis?

Consumption of commercially available alkaline water does not provide significant benefits, partially because of its negligible alkali content, over tap water for patients with uric acid and cystine urolithiasis, reports a study.

“The consumption of alkaline water, water with an average pH of 8 to 10, has been steadily increasing globally as proponents claim it to be a healthier alternative to regular water,” the authors said. “Urinary alkalinization therapy is frequently prescribed in patients with uric acid and cystine urolithiasis, and as such we analysed commercially available alkaline waters to assess their potential to increase urinary pH.”

Bottled alkaline water had pH levels ranging from 9.69 to 10.15, provided minimal electrolyte content, and had physiologic alkali content <1 mEq/L. The alkali content of alkaline water was also insignificant relative to common stone treatment alternatives such as potassium citrate.

Moreover, several organic beverages, synthetic beverages, and other supplements held more alkali content than alkaline water, meeting the recommendation of 30 to 60 mEq per day with ≤3 servings/d set by the American Urological Association and the European Association of Urology.

In this study, the authors assessed five commercially available alkaline water brands (Essentia, Smart Water Alkaline, Great Value Hydrate Alkaline Water, Body Armor SportWater, and Perfect Hydration). Anion chromatography and direct chemical measurements were conducted to determine the mineral contents of each of these products.

The authors then compared the alkaline content of each bottle of water to that of potassium citrate (the gold standard for urinary alkalinization) as well as to other beverages and supplements used to increase urinary citrate or the urine pH.