Posted By Robert Holland on March 20, 1999 at 14:41:54:
In Reply to: Re: Leuten or Luten posted by Robert Holland on March 20, 1999 at 14:30:34:
: : Is there any such product by the name of "leuten" or "luten" that has the ability to slow degeneration of the eye or increase function of the eye? If there is, how does it work and how would you be able to obtain this product?
: To my knowledge, there is no drug available for commercial use by that name. If this drug exists, it may be either a study drug or something not available in this country. I suspect you are referring to macular degeneration, and also to my knowledge there is no drug currently available to slow the disease. There certainly is plenty of research being done but no solutions yet.
This information was provided for medical educational purposes only.
Lutein is not a drug. It is a naturally occurring carotenoind found in abundance in foods like yellow corn, kale, spinach, eggs, I have a list from the USDA site.
Lutein and zeaxanthin are the only two carotenoids known to concentrate in the macula (lutea macula (sp?) and are said to provide antioxidant protection as well as bule light absorbtion.
I will reprint an abstract or two in the following post. (I need to test first)
Here are two and the next poat will contain many more. Feel free to email me.
Exp Eye Res 1997 Jul;65(1):57-62
A one year study of the macular pigment: the effect of
140 days of a lutein supplement.
Landrum JT, Bone RA, Joa H, Kilburn MD, Moore LL, Sprague KE
Department of Chemistry, Florida International University, Miami, FL 33199, USA.
A low density of macular pigment may represent a risk factor for age-related macular
degeneration (AMD) by permitting greater blue light damage. This study was carried out to
determine the effects on macular pigment optical density of dietary supplementation with
lutein, one of the pigment constituents. Two subjects consumed lutein esters, equivalent to
30 mg of free lutein per day, for a period of 140 days. Macular pigment optical density was
determined by heterochromatic flicker photometry before, during, and after the
supplementation period. Serum lutein concentration was also obtained through the analysis of
blood samples by high-performance liquid chromatography. Twenty to 40 days after the
subjects commenced taking the lutein supplement, their macular pigment optical density
began to increase uniformly at an average rate of 1.13+/-0.12 milliabsorbance units/day.
During this same period, the serum concentration of lutein increased roughly tenfold,
approaching a steady state plateau. The optical density curve eventually levelled off 40 to 50
days after the subjects discontinued the supplement. During the same 40 to 50 days, the
serum concentration returned to baseline. Thereafter, little or no decrease in optical density
was observed. The mean increases in the macular pigment optical density were 39% and 21%
in the eyes of the two subjects respectively. In conclusion, the modest period of
supplementation has been estimated to have produced in the subjects a 30 to 40% reduction
in blue light reaching the photoreceptors, Bruch's membrane, and the retinal pigment
epithelium, the vulnerable tissues affected by AMD.
PMID: 9237865, UI: 97383202
Dietary Modification of Human Macular Pigment Density.
Hammond BR Jr , Johnson EJ , Russell RM , Krinsky NI , Yeum KJ , Edwards RB ,
Department of Social and Behavioral Sciences, College of Arts and Sciences, Arizona
State University West, Phoenix 85069-7100, USA.
Invest Ophthalmol Vis Sci 1997 Aug;38(9):1795-801
PURPOSE: The retinal carotenoids lutein (L) and zeaxanthin (Z) that form
the macular pigment (MP) may help to prevent neovascular age-related
macular degeneration. The purpose of this study was to determine
whether MP density in the retina could be raised by increasing dietary
intake of L and Z from foods.
METHODS: Macular pigment was measured psychophysically for 13
subjects. Serum concentrations of L, Z, and beta-carotene were measured
by high-performance liquid chromatography. Eleven subjects modified
their usual daily diets by adding 60 g of spinach (10.8 mg L, 0.3 mg Z, 5
mg beta-carotene) and ten also added 150 g of corn (0.3 mg Z, 0.4 mg L);
two other subjects were given only corn. Dietary modification lasted up to
RESULTS: For the subjects fed spinach or spinach and corn, three types of
responses to dietary modification were identified: Eight "retinal
responders" had increases in serum L (mean, 33%; SD, 22%) and in MP
density (mean, 19%; SD, 11%); two "retinal nonresponders" showed
substantial increases in serum L (mean, 31%) but not in MP density
(mean, -11%); one "serum and retinal nonresponder" showed no changes
in serum L, Z, or beta-carotene and no change in MP density. For the two
subjects given only corn, serum L changed little (+11%, -6%), but in one
subject serum Z increased (70%) and MP density increased (25%).
CONCLUSIONS: Increases in MP density were obtained within 4 weeks of
dietary modification for most, but not all, subjects. When MP density
increased with dietary modification, it remained elevated for at least
several months after resuming an unmodified diet. Augmentation of MP for
both experimental and clinical investigation appears to be feasible for
Here is a compilation of information that may be of interest.
(Mineral Water/Kidney Stones Inf -------------- (off topic but may be of interest)
Optom Vis Sci 1997 Jul;74(7):499-504
Density of the human crystalline lens is related to the macular pigment
carotenoids, lutein and zeaxanthin.
Hammond BR Jr, Wooten BR, Snodderly DM
Vision Sciences Laboratory, College of Arts & Sciences, Arizona State
University, Phoenix, USA. ***@****
PURPOSE: Although oxidative stress may play an important role in the
development of age-related cataract, the degree of protection reported for
antioxidant vitamins and carotenoids has been inconsistent across studies.
These varied results may be due in part to the lack of good biomarkers for
measuring the long-term nutritional status of the eye. The present
experiments investigated the relationship between retinal carotenoids (i.e.,
macular pigment), used as a long-term measure of tissue carotenoids, and
lens optical density, used as an indicator of lens health. METHODS: Macular
pigment (460 nm) and lens (440, 500, and 550 nm) optical density were
measured psychophysically in the same individuals. Groups of younger
subjects--7 females (ages 24 to 36 years), and 5 males (ages 24 to 31
years)--were compared with older subjects--23 older females (ages 55 to 78
years), and 16 older males (ages 48 to 82 years). RESULTS: Lens density (440
nm) increased as a function of age (r = 0.65, p < 0.001), as expected. For
the oldest group, a significant inverse relationship (y = 1.53-0.83x, r =
-0.47, p < 0.001) was found between macular pigment density (440 nm) and
lens density (440 nm). No relationship was found for the youngest group (p or =
3 mm in thickness using a liposomal preparation of benzoporphyrin derivative,
verteporfin. METHODS: Pigmented choroidal tumors were established in 32 New
Zealand albino rabbit eyes. Animals were treated with daily injections of
cyclosporine, and tumor growth was followed by serial fundus examinations and
ultrasonography. When a tumor exceeded 3 mm in thickness (tumor height ranged
from 3.1-4.6 mm), the authors administered benzoporphyrin derivative
intravenously (1 mg/kg) and irradiated the tumor at 692-nm through an
argon-pumped dye laser at different total light doses ranging from 60 to 120
J/cm2. Control animals were treated with light or benzoporphyrin derivative
only. Each animal then was followed-up for 4 to 6 weeks by fundus photography,
fluorescein angiography, and ultrasonography. RESULTS: All animals treated with
benzoporphyrin derivative and light at fluences of > or = 80 J/cm2 showed
complete tumor arrest. In contrast, both control groups showed continuous tumor
growth in all animals with tumors filling most of the vitreous cavity by 3
weeks. Histologic examination results of tumors treated with dye plus light
immediately after treatment showed prominent vascular closure. No vascular
changes were noted in the control eye treated with light or dye alone.
Examination results of the eyes that showed tumor regression after a 4-week
follow-up period showed tumor necrosis and extensive infiltration of
mononuclear cells and pigment-laden macrophages at the tumor site. CONCLUSIONS:
These data suggest that photodynamic therapy may have a role in the management
of pigmented choroidal melanomas.
PMID: 9003336, UI: 97156955
Arch Ophthalmol 1996 Aug;114(8):978-85
Intravenous infusion of liposomal benzoporphyrin derivative for photodynamic
therapy of experimental choroidal neovascularization.
Husain D, Miller JW, Michaud N, Connolly E, Flotte TJ, Gragoudas ES
Laser Research Laboratory, Massachusetts Eye and Ear Infirmary, Boston, USA.
OBJECTIVE: To compare the effectiveness of photodynamic therapy to close
experimental choroidal neovascularization using an intravenous infusion of
liposomal benzoporphyrin derivative (verteporfin) with previous work using a
rapid intravenous injection, before initiating clinical trials. METHODS:
Choroidal neovascularization was induced in cynomolgus monkey eyes using argon
laser. Liposomal benzoporphyrin derivative was delivered by an intravenous
infusion pump for 10 or 32 minutes at a dose of 0.375 mg/kg. Irradiation was
performed with 689- or 692-nm laser light (600-mW/cm2 irradiance and 150-J/cm2
fluence) in 7 normal eyes and 11 eyes with choroidal neovascularization between
30 and 105 minutes after the start of dye infusion. Findings were documented by
fundus photography, fluorescein angiography, and light and electron microscopy.
RESULTS: Irradiation within 32 to 50 minutes of the start of the fast (10
minutes) or slow (32 minutes) dye infusion resulted in closure of choroidal
neovascularization. In normal eyes, this technique caused choriocapillaris
closure and retinal pigment epithelium damage with minimal damage to
surrounding tissues. CONCLUSION: Photodynamic therapy using intravenous
infusion of liposomal benzoporphyrin derivative selectively closed experimental
choroidal neovascularization. This may be a suitable modality for clinical use.
PMID: 8694734, UI: 96326197
Ophthalmology 1996 Mar;103(3):427-38
Liposomal benzoporphyrin derivative verteporfin photodynamic therapy. Selective
treatment of choroidal neovascularization in monkeys.
Kramer M, Miller JW, Michaud N, Moulton RS, Hasan T, Flotte TJ, Gragoudas ES
Laser Research Laboratory, Retina Service, Massachusetts Eye and Ear Infirmary,
Harvard Medical School, Boston, 02114, USA.
PURPOSE: The authors have previously shown that photodynamic therapy (PDT)
using lipoprotein-delivered benzoporphyrin derivative mono-acid (BPD)
effectively closed experimental choroidal neovascularization (CNV). In the
current study, the authors used a clinical preparation, liposomal BPD
verteporfin in the same model, with experiments designed to establish optimal
dye and light doses, and the timing of laser light irradiation after dye
injection, for effective and selective closure of CNV. METHODS: Experimental
CNV was induced in the maculae of cynomolgus monkeys. Liposomal BPD verteporfin
was injected intravenously at doses of 1.0, 0.5, 0.375, and 0.25 mg/kg. Laser
light at 692 nm then was applied to CNV, with an irradiance of 600 mW/cm2 and
fluence of 150 J/cm2, at various times after dye injection, ranging from 5 to
120 minutes. Treatment effect was assessed by fundus photography and
fluorescein angiography and confirmed by light and electron microscopy. The PDT
of experimental CNV was studied to assess efficacy; PDT performance on normal
eyes was studied to investigate selectivity. RESULTS: The CNV closure was
demonstrated by fluorescein angiography and histopathologic findings at all
tested dye doses. A dye dose of 0.375 mg/kg, with laser light irradiation
applied 20 to 50 minutes after dye injection, optimized CNV closure with
minimal retinal and choroidal damage. No major local adverse effects were
noted, and the drug was well tolerated systematically. CONCLUSIONS: Liposomal
BPD verteporfin is a potent photosensitizer, and PDT using this dye is a
potentially effective and selective treatment for CNV.
PMID: 8600419, UI: 96182510
Arch Ophthalmol 1996 Feb;114(2):186-92
Photodynamic therapy of pigmented choroidal melanomas using a liposomal
preparation of benzoporphyrin derivative.
Young LH, Howard MA, Hu LK, Kim RY, Gragoudas ES
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
OBJECTIVE: To evaluate the effectiveness of photodynamic therapy of pigmented
choroidal melanoma using a liposomal preparation of benzoporphyrin derivative
monoacid (BPD), verteporfin. DESIGN: Pigmented choroidal melanomas were
established in 25 New Zealand albino rabbit eyes. The animals were treated with
daily injections of cyclosporine, and tumor growth was monitored with
funduscopic examination and ultrasonography. Fifteen minutes after intravenous
injection of BPD (2 mg/kg), the tumors were irradiated at 692 nm through an
argon-pumped dye laser with the delivered fluence ranging between 40 and 150
J/cm2. Control animals were treated with light only, photosensitizer only, or
observation only. Tumor growth was monitored by indirect ophthalmoscopy, fundus
photography, fluorescein angiography, and ultrasonography. Histologic
examination was performed. RESULTS: Eighteen tumor-bearing rabbits were treated
with light and BPD; 16 were followed up for 1 month, and two were killed
immediately for histologic examination. Tumors regressed in all eyes treated
with 60 J/cm2 or more. With fluence of 40 J/cm2, tumor regrowth was observed in
one animal within 10 days of treatment. In the three control groups, all
animals showed continuous tumor growth. Histologic examination of the eyes
treated with photosensitizer and light immediately after treatment showed
prominent vascular occlusion throughout the full thickness of the tumor. One
month after treatment, tumor necrosis and infiltration of mononuclear cells and
pigment-laden macrophages were the predominant findings. CONCLUSIONS:
Photodynamic therapy with BPD may have a role in the treatment of pigmented
PMID: 8573023, UI: 96164703
Arch Ophthalmol 1995 Jun;113(6):810-8
Photodynamic therapy of experimental choroidal neovascularization using
Miller JW, Walsh AW, Kramer M, Hasan T, Michaud N, Flotte TJ, Haimovici R,
Laser Research Laboratory, Massachusetts Eye and Ear Infirmary, USA.
OBJECTIVE: To investigate photodynamic therapy of experimental choroidal
neovascularization using benzoporphyrin derivative monoacid (Verteporfin).
METHODS: Photodynamic therapy using benzoporphyrin derivative monoacid was
investigated in cynomolgus monkeys. Following intravenous injection of
benzoporphyrin derivative monoacid (1 to 2 mg/kg) complexed with low-density
lipoprotein, the eyes were irradiated with 692-nm light at a fluence of 50 to
150 J/cm2 and irradiance of 150 to 600 mW/cm2. Choroidal neovascularization was
documented before photodynamic therapy and closure was demonstrated by fundus
photography, fluorescein angiography, and light and electron microscopic
examination. RESULTS: Following photodynamic therapy, vessels within choroidal
neovascularization were occluded, and there was damage to the choroidal
neovascularization endothelium and the subjacent choriocapillaris. Damage to
the retinal pigment epithelium and photoreceptors was also observed.
CONCLUSION: Photodynamic therapy with lipoprotein-delivered benzoporphyrin
derivative monoacid was effective in this animal model of choroidal
neovascularization and may be a promising, potentially selective, therapy for
PMID: 7540388, UI: 95305785
Semin Oncol 1994 Dec;21(6 Suppl 15):4-10
Photosensitizers in photodynamic therapy.
Quadra Logic Technologies, Inc, Vancouver, British Columbia, Canada.
Photodynamic therapy (PDT) is based on the use of light-sensitive molecules
called photosensitizers. Photoactivation causes the formation of singlet
oxygen, which produces peroxidative reactions that can cause cell damage and
death. Porfimer sodium (Photofrin, manufactured by Lederle Parenterals,
Carolina, Puerto Rico, under license from Quadra Logic Technologies, Inc,
Vancouver, BC, Canada) is the photosensitizer that has been studied most
extensively. Patients generally have to be hospitalized for 2 days prior to
light treatment after administration of porfimer sodium; it takes approximately
48 hours after injection to reach optimal concentration in tumor tissue. The
tumoricidal capacity of PDT with porfimer sodium is determined in part by the
maximum depth of penetration of light having a wavelength of 630 nm. Porfimer
sodium causes cutaneous photosensitivity that may last for up to 6 weeks.
Benzoporphyrin derivative (BPD verteporfin; BPD-Quadra Logic Technologies, Inc,
Vancouver, BC, Canada), another photosensitizer, accumulates more rapidly in
tumor tissue, permitting optimal PDT 30 to 150 minutes following intravenous
administration. It is rapidly cleared from the body, and skin photosensitivity
does not extend beyond a few days. The primary mechanism of action of PDT is
related to the selective accumulation of photosensitizers in cancer tissue.
Photodynamic therapy also shows promise in the treatment of a number of
nonneoplastic conditions, including psoriasis, macular degeneration of the
retina, atherosclerotic plaque and restenosis, bone marrow purging for
treatment of leukemias with autologous bone marrow transplantation,
inactivation of viruses in blood or blood products, and several autoimmune
conditions, including rheumatoid arthritis. Physiologic characteristics shared
by this disparate group of diseases, and the mechanisms by which they may
mediate photoactivation, are discussed.
PMID: 7992105, UI: 95084221
CIBA Vision Corporation
11460 Johns Creek Parkway
Duluth, GA 30097-1556
FOR IMMEDIATE RELEASE:
JANUARY 5, 1999
FOR MORE INFORMATION:
Ann Bailey Berry, 770-418-3014
QLT AND CIBA VISION ANNOUNCE POSITIVE RESULTS FOR
VISUDYNE (VERTEPORFIN) THERAPY FOR WET AGE-RELATED
VANCOUVER, CANADA and ATLANTA, GA ? QLT PhotoTherapeutics Inc.
(QLT) and CIBA Vision Corporation?the eye care unit of Novartis
AG?announced today that Visudyne (verteporfin) therapy has been shown
to preserve vision in a significant number of patients with the "wet" form
of age-related macular degeneration (AMD), the leading cause of blindness
among people over the age of 50. These findings are based on an initial
12-month analysis of 24-month pivotal Phase III studies using verteporfin,
now referred to by the brand name Visudyne. The treatment is part of an
emerging new platform technology known as photodynamic therapy and is
being co-developed by QLT and CIBA Vision.
Results of the TAP (Treatment of AMD with Photodynamic therapy)
Investigation, which comprises two randomized, double-masked,
placebo-controlled trials involving 609 patients at 22 centers in North
America and Europe, showed that patients treated with Visudyne therapy
were more likely to have stable vision (defined as a loss of less than 3
lines of vision on a standard eye chart) or improved vision compared to
placebo-treated patients at 12-month follow-up. These results were found
to be statistically significant for each of the two studies, as well as for
the combined data (p=0.0002).
Based on these positive 12-month results, QLT and CIBA Vision anticipate
filing for regulatory approval of Visudyne therapy in the U.S., Canada, and
Europe in 1999.
This study remains ongoing in order to determine longer-term efficacy and
safety. As this therapy is still investigational, only patients who are
currently enrolled in these clinical trials are eligible for treatment at this
"Today's announcement is a significant breakthrough in the efforts to find a
treatment for a widespread disease that has grown into a major public
health concern," said Dr. Neil M. Bressler, Chair of the TAP Study
Advisory Group, and a retinal specialist and Professor of Ophthalmology at
the Wilmer Eye Institute of the Johns Hopkins University School of Medicine
in Baltimore, Maryland.
"We are indebted to the hundreds of patients who are continuing to
participate in these trials and to all the investigators for their efforts in
carrying out such a landmark study. Visudyne therapy offers new hope for
potentially preserving the vision and independence of the hundreds of
thousands of individuals who will be diagnosed with wet AMD each year,"
said Dr. Bressler.
Based on an intent-to-treat analysis, vision was stable or improved in
61.4% of patients treated with Visudyne therapy compared to 45.9% of
patients administered placebo. The difference was statistically significant
for the broad range of patients who were entered into the trials.
Accordingly, patients treated with Visudyne therapy were 34% more
likely to retain their vision compared to the placebo group.
Further, among those patients receiving Visudyne therapy, 16%
experienced an improvement in vision of one or more lines on a standard
eye chart compared to 7% for those patients receiving placebo.
Statistically significant results on the combined data favoring Visudyne
therapy were also obtained for all secondary endpoints, including contrast
sensitivity and lesion growth. Visudyne therapy was more likely to confine
the growth of the lesion as well as maintain contrast sensitivity relative to
patients receiving placebo.
Results also showed that Visudyne therapy was well tolerated, with less
than 2% of patients withdrawing from the study due to adverse events. The
majority of adverse events occurred in similar numbers among the
treatment and placebo groups. Those events that occurred more often with
Visudyne therapy were: reactions at the injection site that occurred in 9%
more treated patients; transient mild to moderate decreased vision that
occurred in 2% more treated patients; and self-resolving photosensitivity
reactions that occurred within 24 hours post-treatment in approximately
2% of treated patients.
It was also shown in the Phase III studies that, with re-treatment, the
effect of Visudyne therapy can be sustained for at least one year. Patients
in the study received an average of 3.4 treatments during the 12-month
A complete analysis of the 12-month results of the TAP Investigation is
currently underway and is expected to be submitted to a peer-reviewed
medical journal and presented at the annual Association of Research in
Vision and Ophthalmology (ARVO) meeting in Fort Lauderdale, Florida,
scheduled for May 9-14, 1999.
Wet AMD is characterized by the formation of abnormal leaky blood
vessels that grow across the central part of the retina, called the macula.
Although the wet form of AMD represents an estimated 15% of all AMD
cases, it accounts for approximately 90% of the severe vision loss
associated with the disease. Worldwide, nearly 500,000 new cases of wet
AMD occur each year. In North America, up to 200,000 new cases develop
annually. These estimates are expected to grow dramatically as the baby
boom population ages.
"It is important to note that, while this is a promising potential new
treatment because of its ability to confine retina damage, this therapy
does not restore vision in eyes that have already been significantly
damaged by AMD," added Dr. Bressler.
"We are extremely excited about these results as they confirm the
potential of Visudyne therapy to satisfy a major unmet need among
patients and eye care professionals," said Luzi von Bidder, President of
CIBA Vision's worldwide Ophthalmics Business Unit. "We are aggressively
completing submissions to appropriate regulatory bodies in the U.S.,
Canada, and Europe to ensure general availability of the therapy in early
The TAP study findings expand on the observations made in prior Phase I/II
studies involving 142 patients, which showed that the selective properties
of Visudyne therapy cause the cessation of leakage by abnormal blood
vessels without harming vision.
"These positive results give me a great deal of personal satisfaction,
knowing that a drug discovered by QLT has the potential to benefit so many
people diagnosed with this devastating condition," said Dr. Julia Levy,
President and Chief Executive Officer of QLT. "This accomplishment
certainly moves QLT closer to achieving our goal of becoming one of the
world's leading biopharmaceutical companies."
In view of the prevalence of AMD and the absence of a satisfactory existing
treatment for most cases, high patient expectations and strong interest
among eye care professionals in this potential new therapy is anticipated.
To help meet the requests for information by patients and eye care
professionals, QLT and CIBA Vision have established a web site and country
specific patient/practitioner information lines where up-to-date
information can be obtained. In North America, the number is
1-800-821-2450 (see attached list for other countries) and the web site
address is www.visudyne.com.
Background on QLT and CIBA Vision:
Visudyne therapy is being co-developed for ocular conditions by QLT
PhotoTherapeutics Inc. and CIBA Vision Corporation. Upon
commercialization, QLT will be responsible for manufacturing Visudyne and
CIBA Vision will market the product worldwide.
Visudyne therapy is protected by a series of U.S. and foreign issued
patents which cover the composition of matter, formulations and
manufacturing, and the method of use in treating AMD and other conditions.
QLT PhotoTherapeutics Inc. is a world leader in the development and
commercialization of proprietary pharmaceutical products for use in
photodynamic therapy, an emerging field of medicine utilizing
light-activated drugs in the treatment of disease. QLT's innovative science
has advanced photodynamic therapy beyond applications in cancer towards
potential breakthrough treatments in ophthalmology and autoimmune
In addition to Visudyne therapy, QLT's portfolio of products include
PHOTOFRIN (porfimer sodium), the world's only approved photodynamic
therapy drug, used in the treatment of various cancers throughout North
America, Japan and Europe.
With worldwide headquarters in Atlanta, Georgia, USA, CIBA Vision is a
global leader in research, development and manufacturing of optical and
ophthalmic products and services, including contact lenses, lens care
products, and ophthalmic pharmaceuticals. CIBA Vision products are
available in more than 70 countries.
CIBA Vision is the eye care unit of Novartis AG, a world leader in Life
Sciences with core businesses in Healthcare, Agribusiness and Consumer
Health (Self-Medication and Nutrition). In 1997, Novartis Group sales were
31.2 billion Swiss francs, of which 17.0 billion were in Healthcare, 8.3
billion in Agribusiness and 5.9 billion in Consumer Health. The group
annually invests more than 3.6 billion Swiss francs in R&D. Headquartered
in Basel, Switzerland, Novartis employs about 86,000 people and operates
in over 100 countries around the world.
Visudyne is a trademark of Novartis AG.
MINERAL WATERS/KIDNEY STONES:
S Afr Med J 1998 Apr;88(4):448-451 The influence of South African mineral water on reduction of riskof calcium oxalate kidney stone formation.Rodgers ALDepartment of Chemistry, University of Cape Town. OBJECTIVES: This study was undertaken to identify a South African mineral water containing relativelyhigh concentrations of calcium and magnesium and to investigate its effect on urinary biochemical andphysicochemical risk factors associated with calcium oxalate kidney stone formation. DESIGN: The studyfollowed a change-over design in which each subject followed a randomised sequence of threewater-drinking protocols involving their normal diet, a calcium and magnesium-rich mineral water and amineral water deficient in these elements. SETTING: University of Cape Town. SUBJECTS: 54 volunteerswithout any previous history of stone disease (27 men, 27 women) in the age group 21-35 years and 31with a history of calcium oxalate kidney stones (24 men, 7 women) in the age group 25-45 yearsparticipated in the study. OUTCOME MEASURES: Both mineral waters favourably altered several riskfactors. However, the effect of the calcium- and magnesium-rich water was shown to be significantlygreater as it altered a larger number of these factors and induced several unique changes that were notachieved by the other water. CONCLUSIONS: The risk of calcium oxalate stone formation can besignificantly reduced by consumption of mineral water which is rich in calcium and magnesium.
Most recent update September 25, 1997
Kidney stones and mineral water A Medline Abstract appears below.
Effect of mineral water containing calcium and magnesium on calcium oxalate urolithiasis risk factors.
Department of Chemistry, University of Cape Town, South Africa. ***@**** Urol Int 1997;58(2) :93-9 Unique Identifier: 97250414
Abstract: Calcium oxalate kidney stone formers are invariably advised to increase their fluid intake. In addition, magnesium therapy is often administered. Recently, a prospective study showed that a high dietary intake of calcium reduces the risk of symptomatic kidney stones. The present study was performed to test whether simultaneous delivery of these factors--high fluid intake, magnesium ingestion and increased dietary calcium--could reduce the risk of calcium oxalate kidney stone formation. A French mineral water, containing calcium and magnesium (202 and 36 ppm, respectively) was selected as the dietary vehicle.
Twenty calcium oxalate stone-forming patients of each sex as well as 20 healthy volunteers of each sex participated in the study. Each subject provided a 24-hour urine collection after ingestion of mineral water over a period of 3 days; after a suitable rest period the protocol was repeated using local tap water (Ca: 13 ppm, Mg: 1 ppm).
In addition, 24-hour urines were collected by each subject on their free diets. The entire cycle was repeated at least twice by each subject. Several risk factors (excretion of oxalate; relative supersaturations of calcium oxalate, brushite and uric acid; calcium oxalate metastable limit; oxalate:magnesium ratio and oxalate:metastable limit ratio) were favourable altered by the mineral water and tap water regimens but the former was more effective.
In addition, the mineral water protocol produced favourable but unique changes in the excretion of citrate and magnesium as well as in the relative supersaturation of brushite which were not achieved by the tap water regimen. To the contrary, tap water produced an unfavourable change in the magnesium excretion.
The group which benefitted most were male stone formers in whom 9 risk factors were favourably altered by the mineral water protocol.
It is concluded that mineral water containing calcium and magnesium, such as that used in this study, deserves to be considered as a possible therapeutic or prophylactic agent in calcium oxalate kidney stone disease.
Urol Int 1998;60(2):105-107
Magnesium hydrogen carbonate natural mineral water enriched withK(+)-citrate and vitamin B6 improves urinary abnormalities inpatients with calcium oxalate nephrolithiasis.
Bren A, Kmetec A, Kveder R, Kaplan-Pavlovcic SDepartment of Nephrology, University Medical Center, Ljubljana, Slovenia. Andrej.***@****-lj.si
The influence of drinking magnesium hydrogen carbonate natural mineral water enriched with potassiumcitrate on urinary metabolic abnormalities was prospectively studied in 27 patients with recurrentcalcium oxalate nephrolithiasis. The mean 24-hour urinary pH shifted from 6.34 to 6.93 (p < 0.01), themean urinary magnesium/urinary creatinine ratio rose from 0.47 to 0.67 (p < 0.01), the mean urinarycitrate/urinary creatinine ratio increased from 0.26 to 0.35 (p NS), and the mean 24-hour urinarycalcium decreased from 7.98 to 6.05 mmol (p < 0.05). The effects of magnesium hydrogen carbonatenatural mineral water enriched with potassium citrate were found to be favorable on urinary calcium,urinary magnesium/urinary creatinine ratio and urinary pH in patients with calcium oxalatenephrolithiasis.
Stanley Gershoff, Ph.D., professor of nutrition and dean
emeritus at Tufts University School of Nutrition in Medford,
In a study that Dr. Gershoff did years ago, 149 people who
had had at least two stones annually for five years saw their
stone formation drop dramatically when they started taking
300 milligrams of magnesium a day. (They also took 10
milligrams of vitamin B6 a day, which is discussed below.)
The people were followed for 4 1/2 to 6 years. Over 90
percent had no stones during that period, Dr. Gershoff says.
Only 12 people continued to make stones, but with much less
frequency, he adds. "I think magnesium is definitely worth a
try," he says.
Studies also show that magnesium-deficient animals are
more likely than normal to develop calcium oxalate crystals
in their kidneys, making stones more likely.
In Dr. Gershoff's studies, urine from people taking
supplemental magnesium was capable of holding more than
twice as much calcium oxalate in solution compared with
urine from people not taking magnesium. This finding held
even when the pH and the amount of calcium in the urine were
adjusted so that they were exactly the same for both groups.
"Magnesium helps prevent calcium oxalate from
crystallizing, although exactly how it does that isn't known,"
Dr. Gershoff says. One theory, that magnesium competes with
calcium to bind with oxalate and forms a soluble compound
that can be excreted from the body, is intriguing but not
proven, Dr. Gershoff says.
He recommends that anyone who has passed a calcium
oxalate stone take 300 milligrams of supplemental
magnesium a day. "That amount worked just fine in our
study," he says. Some other doctors recommend taking 400
to 500 milligrams daily.
Studies show that most men get about 329 milligrams a day
and most women get about 207 milligrams a day through
Stick to the lowest dose that works for you and get medical
supervision, especially if your kidneys have been damaged
or if you have a heart problem, Dr. Gershoff says.
Minerva Med 1987 Dec 31;78(24):1823-1829 [Prevention of the recurrence of urinary lithiasis: mineral waterswith high or low calcium content]?[Article in Italian] Sommariva M, Rigatti P, Viola MRIstituto di Ricovero e Cura a Carattere Scientifico Ospedale S. Raffaele, Milano. The influence of a calcium-rich mineral water on urine crystallisation in patients with recurring kidneystones was investigated. A calcium and magnesium rich water like the one tested increases the calciumand magnesium content of the urine but decreases oxaluria even after a dietary oxalate load.
found this at, http://www.aceology.com/med/mpost/calcium.htm
Comparison of Dietary Calcium with Supplemental Calcium (Calcium Pills) and otherNutrients as FactorsAffecting the Risk for Kidney Stones in Women This is a study looking at the relationship between dietary intake of Calcium versusSupplemental Calcium ( Calcium Pills )and risk of kidney Stones. The study is based on the Nurses Health Study I involving91,731 women who were at the ages of34 to 59 in 1980 and had no previous history of kidney stones.The authors looked at the "self-administered food-frequency questionnaires" toassess the dietary intake in 1980, 1984,1986, and 1990 as well as occurance of kidney stones.They found that high intake of dietary calcium such as that with dairy products wasassociated with decrease risk ofkidney stones while supplemental Calcium ( Calcium Pills) was associated withincreased risk of Kidney Stones.Annals of Internal Medicine, April 1, 1997.PMID: 9594989, UI: 98257345