SODIUM CHLORIDE WATERS OF MAXAQUA WATER DEPOSIT AND THEIR EFFICIENCY IN TREATMENT OF RENAL DISEASES
Branch of Regional Geology and Hydrogeology, Amur Scientific Centre Far Eastern Branch of the Russian Academy of Sciences ( FEB RAS), Municipal Health Care facility Clinical Hospital №3, Blagoveshchensk
Considered are the materials on the application of mineral sodium chloride water for treatment of patients suffering from the renal diseases. The research was conducted at the Nephrology Department of the Municipal Clinical Hospital №3 of the town of Blagoveshchensk. The obtained data are indicative of the clinical efficiency of the MAXAQUA mineral water in a combined treatment of the oxalate nephropathy.
The basis of many pathological processes in the body, particularly at the kidney and urinary tract disorders, parallel with the inflammatory ones, is the metabolic pattern of violations. As the trigger factors predisposing to the origin of the oxalic acid metabolism violation serve the adverse ambient conditions, infectious diseases and nerve stress.
Oxalate nephropathy is the multifactorial pathology related to the oxalate metabolism violation at the familial renal cytomembrane instability manifesting as the isolated urine syndrome accompanied with the calcium oxalate crystalluria, tubular disfunction progressing from the tubular alterations towards the tubulointerstitial nephritis and urolithiasis . According to the research data, the prevalence rate of calcium oxalate crystalluria in Amur Region is 210,8 per 1000 population and that one of the oxalate nephropathy is 100,8 per 1000 population, while there is a tendency to an increase in number of patients with this pathology . Thus, the search for the new and effective methods of prevention and treatment of oxalate nephropathy is the urgent problem of practical medicine. The efficacy of mineral waters at various dismetabolic kidney diseases has long been known, what is proved by numerous scientific studies, but it is fully valid only for the great deal of waters of the North Caucasus whereas the mineral waters in other regions have been studied to a much lesser extent. This fully applies to the mineral waters of Amur Region.
In the territory of Amur Region revealed and in various details studied are up to 20 manifestations of mineral waters of different mineralization grade, temperature, gas and ionic composition. The most widely represented among them in the northern districts are cold carbonated waters and to a lesser degree – nitrogen-siliceous thermae. In the southern areas there are chalybeate waters. Of narrow local prevalence are sodium chloride waters and mineral waters with high organic carbon contents. With respect to the balneology, it is evident that the Amur Region disposes of the most varied and valuable types of mineral waters. Due to the collapse of the USSR Russia has lost much of medical resources, including mineral waters, in Caucasus, in the Ukraine, in the Baltic States, in Moldova, Kirgizia and in others.
Considering the current economic situation in the country it becomes apparent that the development of the Sanatorium Health Resort base of the region and of the entire Far-Eastern economic region is possible and promising only at the expense of the local mineral water resources that are capable to provide a wide range of SPA treatment.
However, in spite of numerous water manifestations, the finished objects for the industrial exploitation where the hydrogeological work is completed and the mineral water storage is assessed, are two deposits only: “Gonzhinskoye” of carbonated waters and MAXAQUA represented by two plots - “The Central” and “The Southern” one disclosing sodium chloride waters and waters with a high content of organic carbon. At the first of them there runs a balneary with 100 beds where the carbonated mineral waters are both for external and internal use providing treatment for gastrointestinal tract, joint and other diseases. There is no balneary at the second deposit.
In recent years there is a considerable interest among the population and the doctors in the mineral water of MAXAQUA deposit which is being disclosed via the boreholes 2990 and 2900 AT in the village of Konstantinovka on the bank of the river Amur. The mineral waters are of pressured nature, isolated from the overlying horizons by clays, overlain from the surface area with an impermeable aquitard that prevents the pollutants penetration from the surface area. Mineral waters are of abyssal origin and are related to the major regional faults having the continuation in China. Mineral water storage is assessed in the amount of 60 m³ per day . In accordance with the current classification  the mineral waters refer to the cold ones (8°C), slightly mineralized (1,5 -1,6 g/dm³), sodium chloride, alkalescent (pH=7,6-8,2). Of the micronutrients present in the water are ( in mg/dm³): lithium 0,05-0,07, strontium 0,5-0,6, aluminum 0,03-0,04, manganese 0,03-0,04, copper 0,004-0,006, cobalt 0,005-0,008, nickel < 0,02, lead 0,003-0,005, zinc 0,02- 0,025, cadmium < 0,0005, chrome 0,005-0,01, molybdenum 0,00025, fluorine 0,1-0,2, bromine 1,0-3,3, iodine 0,1-0,6, iron (total) 0,1-1,5. Silicic acid content ranges from 18 to 24 mg/dm³.
Predominated in MAXAQUA mineral water gases are helium and methane, carbon dioxide and nitrogen are marked in smaller amount. The mass concentration of toxic and standardized micronutrients, nitrogen compounds (nitrites, nitrates, ammonium), radionuclides is below the ACL for drinking mineral waters. The organoleptic and microbiological indicators comply with the regulatory requirements.
In accordance with GOST 13273-88 “Drinking medicinal and medicinal-table mineral waters” belong to the XXVII group of Myrhorod water type sodium chloride waters. On the conclusion of the Russian Scientific Center for Restorative Medicine and Balneology (RSC RMB) they can be used for water therapy in the Health and Leisure Institutions as well as in the industrial bottling. Medical indications for the intake of mineral water out of the borehole 2990 are:
- chronic gastritis with normal and low gastric secretory function
- chronic colitis and enterocolitis
- chronic diseases of liver and biliary tract
- chronic pancreatitis
- metabolic diseases: diabetes, urune acid diathesis,obesity, oxaluria, phosphaturia
- chronic urinary tract diseases.
In a bottled form this water is produced under the trademark MAXAQUA. The objective of our research was to study the efficacy of the MAXAQUA mineral water in treatment of oxalate nephropathy.
MATERIALS AND METHODS
The clinical and experimental study of sodium chloride mineral water MAXAQUA efficacy in treatment of patients affected by nephropathy was conducted at the Nephrology Department of the Municipal Clinical Hospital №3 of the town of Blagoveshchensk. A total of 200 patients with history aged of 18-40 years were examined. The diagnosis was confirmed by urinalysis and renal ultrasonography. The patients under investigation were divided into two groups each of 100 persons- the main group and the control one. In the main group the MAXAQUA mineral water was prescribed in addition to the traditional treatment including dietary and complex therapy. Still mineral water of room temperature (18-20°C) was taken by the patients 20 minutes before meals 3 times a day in the amount of 200 ml ( it is an accepted method for calculating the dose on the patient’s body mass: up to 10 ml per 1 kg of body weight at the urogenital diseases). The patients in control group received boiled drinking water in a dose of 200 ml 3 times a day.
RESULTS AND DISCUSSION
Large interlinked crystals in amount of more than 20-25 within eyeshot were determined in 10% of patients in both main and control group before treatment. The average index was 24±3,2 ( while the norm is 10-12). The increase of diurnal urinary calcium was registered in 12 % of the patients under investigation. The average indices were 4,5±0,24 µmol/l per day. The increase of daily oxalate excretion in urine up to 151±10,25 µmol/l per day was observed in all patients . When on kidney ultrasonography in 100% of cases there were registered the typical for the oxalate nephropathy alterations as multiple linear shadows up to 4 mm with no acoustic track. Following the treatment the appreciable improvement in health, which resulted in good spirits and increased capacity for work, was noted in the main group of patients. In 51% of patients the pronounced balneological response was observed after 3-4 days treatment. There occurred the intensifying pains in the lumbar area, the sensation of heaviness, frequent urination, gripes. The urine reaction shifted from acid to alkaline. Toward the 18-th day of the MAXAQUA water application the daily oxalate excretion in the main group reliably decreased to 123±3,9 µmol/l per day (p<0,05). On average the daily urine output increased by 300±50 ml a day. On qualitative assessment of renal ultrasonography notable differences between the groups were revealed. The application of mineral water resulted in disappearance of microlites in pyelocaliceal renal system. The above mentioned indices in patients of the control group remained unchanged. Positive results were also obtained previously from 1998 to 2000 at the Urology Department of the Amur Regional Hospital when evaluating efficiency of the MAXAQUA mineral water at the urolithiasis.
The use of sodium chloride MAXAQUA mineral water has a positive effect in combined treatment of the oxalate nephropathy as evidenced by clinical and laboratory data.
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