Alkalizing urine is a process of voluntary modification of the pH of the renal filtrate, and therefore of the blood; it is fundamental to try to alkalize the urine if metabolic acidosis is established, a condition unfavorable to organic homeostasis induced by the excessive presence of acid molecules.
Medical Aspects
Importance of urine alkalinization in the medical field
Alkalizing literally means "making alkaline / basic", that is, a chemical process that increases the pH of a solution; in the case of urine, pharmacological research has experimented with various active ingredients that allow for variations in the filtrate ranging from 5 to 8.5 (where the neutral is 7). Among these molecules, the most used are undoubtedly carbonic anhydrase inhibitors (diuretics); they act by preventing the reabsorption of bicarbonate and find their application in the buffer of pharmacological overdoses facilitating urinary excretion. Citrates are also very widespread, which are directly expelled, preventing the crystallization-precipitation of drugs and thus preventing kidney stones; other isomers enter the Krebs cycle, are converted to bicarbonates and indirectly alkalize the pH of the urine. Citrates also perform a mild antibacterial and anti-inflammatory function.
The disease that most frequently needs to alkalize urine is urate stones, typical of hyperuricosuric patients; fortunately this disorder can completely regress with the sole association of alkalis and acetazolamide (to be avoided in hypercalciuric subjects).
Alkalinizing urine is a fundamental procedure also in the prevention of complications induced by antineoplastic chemotherapy with high doses of methotrexate (antimetabolite). In this case, strict monitoring of the parameters of renal function and blood concentration of the drug is necessary, but without neglecting the maintenance of the state of hydration and the alkalinization of the urine. The most suitable alkalizing agents are: acetazolamide and bicarbonate infusion.
Health aspects
Alkalinize urine in healthy subjects
Evaluation of urine pH is a useful tool for monitoring the body's acid-base balance, however, it is essential to point out that pathological changes in blood pH are more easily identified due to the severity of the symptoms related to them (collapse, coma and death). In contrast, small changes in the urine pH are normal and absolutely harmless, and represent the highly effective kidney blood purification system. In physiological conditions, the buffer system and glomerular filtration are perfectly able to comply with the maintenance of the acid-base balance, provided that the organism is constantly supported by a BALANCED FOOD REGIME. It provides:
- Correct supply of water equal to 1ml / kcal of energy introduced and adapted to the subject's sweating
- Correct supply of mineral salts and trace elements, especially from vegetables and fruit
- Limitation of the protein excess and the relative nitrogen accumulation
- Stimulation of the keto-acidosis induced by a diet of carbohydrate discharge
- Limitation of alcohol and coffee
In the case of mild acidosis induced by an inappropriate diet, trying to alkalize the urine is essential; this preventive measure, in the long term, makes it possible to reduce a "probable and probable" risk factor for numerous degenerative pathologies: arthrosis, osteoporosis, etc.
It is possible to monitor the pH trend of the urine through a detection technique repeated 3 times a day for 7 days using simple litmus paper found in all pharmacies. The arithmetic mean of the 21 detections corresponds to the relative degree of acidity of the urine.
Bibliography:
- Manual of clinical nutrition. MediCare - by Rosalba Mattei - FrancoAngeli - page 257
- Oncological medicine. Eighth Edition - G. Bonadonna, G. Robustelli della Cuna, P. Valagussa - Elsevier Masson - chap. 63 - pag. 1766
- Pharmacology. Sixth Edition - Humphrey P. Rang, M. Maureen Dale, ames M. Ritter, Rod J. Flower - Elsevier Masson - pag 383.
