Alkalizing the urine is a process of voluntary modification of the pH of the renal filtrate, and therefore of the blood one ; it is essential to try to alkalize the urine if metabolic acidosis sets in , a condition unfavorable to organic homeostasis induced by the excessive presence of acid molecules. These can be of exogenous or endogenous origin as well as different in nature and function, but they all have the ability to alter the acid-base balance of the organism.
Medical aspects
Importance of urine alkalization in medicine
Alkalize literally means “to make 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 principles which allow to obtain variations of the filtrate which vary from 5 to 8.5 (where the neutral is 7). Among these molecules, the most used are undoubtedly the carbonic anhydrase inhibitors ( diuretics ); they act by preventing the reabsorption of the bicarbonate and find application in the buffering of pharmacological overdoses by facilitating their urinary excretion. Citrates are also very widespread , which are expelled directly, preventing the crystallization-precipitation of the drugsand consequently preventing kidney stones ; other isomers enter the Krebs cycle , are converted into bicarbonates and indirectly alkalize the pH of the urine . Citrates also perform a mild antibacterial and anti-inflammatory function.
The pathology that most frequently requires alkalizing the urine is urate stones , typical of hyperuricosuric patients ; fortunately this disorder can completely regress with the sole association of alkali and acetazolamide (to be avoided in hypercalciuric subjects ).
Alkalizing the urine is also a fundamental procedure in preventionof complications induced by antineoplastic chemotherapy at HIGH doses of methotrexate (antimetabolite). In this case, strict control 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 alkalization of the urine. The most suitable alkalizing agents are: acetazolamide and bicarbonate infusion .
Health aspects
Alkalize 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 identifiable due to the severity of the symptoms related to them ( collapse , coma and death). On the contrary, small variations in urine pH are normal and absolutely harmless, and represent the highly effective blood purification system performed by the kidneys. Under physiological conditions, the buffer system and glomerular filtrationthey are perfectly capable of complying with the maintenance of the acid-base balance, provided that the body is constantly supported by a BALANCED DIETARY REGIME . It provides:
- Correct intake of water equal to 1ml/kcal of energy introduced and adapted to the perspiration of the subject
- Correct intake of mineral salts and trace elements , especially from vegetables and fruit
- Limitation of protein excess and the relative azotemic accumulation
- Prevention of keto-acidosis induced by a carbohydrate -restricted diet
- Limitation of alcohol and coffee
In case of mild acidosis induced by an inappropriate diet, attempting to alkalize the urine is essential; this preventive measure, in the long term, allows to reduce a “probable and probable” risk factor for numerous degenerative pathologies: osteoarthritis , osteoporosis , etc.
It is possible to check the urine pH trend through a detection technique repeated 3 times a day for 7 days by using simple litmus paper available in all pharmacies. The arithmetic mean of the 21 readings corresponds to the relative degree of acidity of the urine.
