Are medicines containing magnesium able to reduce the risk urolithiasis of recurrence?

Golovanov S.A., Sivkov A.V.

Using of magnesium medications in anti-relapse treatment of calcium urolithiasis is still in the center of urologists' debates. Recurrent calcium urolithiasis is often characterised by hyper excretion of magnesium in urine, which however is not a protective feature referring to calculi relapse, as far as in these patients have more severe recurrence clinical manifestation. Oversaturation of urine towards calcium oxalate in patients with recurrent calcium oxalate is commonly lower, and towards hydroxyapatite is higher than in normal. It's supposed that hydroxyapatite crystals are able to induce heterogeneous nucleation of calcium oxalate crystals, promoting further growth of crystals and calculi formation this way. This fact indicates on a participation of other mechanisms in pathogenesis of recurrent calculi formation, that are not connected directly with concentration of magnesium in urine and needs further investigation. Publications analysis witnesses increase of calciuria under the influence of magnesium medications (magnesium oxide, magnesium hydroxide, magnesium citrate) as a monotherapy in patients with calcium calculi. Combination of these medications with potassium citrate stimulates urine alkalization and decreases the undesirable effect of hypercalciuria. That's why in choosing of clinical tactics it's preferable to recommend magnesium medications not as a monotherapy, but in combination with pyridoxine, potassium citrate, alkali and / or thiazide diuretics. Such schemes of calcium metaphylaxis are to be the objective of further clinical trials.