What water should I drink, Doc?

• Autor(a) principal: Silva,Rui F.
• Data de Publicação: 2019
• Outros Autores: Beco,Ana, Marques,Sofia
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692019000300003
• topic: chronic kidney disease; metabolic acidosis; water

Chronic kidney disease (CKD) is commonly associated with normal anion gap metabolic acidosis and its correction has shown multiple benefits, such as improved bone health and nutritional status, a slower progression of CKD and a lower incidence of end-stage renal disease. Kidney Diseases Improving Global Outcomes 2013 recommend maintaining serum bicarbonate concentration in the normal range (≥ 22mEq/L), which is usually accomplished by using a starting dose of 0.5 - 1mEq/kg/day of bicarbonate supplements. Nutritional strategies incorporating base-producing fruits and vegetables might show equal value. In this context, we analyzed the ingredients instead of labels of widely sold bottled water in Portugal to identify the most bicarbonate-rich bottled water which might help mitigate the complications of CKD chronic metabolic acidosis. We included 32 varieties of bottled water sold in Portuguese supermarkets. If a 70kg-adult is advised to ingest a bicarbonate dose of 0.5 - 1 mEq/kg/day, this amount could be supplied by 1 - 2 liters of Frize® per day, approximately the same as in Pedras Salgadas® and Vidago® (1.1 - 2.2 liters). We concluded that, along with nutritional strategies addressing dietary H+ reduction, Portuguese CKD patients with chronic metabolic acidosis could benefit from drinking water brands such as Frize®, Pedras Salgadas® or Vidago®.