Introduction: The consumption of alkaline water, an electrolyzed mineral water with an average pH of 8-10, has been steadily increasing globally as proponents claim it to be a healthier alternative to tap water. Urinary alkalinization therapy is frequently prescribed in patients with uric acid nephrolithiasis but given low compliance there has been interest in alkaline water as a potential therapeutic alternative. For any fluid to have an alkalinizing effect on urine, it must contain organic anions such as citrate and bicarbonate. We analyzed five commercially available alkaline water products to assess their electrolyte and organic anion composition. Methods: Five commercially available alkaline water brands (Essentia®, Smart Water® Alkaline, Great Value™ Hydrate Alkaline Water, Body Armor® SportWater, and Perfect Hydration®) were subjected to anion chromatography, acid titration, and direct chemical measurements to determine the mineral contents of each product. The alkali content of each brand of alkaline water was then contrasted with the alkali content of potassium citrate, sodium bicarbonate and other over the counter organic and synthetic beverages. Results: The pH levels of the five alkaline waters ranged from 9.69-10.15; however, the electrolyte content was minimal, and the physiologic alkali content was <1 mEq (Table 1). The alkali content of all five brands of alkaline water was considerably lower than potassium citrate, sodium bicarbonate, and other common over the counter organic and synthetic beverages (Table 2). Conclusions: For uric acid stone patients, commercially available alkaline water has negligible alkali content and thus would likely provide no added benefit over consumption of an equal volume of tap water. SOURCE OF Funding: None.
