A content analysis of 'Water Apps' and prevention of urological diseases: Do apps really help?

INTRODUCTION: Maintaining hydration reduces incidence of kidney stone disease (KSD), chronic kidney disease (CKD) and urinary tract infections (UTIs). Mobile applications (apps) measuring hydration are gaining in usage, allowing users to monitor intake whilst also taking into account the signs and symptoms of dehydration. Our study looked at the water apps in the management and/or prevention of urological disease. MATERIAL AND METHODS: The original android app store (Google Play Store), and the Apple App Store (iOS App Store) were searched using the term 'hydration', 'fluid' and 'water'. All apps from each distribution platform, with a minimum of 100 reviews, were then selected and analysed. RESULTS: After identification of 51 applications (13 from Apple App Store, and 38 from Google Play Store), 45 were free to download and 6 were paid (cost range: $2.19-$7.97). While none of the apps facilitated measurement of urine output and colour, 12 mentioned signs and symptoms of dehydration. Furthermore, when calculating required fluid intake, the level of activity was considered by 31 apps. With regards to information provision, only one of the apps included advice or education about urological conditions associated with poor hydration. None of the apps gave advice on hydration related to CKD and UTI. CONCLUSIONS: Mobile phone apps are a well-established tool for measuring fluid intake. However, they provide little information regarding the importance of hydration, and don't utilise other measures such as level of activity, urine output or colour. Considering the increasing popularity of fitness and hydration apps in our daily lives, the developers need to make them more comprehensive and informative.

The role of fluid intake in the prevention of kidney stone disease: A systematic review over the last two decades.

OBJECTIVE: The incidence of kidney stone disease (KSD) is rising worldwide; hence, more focus must be directed toward its etiology and risk factors. Increasing fluid intake is recommended as the most ideal prevention; yet, there is inconsistent evidence surrounding optimum volumes and types of fluid that affect stone formation. This review aimed to analyze the published literature on fluid intake and types of fluid consumed and their impact on KSD prevention. MATERIAL AND METHODS: Papers were acquired from databases: MEDLINE, EMBASE, PubMed, CINAHL, and Cochrane Library. Included English language studies that involved adults consuming beverages along with a standardized diet in relation to KSD. Those failing to control dietary factors were excluded. RESULTS: After an initial search of 1099 papers, 9 (541 participants) were included in the final review. Six varieties of water and ten different types of juices were investigated. Higher fluid intake was associated with increased urine output and reduced stone formation. Water with high calcium content seemingly increased the rate of calcium oxalate (CaOx) stone formation. The relative supersaturation of CaOx in urine was decreased with grapefruit, apple, orange juices, and sodas, whereas cranberry juice increased it. Plum juice and the energy drink Gatorade had no effect on stone formation. CONCLUSION: Fluids low in calcium seem to reduce the risk of KSD. Certain varieties of fluid, such as grapefruit, apple, and orange juices reduce urine CaOx saturation, with a subsequent reduction in stone formation. Findings from this review could contribute to primary prevention for those at risk of KSD.

Which Type of Water Is Recommended for Patients with Stone Disease (Hard or Soft Water, Tap or Bottled Water): Evidence from a Systematic Review over the Last 3 Decades.

PURPOSE OF REVIEW: The role of the mineral constituents in water and their role in kidney stone disease (KSD) have been a long-standing subject of debate. The aim of our systematic review was to evaluate the relevance of different types of water in stone disease. RECENT FINDINGS: Studies to date have had varying results regarding the importance of hardness of water which is mostly determined by its calcium content. Other elements including magnesium and bicarbonate also play a crucial role in prevention of renal stones. Patients with stone disease are provided varying advice due to a lack of consensus on the types of water recommended. Increased fluid intake prevents stone formation. Our review of the literature suggests that hard water and bottled mineral water might be helpful for calcium stone formers. High calcium content in them leads to hypercalciuria; however, other factors also influence stone formation and the overall impact seems to be a reduction in calcium stone formation. The mineral content varies across different water types but high magnesium and bicarbonate content in water is also recommended for kidney stone patients.