This is a single-arm, pretest-posttest study evaluating the effects of a 21-day comprehensive spa care (Komplexní lázeňská léčebně rehabilitační péče, KLP) on patients with nephrological and urological conditions treated at a spa facility in Mariánské Lázně, Czech Republic. The study enrolls 150 adult patients (75 men and 75 women), aged 40-70 years, who are prescribed KLP for indications VIII/1 (recurrent and chronic non-tuberculous inflammation of the kidneys and urinary tract), VIII/2 (nephrolithiasis without urinary tract obstruction, nephrocalcinosis), VIII/3 (conditions after kidney and urinary tract surgery), and VIII/4 (chronic prostatitis or prostatovesiculitis resistant to pharmacological treatment). The spa treatment consists of the use of natural healing resources of Mariánské Lázně, including a mineral spring drinking cure, balneotherapy (mineral water baths), peloid therapy, carbon dioxide therapy, climatotherapy, exercise therapy, and dietotherapy. The standard treatment duration is 21 days, during which each patient receives a total of 63 therapeutic procedures and drinks mineral spring water three times daily. Patients undergo assessments at the beginning (days 1-3) and at the end (days 19-21) of their treatment. Assessments include physical examination, abdominal and urinary tract ultrasound, blood and urine sampling with laboratory analysis, body composition measurement using bioelectrical impedance analysis (InBody), and psychometric questionnaire surveys. The primary aim of the study is to objectively assess the therapeutic effect of comprehensive spa care on nephrological and urological diseases by comparing pre-treatment and post-treatment clinical, laboratory, and patient-reported outcomes. The study was approved by the Ethics Committee of the University Hospital and Faculty of Medicine in Pilsen (decision of November 2, 2023, ref. no. 437/23).
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Change in serum creatinine level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in serum cystatin C level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in eGFR calculated by CKD-EPI EKFC equation from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in serum sodium level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in quantitative microbiological urine culture results from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in serum uric acid level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in serum potassium level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in serum calcium level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)
Change in serum phosphorus level from baseline to day 21
Timeframe: Baseline (day 1-3) and end of treatment (day 19-21)