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Dietary Manipulation With Lemonade to Treat Hypocitraturic Calcium Nephrolithiasis

1996; Lippincott Williams & Wilkins; Volume: 156; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(01)65659-3

1527-3792

Marc Seltzer, Roger K. Low, Michael W. McDonald, Gina S. Shami, Marshall L. Stoller,

Metabolism and Genetic Disorders

No AccessJournal of UrologyClinical Urology: Original Article1 Sep 1996Dietary Manipulation With Lemonade to Treat Hypocitraturic Calcium Nephrolithiasis Marc A. Seltzer, Roger K. Low, Michael McDonald, Gina S. Shami, and Marshall L. Stoller Marc A. SeltzerMarc A. Seltzer , Roger K. LowRoger K. Low , Michael McDonaldMichael McDonald , Gina S. ShamiGina S. Shami , and Marshall L. StollerMarshall L. Stoller View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65659-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Pharmacological treatment of hypocitraturic calcium nephrolithiasis requires as many as 12 tablets, or numerous crystal packages or liquid supplements taken throughout the day. In addition to added cost, this cumbersome regimen decreases patient compliance, which may increase stone recurrence rates. We evaluated the urinary biochemical effects of dietary citrate supplementation in hypocitraturic calcium stone formers in an attempt to decrease or eliminate the need for pharmacological therapy. Materials and Methods: A total of 12 patients who were either noncompliant with or intolerant of pharmacological citrate therapy supplemented their routine diet with citrate in the form of lemonade, consisting of 4 ounces of reconstituted lemon juice (5.9 gm. citric acid) mixed with tap water to a total volume of 2 1. and consumed at uniform intervals throughout the day. Urine specimens (24-hour) were obtained for biochemical analysis after 6 days of lemonade therapy and compared to pre-lemonade baseline values. Results: Of the 12 patients 11 had increased urinary citrate levels during lemonade therapy (average 204 mg. per day). Average levels increased from 142 mg. daily (range less than 10 to 293) at baseline to 346 mg. daily (range 89 to 814) after treatment (p less than 0.001). Daily total urinary volumes were similar (2.7 versus 2.9 1.). Seven of 12 patients became normocitraturic while consuming lemonade. Urinary calcium excretion decreased an average of 39 mg. daily, while oxalate excretion was unchanged. The lemonade mixture was well tolerated. Two patients complained of mild indigestion that did not require cessation of therapy. Conclusions: Citrate supplementation with lemonade increased urinary citrate levels more than 2-fold without changing total urinary volume. Lemon juice, which contains nearly 5 times the concentration of citric acid compared to orange juice, is an inexpensive and well tolerated dietary source of citrate. Lemonade therapy may improve patient compliance, and may be useful as adjunctive treatment for patients with hypocitraturic calcium nephrolithiasis. References 1 : Citrate in daily and fasting urine: results of controls, patients with recurrent idiopathic calcium urolithiasis, and primary hyperparathyroidism. Invest. 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Link, Google Scholar From the Department of Urology, University of California, San Francisco, California.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAssimos D (2019) Re: The Effect of Lemonade and Diet Lemonade upon Urinary Parameters Affecting Calcium Urinary Stone FormationJournal of Urology, VOL. 201, NO. 5, (853-853), Online publication date: 1-May-2019.Tasian G, Kabarriti A, Kalmus A and Furth S (2016) Kidney Stone Recurrence among Children and AdolescentsJournal of Urology, VOL. 197, NO. 1, (246-252), Online publication date: 1-Jan-2017.Sorensen M, Hsi R, Chi T, Shara N, Wactawski-Wende J, Kahn A, Wang H, Hou L and Stoller M (2014) Dietary Intake of Fiber, Fruit and Vegetables Decreases the Risk of Incident Kidney Stones in Women: A Women's Health Initiative ReportJournal of Urology, VOL. 192, NO. 6, (1694-1699), Online publication date: 1-Dec-2014.Tasian G and Copelovitch L (2014) Evaluation and Medical Management of Kidney Stones in ChildrenJournal of Urology, VOL. 192, NO. 5, (1329-1336), Online publication date: 1-Nov-2014.Pearle M, Goldfarb D, Assimos D, Curhan G, Denu-Ciocca C, Matlaga B, Monga M, Penniston K, Preminger G, Turk T and White J (2014) Medical Management of Kidney Stones: AUA GuidelineJournal of Urology, VOL. 192, NO. 2, (316-324), Online publication date: 1-Aug-2014.Eisner B, Asplin J, Goldfarb D, Ahmad A and Stoller M (2010) Citrate, Malate and Alkali Content in Commonly Consumed Diet Sodas: Implications for Nephrolithiasis TreatmentJournal of Urology, VOL. 183, NO. 6, (2419-2423), Online publication date: 1-Jun-2010.Eisner B, Porten S, Bechis S and Stoller M (2010) The Role of Race in Determining 24-Hour Urine Composition in White and Asian/Pacific Islander Stone FormersJournal of Urology, VOL. 183, NO. 4, (1407-1411), Online publication date: 1-Apr-2010.Khan A, Housami F, Melotti R, Timoney A and Stickler D (2010) Strategy to Control Catheter Encrustation With Citrated Drinks: A Randomized Crossover StudyJournal of Urology, VOL. 183, NO. 4, (1390-1394), Online publication date: 1-Apr-2010.Kang D, Sur R, Haleblian G, Fitzsimons N, Borawski K and Preminger G (2018) Long-Term Lemonade Based Dietary Manipulation in Patients With Hypocitraturic NephrolithiasisJournal of Urology, VOL. 177, NO. 4, (1358-1362), Online publication date: 1-Apr-2007.Gürocak S and Küpeli B (2018) Consumption of Historical and Current Phytotherapeutic Agents for Urolithiasis: A Critical ReviewJournal of Urology, VOL. 176, NO. 2, (450-455), Online publication date: 1-Aug-2006.DHAR N, GRUNDFEST S, JONES J and STREEM S (2018) JEJUNOILEAL BYPASS REVERSAL: EFFECT ON RENAL FUNCTION, METABOLIC PARAMETERS AND STONE FORMATIONJournal of Urology, VOL. 174, NO. 5, (1844-1846), Online publication date: 1-Nov-2005.GETTMAN M, OGAN K, BRINKLEY L, ADAMS-HUET B, PAK C and PEARLE M (2018) EFFECT OF CRANBERRY JUICE CONSUMPTION ON URINARY STONE RISK FACTORSJournal of Urology, VOL. 174, NO. 2, (590-594), Online publication date: 1-Aug-2005.GOLDFARB D and ASPLIN J (2018) EFFECT OF GRAPEFRUIT JUICE ON URINARY LITHOGENICITYJournal of Urology, VOL. 166, NO. 1, (263-267), Online publication date: 1-Jul-2001. Volume 156Issue 3September 1996Page: 907-909 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Marc A. Seltzer More articles by this author Roger K. Low More articles by this author Michael McDonald More articles by this author Gina S. Shami More articles by this author Marshall L. Stoller More articles by this author Expand All Advertisement PDF downloadLoading ...