Tags

Type your tag names separated by a space and hit enter

Long-term lemonade based dietary manipulation in patients with hypocitraturic nephrolithiasis.

Abstract

PURPOSE

Citrus fruits and juices are a known natural source of dietary citrate. Of all the citrus juices, lemon juice appears to have the highest concentration of citrate. Therefore, lemonade therapy has been proposed as a potential treatment for patients with hypocitraturia. We retrospectively evaluated the impact of long-term lemonade therapy on urinary metabolic parameters and stone formation in patients with hypocitraturic nephrolithiasis.

MATERIALS AND METHODS

A total of 32 patients were identified as being on long-term lemonade therapy for hypocitraturic nephrolithiasis. The 11 patients on lemonade therapy who met the entrance criteria for evaluation were compared to an age and sex matched control group of patients treated with oral slow release potassium citrate. Pre-therapy and post-therapy urinary parameters were recorded for both groups. The effect of lemonade therapy on stone burden and stone formation rate was calculated. New stone formation was defined as passage, surgical removal or appearance of new stones, or an increase in the size of existing stones on radiographic imaging.

RESULTS

Four males and 7 females (mean age 52.7 years) were treated with lemonade therapy for a mean of 44.4 months. The control group consisted of 4 males and 7 females (mean age 54.5 years) treated with potassium citrate for a mean of 42.5 months. Of the 11 patients on lemonade 10 demonstrated increased urinary citrate levels (mean increase +383 mg per day, p <0.05). All potassium citrate therapy subjects demonstrated an increase in urinary citrate (mean increase +482 mg per day, p <0.0001). Mean pretreatment and posttreatment stone burden in the lemonade group was 37.2 and 30.4 mm(2), respectively (p >0.05). During lemonade therapy the stone formation rate decreased from 1.00 to 0.13 stones per patient per year (p >0.05).

CONCLUSIONS

Due to its significant citraturic effect, lemonade therapy appears to be a reasonable alternative for patients with hypocitraturia who cannot tolerate first line therapy. Future study in the form of a prospective, randomized trial is needed to validate these findings.

Links

  • Publisher Full Text
  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Comprehensive Kidney Stone Center, Duke University Medical Center, Division of Urology, Durham, North Carolina 27710, USA.

    , , , ,

    Source

    The Journal of urology 177:4 2007 Apr pg 1358-62; discussion 1362; quiz 1591

    MeSH

    Adult
    Aged
    Beverages
    Citric Acid
    Citrus
    Female
    Humans
    Male
    Metabolic Diseases
    Middle Aged
    Nephrolithiasis
    Retrospective Studies
    Time Factors

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    17382731

    Citation

    Kang, David E., et al. "Long-term Lemonade Based Dietary Manipulation in Patients With Hypocitraturic Nephrolithiasis." The Journal of Urology, vol. 177, no. 4, 2007, pp. 1358-62; discussion 1362; quiz 1591.
    Kang DE, Sur RL, Haleblian GE, et al. Long-term lemonade based dietary manipulation in patients with hypocitraturic nephrolithiasis. J Urol. 2007;177(4):1358-62; discussion 1362; quiz 1591.
    Kang, D. E., Sur, R. L., Haleblian, G. E., Fitzsimons, N. J., Borawski, K. M., & Preminger, G. M. (2007). Long-term lemonade based dietary manipulation in patients with hypocitraturic nephrolithiasis. The Journal of Urology, 177(4), pp. 1358-62; discussion 1362; quiz 1591.
    Kang DE, et al. Long-term Lemonade Based Dietary Manipulation in Patients With Hypocitraturic Nephrolithiasis. J Urol. 2007;177(4):1358-62; discussion 1362; quiz 1591. PubMed PMID: 17382731.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Long-term lemonade based dietary manipulation in patients with hypocitraturic nephrolithiasis. AU - Kang,David E, AU - Sur,Roger L, AU - Haleblian,George E, AU - Fitzsimons,Nicholas J, AU - Borawski,Kristy M, AU - Preminger,Glenn M, PY - 2006/09/07/received PY - 2007/3/27/pubmed PY - 2007/5/1/medline PY - 2007/3/27/entrez SP - 1358-62; discussion 1362; quiz 1591 JF - The Journal of urology JO - J. Urol. VL - 177 IS - 4 N2 - PURPOSE: Citrus fruits and juices are a known natural source of dietary citrate. Of all the citrus juices, lemon juice appears to have the highest concentration of citrate. Therefore, lemonade therapy has been proposed as a potential treatment for patients with hypocitraturia. We retrospectively evaluated the impact of long-term lemonade therapy on urinary metabolic parameters and stone formation in patients with hypocitraturic nephrolithiasis. MATERIALS AND METHODS: A total of 32 patients were identified as being on long-term lemonade therapy for hypocitraturic nephrolithiasis. The 11 patients on lemonade therapy who met the entrance criteria for evaluation were compared to an age and sex matched control group of patients treated with oral slow release potassium citrate. Pre-therapy and post-therapy urinary parameters were recorded for both groups. The effect of lemonade therapy on stone burden and stone formation rate was calculated. New stone formation was defined as passage, surgical removal or appearance of new stones, or an increase in the size of existing stones on radiographic imaging. RESULTS: Four males and 7 females (mean age 52.7 years) were treated with lemonade therapy for a mean of 44.4 months. The control group consisted of 4 males and 7 females (mean age 54.5 years) treated with potassium citrate for a mean of 42.5 months. Of the 11 patients on lemonade 10 demonstrated increased urinary citrate levels (mean increase +383 mg per day, p <0.05). All potassium citrate therapy subjects demonstrated an increase in urinary citrate (mean increase +482 mg per day, p <0.0001). Mean pretreatment and posttreatment stone burden in the lemonade group was 37.2 and 30.4 mm(2), respectively (p >0.05). During lemonade therapy the stone formation rate decreased from 1.00 to 0.13 stones per patient per year (p >0.05). CONCLUSIONS: Due to its significant citraturic effect, lemonade therapy appears to be a reasonable alternative for patients with hypocitraturia who cannot tolerate first line therapy. Future study in the form of a prospective, randomized trial is needed to validate these findings. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/17382731/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(06)03121-1 DB - PRIME DP - Unbound Medicine ER -