A small study found that drinking 2 liters of lemonade daily doubled urinary citrate in people with decreased urinary citrate. 15 Lemon juice may be preferable, as it has almost five times the citrate of orange juice. Like potassium citrate, orange juice decreases urinary acidity and raises urinary citrate, but it also raises urinary oxalate, which might tend to work against its beneficial effects. Some physicians have proposed drinking citrus juices as a means of increasing urinary citrate levels. However, calcium citrate has not yet been studied as a preventive for kidney stones. Besides increasing citrate in the urine, this supplement has the advantage of being a readily absorbed form of calcium for those seeking to increase their calcium intake for other health reasons. 56,60Ĭitrate is available in the form of calcium citrate. Benefits have been seen in other small studies as well. 13 During the study, new stones formed in only 12.9% of those taking the potassium-magnesium citrate supplement, compared to 63.6% of those taking placebo. Potassium-magnesium citrate was studied in a 3-year trial involving 64 participants with a history of calcium oxalate stones. Placebo had no change in their rate of stone formation. Study of 57 people with a history of calcium stones and low urinary citrate levels, those given potassium citrate developed fewer kidney stones than they had previously. One form of citrate supplement, potassium citrate, was approved by the FDA in 1985 for the prevention of two kinds of kidney stones: calcium stones (including calcium oxalate stones) and uric acid stones. What is the scientific evidence for citrate? These methods include increasing fluids, modifying the diet, and taking drugs or supplements to alter the chemistry of the urine. "Silent" stones, or those causing no symptoms, are often treated with preventive measures alone. Occasionally, however, surgery may be necessary. Those causing problems may be treated withĮxtracorporeal shock-wave lithotripsy, a technique that can break up these stones from outside the body, allowing them to pass more easily. Treatment depends on their location and symptoms. Other stones may be detected earlier, when they are still in the kidney. The chemical composition of passed stones can be analyzed to determine their cause. For those who pass a stone spontaneously, the main treatments are painkillers and fluids. Other Proposed Treatments for Kidney StonesĬonventional treatment for kidney stones varies depending on symptoms as well as the location and chemical composition of the stones. Strangely, however, high-calcium foods don't seem to increase the risk of calcium oxalate stones. In addition, vitamin D affects calcium levels in the body, and prolonged use of extremely excessive doses of vitamin D has been known to cause kidney stones. Indirect evidence suggests that regular use of cranberry concentrate tablets might also increase risk of kidney stones. Rhubarb, and cocoa may also increase the risk of developing calcium oxalate stones. 4,5Ħ,7 and protein (particularly animal protein) may also increase the risk of calcium oxalate stones, 8,9 although some studies have found that protein has no such effect. However, while there is evidence that fluids in the form of coffee, tea, beer, and wine can decrease risk of kidney stone development, apple juice and grapefruit juice may have the opposite effect. 1,2,3 For this reason, individuals at risk of developing stones are often advised to increase their fluid intake. Low fluid intake greatly increases the risk of developing virtually all types of stones. However, once you've had a stone, you are fairly likely to develop another. It isn't known why some people develop kidney stones and others do not. Less commonly, kidney stones may be made from calcium and phosphate, from another substance called struvite (usually the result of an infection) or, rarely, from uric acid or cystine. However, sometimes these protective methods fail and a stone develops. Although these chemicals occur in everyone's urine, our natural biochemistry is usually able to prevent them from crystallizing. Most kidney stones are composed of calcium and oxalic acid, substances present in the urine that can crystallize inside the kidneys. While tiny stones may pass unnoticed, a larger stone can induce some of the worst pain that humans experience. If you've ever passed a kidney stone, you do not want to repeat the experience! The sharp and irregular stones travel down the slender tube (ureter) leading from the kidney to the bladder, and from the bladder to the urethra, following the path by which urine exits the body.
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