Why It Is Important To Do This Review
Various studies have demonstrated that citrate excretion is significantly lower in stone formers than in normal controls and citrate supplementation increases the urinary citrate level. A number of nonrandomised studies have demonstrated a beneficial effect of citrate salts therapy in patients with kidney stones. demonstrated superiority of potassium citrate’s over sodiumpotassium citrate. The European Association of Urology Guidelines on Urolithiasis recommends the use of citrate in hypocitraturia. However, the evidence base for this recommendation is limited.
There is no consensus on the best formulation to treat recurrent kidney stone disease. This uncertainty warranted a systematic review to synthesise all available evidence on the efficacy, safety and acceptability of products containing citrate salts to assist people with stone disease and to reduce recurrence by creating good evidencebased treatment decisions.
Kidneys Filter And Reabsorb Citrate
In one published study,;concentration of citrate in blood is about 80 170 micromolar. A recent review places it at 120micromoles/liter.;If we use 120 micromoles/liter;as a reasonable average, and a common value for glomerular filtration of 120 milliliters/minute, the filtration of citrate is about 21;millimoles a day. Of this about 1; 4;millimoles appear in the urine, the rest being reabsorbed by the kidney cells. So the fraction of filtered citrate excreted is about 5;to 20%, and regulation of this fraction controls the amount of citrate in the urine.
Try To Avoid Soft Drinks
Many soft drinks like cola contain phosphoric acid , which may possibly increase the likelihood of kidney stones forming. There has only been one high-quality study on the question of whether not drinking soft drinks also lowers the risk of developing more kidney stones. In the study, 500 men were advised to drink fewer soft drinks. On average, they lowered their consumption to under 100 milliliters per day that’s less than half a glass. Their risk of kidney stones dropped in comparison to the group of men who didn’t change their drinking habits. The study showed the following after three years:
- 41 out of 100 men who drank as many soft drinks as before developed another kidney stone.
- 34 out of 100 men who drank fewer soft drinks developed another kidney stone.
In other words, drinking fewer soft drinks prevented the development of further kidney stones in 7 out of 100 men. Some men dropped out of the study early possibly because they found it difficult to change their drinking habits.
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Herbs And Supplements To Use Only With Caution
According to some, but not all research, use ofvitamin C supplements can slightly raise levels of oxalate in the urine,40,41,53 which could, in turn, increase risk of kidney stones. However, large-scale observational studies have found that people who consume large amounts of vitamin C have no increased risk or even a decreased risk of kidney stone formation.42-44 Nonetheless, it seems that in certain people, high vitamin C intake can lead to a rapid increase in urinary oxalate, and in one case stones developed within a few days.45 The bottom line: People with a history of kidney stones should probably limit vitamin C supplements to about 100 mg daily.46
Some evidence hints that excessive consumption of phosphorus in the form of soft drinks might increase kidney stone risk, but study results are contradictory, and if there is an effect, it appears to be small.62-64
As noted above, regular consumption of grapefruit juice may significantly increase risk of stones.17
What Are Struvite Stones
Struvite stones are caused by infections in the upper urinary tract. A kidney stone is a hard object that is made from chemicals in the urine. After formation, the stone may stay in the kidney or travel down the urinary tract into the ureter. Stones that don’t move may cause significant pain, urinary outflow obstruction, infection, or other health problems.
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Oj Better Than Lemonade
In the study, researchers compared the effects of orange juice and lemonade in preventing recurrent kidney stones. Both juices contain comparable citrate levels.
Thirteen volunteers, some with a history of kidney stones and some without, participated in the three-phase study.
In random order, the participants drank approximately 13 ounces of either distilled water, orange juice, or lemonade three times a day with meals for one week, with a three-week interval before moving to the next phase. They also followed a special diet as recommended for preventing recurrent kidney stones.
The results showed that orange juice increased levels of citrate in the urine and decreased urine acidity, which reduced the risk of kidney stones. But lemonade did not have the same effect.
“Orange juice could potentially play an important role in the management of kidney stone disease and may be considered an option for patients who are intolerant of potassium citrate,” says researcher Clarita Odvina, MD, assistant professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas, in a news release.
The results appear in the Clinical Journal of the American Society of Nephrology. Researchers say this was a small study and further research is needed to evaluate the role of orange and other citrus juices in preventing kidney stones.
The study was supported by research grants from NIH.
We Do Need A Trial Of Citrate For Calcium Phosphate Stone Formers
I do not know how often this must be said. Calcium phosphate stone formers must lurk in each of the trials I have reviewed, but I do not know their outcomes. One trial insisted stones be at least >50% calcium oxalate. That means perhaps a few had considerable phosphate is stones.
Calcium phosphate crystal formation is sensitive to urine pH whereas calcium oxalate stone formation will not be. The reason is that calcium phosphate supersaturation requires divalent phosphate be present, and the pKa for the second proton is about 6.8. Citrate salts can raise urine pH, so they can raise supersaturation with respect to calcium phosphate salts. On the other hand, citrate is an inhibitor of crystallization both because it is calcium binding and because it directly affects calcium crystal growth.
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Does Potassium Citrate Reduce Kidney Stones
The surgeon can remove the stone through this tunnel. Potassium citrate. Your healthcare provider.
Take medicines prescribed to prevent calcium and uric acid stones from forming. A kidney stone is.
How Long Does It Take For A Kidney Stone To Pass The small Chibuzor entered and like the proverbial rejected stone that became the chief corner. this stubborn boy what is he going there to do? All the humble children of
Potassium citrate is used to treat a kidney stone condition called renal tubular acidosis. It is also used to prevent kidney stones that may occur with gout.
a medicine, the risks of taking the medicine must be weighed against the good it will do.
Potassium citrate is prescribed to decrease stone recurrence in patients with.
Keywords: hypercalciuria, kidney stones, mineral metabolism.
Overall mean urinary uric acid excretion did not differ (K-cit, 1.6±0.1 mg/d versus.
A machine-learning algorithm can use demographic, symptomatic, and clinical data to accurately predict the health-related quality of life of patients with kidney stones, new research shows.
in calcium citrate supplements and in some medications , is closely related to citric acid and also has stone prevention benefits. These medications may be prescribed to alkalinize your urine. How does citric acid protect against kidney stones? Citric acid makes urine less favorable for the formation of stones.
Their appearance can.
potassium citrate to achieve a urine pH of.
May 17, 2019.
Should You Use Potassium Citrate
Potassium citrate can help people, and sometimes dogs, with treating kidney stones.
It may also help reduce the risk of stroke, but must be used with caution and under the supervision of a medical professional.
The evidence for its effects on bone health are inconclusive, so its best to play it safe and obtain adequate potassium intake from food sources.
Dosing is based on individual need to help maintain healthy serum potassium levels.
A wide array of serious side effects can result if used improperly. If you suffer from heart, kidney or adrenal disease, ask your doctor if potassium citrate is appropriate for you.
About Erin Peisach
Erin;Peisach, RDN, CLT attended the University of Maryland, College Park for her Bachelor’s degree in Dietetics. She is now the owner of Nutrition by;Erin, a San Diego-based virtual nutrition private practice specializing in gastrointestinal disorders.;
Learn more about her on the About page.;
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They Transport More Than Citrate
NaDC1;permits not only citrate to cross cell membranes but also succinate, alpha ketoglutarate, fumarate, malate, and a variety of less biologically relevant molecules. One might ask why, and I presume it is because the named molecules;are all part of the citric acid cycle, which is the main engine of cell energy production. NaDC3 transports;all of the same molecules as NaDC1, along with glutarate and a very long list of other molecules not in the citric acid cycle.
This cycle is at the center of that metabolism which uses oxygen to produce energy from food. The reference is to an excellent textbook review that is free online. Another chapter in that book finishes the story of how the cycle produces energy.;The antiquity and centrality of the citric acid cycle will become apparent to you if you even browse these chapters. If you read them, you will encounter some;of the most important aspects of living cells.
Calcium Oxalate And Calcium Phosphate Stones
Calcium stones are the most common type of kidney stones, and can be either calcium oxalate or calcium phosphate. As mentioned, good hydration is important to prevent calcium stones. It may be surprising, but results of a randomized clinical trial show that people with calcium kidney stones should not cut back on dietary calcium. In fact, they should consume the recommended daily allowance of calcium . Why? Calcium binds to oxalate in the intestine and prevents its absorption through the gut, so there is less in the urine to form stones. Ideally, calcium should come from food. Talk with your doctor before taking calcium supplements, and increasing fluid intake might be beneficial depending on how much calcium you take.
Foods high in oxalates can increase the amount of oxalate in the urine. Consume these in moderation.
Calcium phosphate stones are less common than calcium oxalate stones. Causes include hyperparathyroidism , renal tubular acidosis , and urinary tract infections. It is important to understand if one of these conditions is behind the formation of calcium phosphate stones.
Good hydration can help prevent recurrence of calcium stones. In addition, thiazide diuretics such as hydrochlorothiazide can help the kidney absorb more calcium, leaving less of it in the urine where it can form stones. Potassium citrate is another medication that can bind to calcium and help keep calcium oxalate and calcium phosphate in the urine from forming into stones.
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Why Are Potassium Citrate Pills An Alkali Load
In the citric acid cycle citrate is metabolized as citric acid, meaning that 3 protons are taken up from blood with each molecule. Removing protons is identical to adding alkali. Typical dosing is about 20 40 mEq of potassium salt daily, but the amount can vary widely.
Commercial potassium citrate contains 1080 mg of the compound in a 10 mEq pill. Typically the potassium citrate salts have a potassium on each of the three anion sites on the citrate molecule.;The MW of citrate anion is 189.1.;Urocit K, a common commercial version, is a crystalline monohydrate salt;so it has a MW of 3×39 + 189.1 + 18 for the one water molecule, or 324.1 in all. Given 324.1 for 3 mEq of base, the 10 mEq tablet contains 10/3 x 324.1 or 1080 mg.
Should I Cut Out All Foods That Have Oxalate Or Calcium
No, this is a common mistake. Some people think that cutting out all foods that have oxalate or all foods with calcium will keep stones from forming. However, this approach is not healthy. It can lead to poor nutrition and can cause other health problems. A better plan? Eat and drink calcium and oxalate-rich foods together during a meal. Doing this helps oxalate and calcium bind to one another in the stomach and intestines before reaching the kidneys, making it less likely for kidney stones to form in the urine.
Plan Your Plate For Kidney Stones
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Description Of The Condition
Kidney stones remain a public health problem around the world irrespective of geographical, cultural or racial backgrounds, with an incidence of approximately 0.1% to 0.3%. The lifetime risk is estimated to be between 10% and 20% in the Western world, but can be as high as 20% to 25% in the Middle East. Stone disease typically affects men two times more commonly than women and peak incidence is in the fourth to sixth decades of life . Recent studies reported that the male:female ratio of patients with stones altered from 1.6:1 to 1.2:1 ,1.7:1 to 1.3:1 . Between the mid1970s and the mid1990s, the prevalence of stone disease increased from 3.2% to 8.8% in the USA . The stone recurrence rate without treatment is approximately 10% at one year, 33% at five years, 50% at 10 years, and 75% at 20 years . Following first recurrence, the subsequent relapse risk is increased with a shortened time interval between recurrences .
Most stones are composed of calcium salts . The remainder are noncalcium stones such as struvite , uric acid , cystine , or other substances . Kidney stone formation is based on supersaturation of urinary salts and crystal retention in the urinary tract. Urinary Inhibitors and promoters are involved in the process and deficiency of inhibitors or abundance of promoters in the urine thought to predispose to stone disease .
What Are Side Effects Of Potassium Chloride
Common side effects of potassium chloride include nausea, vomiting, upset stomach, gas, diarrhea, and tingling in the hands and feet. Potassium chloride can also cause hyperkalemia , and is only recommended in pregnant women under strict physician supervision as hyperkalemia can pose a risk to the fetus.
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National Kidney Foundation & Moonstone Nutrition
This partnership will focus on providing valuable information to both patients and healthcare professionals regarding risk factors, symptoms, prevention and treatment options, and include the development of new, educational resources, as well as a series of virtual events. To learn more about this partnership, click below.
Monitoring The Intake Of High Acid Foods
Highly acidic urine can increase the risk of uric acid kidney stones and make passing them more painful.
High amounts of acid in the urine also encourage the kidneys to reabsorb citrate rather than excrete it. Citrate is a compound that can help flush out calcium-based stones, as well as impair their growth.
Highly acidic foods include:
According to the National Kidney Foundation, almost 1 in 10 people in the United States develop a kidney stone during their lifetime. The risk is around 19% for men and 9% for women.
Most men experience their first kidney stone after the age of 30 years.
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How Much Does Potassium Chloride Cost
Potassium chloride is inexpensive. With a GoodRx discount, 30 effervescent tablets cost only $20, and both the 450 ml bottle of 10% oral solution and the 20 meq packets can be purchased for as little as $60 for a 30-day supply.
How To Dissolve Kidney Stones
How Kidney Stones Form
If you have ever passed a kidney stone, you most likely would not wish to go through this excruciating process again; in fact, you probably would not wish it on your worst enemy. Kidney stones are common in both males and females and can strike again in half of those who develop it, usually within 5 to 7 years if preventive measures are not taken.
Kidney stones form when substances like oxalate, calcium, and uric acid become overly concentrated and create crystals in the kidneys. Those crystals then grow larger and form kidney stones. About 75 percent of all kidney stones are calcium oxalate stones.
After kidney stones develop, they can dislodge and pass down to the ureter, blocking urine flow. This can lead to periods of severe pain and discomfort, including pain in one side of the body between your stomach and your back. At times, pain can be accompanied by blood in the urine, nausea, and vomiting.
As the stones travel down the ureter to the bladder, they may result in bladder pressure, groin pain, or frequent urination. If you experience any of these symptoms, you should speak to your doctor. He/she will probably carry out a urinalysis and renal ultrasound, abdominal x-ray, or CT scan to determine if you have kidney stones and confirm their size and number.
Diagnosis of Kidney Stones
If your doctor suspects that you have a kidney stone, he/she may carry out diagnostic tests and procedures, such as:
1. Blood test:
2. Urine test:
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Easy Ways To Prevent Kidney Stones
Did you know that one in ten people will have a kidney stone over the course of a lifetime? Recent studies have shown that kidney stone rates are on the rise across the country. Those in the know believe that some major misconceptions may be the culprit.
The National Kidney Foundation has teamed up with Dr. Allan Jhagroo, a kidney stone specialist at the University of Wisconsin School of Medicine and Public Health, to help you stay stone-free by debunking some of the major kidney stone myths and misconceptions.