Citrus juices and prevention of calcium stones: Some, but not all?

Abstract

Citrus juices and some other beverages are widely available, nonpharmacologic sources of citrate, a naturally occurring inhibitor of urinary stone formation. The mechanisms of citrate supplementation are complex, as urinary citrate levels are dependent not only on the citrate content of a given beverage, but also on the patient's systemic acid-base status. Moreover, delivering an appropriate amount of citrate by juice or other beverage may be accompanied by a caloric intake that would make such a prescription inadvisable. Herein, we summarize all available English-language PUBMED-indexed literature on beverages and 24-h urine composition, as well as epidemiologic data on beverage intake and kidney stone risk with special emphasis on calcium urolithiasis.