Kidney stone disease affects millions of people yearly. The pain associated is so severe that those who experience it will do almost anything to prevent it from recurring. However, natural kidney stone prevention requires a disciplined approach involving lifestyle modification and essential dietary changes. Medication may be prescribed depending on the type of stone formed in order to prevent the recurrence of stones, however these medications have to be taken with high compliance and the drugs are not always tolerated. The most prescribed drug for the prevention of calcium stones in patients whose urine is too acidic due to a deficiency of citrate in the urine, is potassium citrate.
In patients who are unable to tolerate potassium citrate the use of dietary citrate to prevent kidney stones is a viable option. Patients are generally instructed to drink limejuice or orange juice for the purposes of supplementation of citrate levels in the urine. This practice was based on the assumption that citrate obtained from either source is just as effective. However based on a study of patients who formed kidney stones due to low urinary citrate levels, supplementation with lime juice did not show as much benefit as supplementation with orange juice. The study performed by Dr. Odvina at the University of Texas Southwestern medical center revealed that despite a comparable citrate content lime juice did not elevate urinary citrate levels to the same extent as orange juice. As a result of this orange juice was superior to lemonade in natural kidney stone prevention particularly for calcium and uric acid stones by its effects on urinary pH.
However fruit juices are associated with a significant carbohydrate load particularly at the volumes necessary to provide dilution of the urine and effectively increase urine pH. This caloric load could cause increased weight which may increase risk for stone formation in the future. In order to adequately assess the effectiveness of orange juice for this indication a long study will be needed to weight the risk vs the benefit.
