title: Comparison between lemonade and potassium citrate and impact on urine pH and 24-hour urine parameters in patients with kidney stone formation.
abstract: OBJECTIVE
  The past few decades have been notable for advances in minimally invasive techniques to treat kidney stones. Despite successful surgical management of calculi, the impact of diet on stone disease prevention remains an important factor. Dietary modifications can be applied to prevent stone recurrence in an economical manner that is acceptable to patients. Lemonade has been studied in the past and found to increase urinary citrate levels in small groups of patients. The present study examined the effect of lemonade intake on a change in urinary pH and improvement of urinary stone risk factors compared with potassium citrate treatment.
  
  
  METHODS
  A total of 21 stone-forming patients were treated with lemonade therapy and potassium citrate supplementation in a prospective cross-over trial. we performed 24-hour urine collections at baseline and with each treatment arm. the results between the two groups were examined to determine whether differences existed in the urinary stone risk factors.
  
  
  RESULTS
  Potassium citrate, but not lemonade, improved citrate levels and urinary ph to a significant degree. patients taking potassium citrate had a significantly decreased urine volume compared with their urine volume drinking lemonade. neither lemonade nor potassium citrate affected the uric acid levels to a significant degree.
  
  
  CONCLUSIONS
  The results of our study have shown that lemonade did not provide improvements in urinary citrate or pH levels but did assist patients in maintaining urine output compared with potassium citrate therapy.
authors.affiliation: Department of Surgery, Urology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. stacey.koff@na.amedd.army.mil
authors.forename: Stacey G
authors.initials: SG
authors.lastname: Koff
authors.forename: Edmond L
authors.initials: EL
authors.lastname: Paquette
authors.forename: Jenny
authors.initials: J
authors.lastname: Cullen
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Gancarczyk
authors.forename: Paulette R
authors.initials: PR
authors.lastname: Tucciarone
authors.forename: Noah S
authors.initials: NS
authors.lastname: Schenkman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001628:Beverages; D019343:Citric Acid / Q000652:urine; D002957:Citrus; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007669:Kidney Calculi / Q000178:diet therapy* / Q000517:prevention & control / Q000652:urine; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D019357:Potassium Citrate / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000652:urine
chemical_list: D014527:Uric Acid; D019343:Citric Acid; D019357:Potassium Citrate