Citraturic, alkalinizing and antioxidative effects of limeade-based regimen in nephrolithiasis patients.
Potassium citrate has long been used as a prophylactic remedy for nephrolithiasis recurrence. Lemonade consumption is also suggested as an option. We compared the efficacy of consumption of solution containing manufactured lime powder with that of potassium citrate, on the improvement of metabolic risk factors, oxidative stress and renal tubular damage in nephrolithiasis patients. Patients with kidney stone were enrolled and randomly assigned to three treatment programs for 3 month period consisting of consumption of solution containing lime powder (Group 1, n=13), potassium citrate (Group 2, n=11) and lactose as placebo regimen (Group 3, n=7). Lime powder and potassium citrate contained equal amounts of potassium (21 mEq) and citrate (63 mEq). After treatment, there was an increase in urinary pH, potassium and citrate in Group 1 and 2. Increased plasma potassium and red blood cell glutathione (R-GSH) and decreased urinary malondialdehyde were found in Group 1, but not observed in Group 2. R-GSH was decreased in Group 2. Urinary N-acetyl-beta-glucosaminidase activity and fractional excretion of magnesium, as renal tubular damage indicators, were decreased only in Group 1. In Group 3, all measured parameters were unaltered except for an increased urinary chloride. In conclusion, consumption of our in-house lime powder exerted citraturic and alkalinizing actions as efficient as consumption of potassium citrate. In addition, it provided an antioxidative effect and was able to attenuate renal tubular damage. These pharmacological properties may be clinically useful to diminish the stone-forming potential in kidney stone patients and hence for preventing recurrent calculi.
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. fmedpts@md2.md.chula.ac.th
Piyaratana
P
Tosukhowong
Chatchai
C
Yachantha
Thosaphol
T
Sasivongsbhakdi
Supoj
S
Ratchanon
Suchada
S
Chaisawasdi
Chanchai
C
Boonla
Kriang
K
Tungsanga
D000328:Adult; D000468:Alkalies / Q000378:metabolism; D000975:Antioxidants / Q000008:administration & dosage; D032082:Citrus aurantiifolia; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000188:drug therapy* / Q000378:metabolism / Q000517:prevention & control*; D018384:Oxidative Stress / Q000187:drug effects; D028321:Plant Preparations / Q000008:administration & dosage*; D019357:Potassium Citrate / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
D000468:Alkalies; D000975:Antioxidants; D004232:Diuretics; D028321:Plant Preparations; D019357:Potassium Citrate