Photo by Arria Belli, via Wikimedia Commons

A number of years ago I stumbled upon an article that suggested that a certain name-brand sugar-free lemonade, what I affectionately call fake lemonade, may be helpful in the prevention of kidney stones. Hint: it rhymes with ‘pistol fight‘. Like most people who get lost in the Internet, I moved on to something else and promptly lost the article.

Taby, our do-everything team member, has finally unearthed the study that was behind this, entitled: Assessment of citrate concentrations in citrus fruit-based juices and beverages: implications for management of hypocitraturic nephrolithiasis., published in 2009 in Reviews in Urology. The study reviewed dietary citrate in general and it’s ability to inhibit certain types of kidney stone growth, though it mentions Crystal Light lemonade by name. Increased citrate in the urine has been shown to prevent kidney stone formation, in particular calcium oxalate stones.

Out of all of the beverages analyzed by the researchers, Crystal Light and similar sugar-free lemonade drink mixes have the highest level of citrate, in the forms of sodium citrate and potassium citrate. Both sodium citrate and potassium citrate are commonly used as buffering agents to regulate the acidity of beverages.

Why should I care?

The study suggests that if you have calcium oxalate, uric acid, or cystine kidney stones, citrate may help prevent these types of stones. It is also useful in the treatment of the genetic disorder cystinuria, which is the cause of cystine stones. There are a number of prescription strength preparations of potassium citrate (Cytra-K, Urocit-K), though they tend to have some unpleasant side effects.

Potassium Citrate Molecule

How to Increase Your Dietary Citrate

The best way to increase your dietary citrate, without resorting to prescription drugs, is by eating or drinking more citrus fruit or pineapple, or beverages high in citrate. However researchers found that only lemons reduced the risk factors for kidney stone formation, whereas oranges, grapefruit and pineapples did not. The reason: lemons are loaded with potassium citrate. My personal experience confirms the researchers’ findings, as my first kidney stone formed while I was drinking 12 ounces of orange juice every morning with breakfast.

You may be tempted to drink straight lemon juice, but that is a good way to strip the enamel from your teeth.  Be nice to your teeth and don’t do it.

So here are two good ways to increase your dietary citrate:

• Lemon juice with water: 3-6 tablespoons in 2 liters of water per day
• Fake lemonade: Crystal Light, private label, or store brand, 2 liters per day

Both of these have their merits. Lemon juice with water is actually pretty effective, according to some of the health forums that I frequent and in my experience. Some people can’t tolerate the tartness. There are a number of store brand and private label fake lemonades that are usually cheaper than Crystal Light. I prefer Fit & Active from Aldi’s because it’s the cheapest, but it’s pretty much the same in my humble opinion. I make mine with distilled water and use 3 liters of water per packet, instead of 2, as I find I can drink more of it when it’s more like ‘lemon water’ than lemonade.

The downside of fake lemonade is that it is, well, fake. The main problem I have is the artificial sweetner, but it beats added sugar. For the most part, both regular and pink lemonade have citrate,but you should look at the label if you want other flavors. If you are going to drink this, then look for potassium citrate on the label.

Here is a picture of the ingredient list from store brand, sugar-free lemonade (click to make it bigger):

Lemonade Mix Ingredients List

Mark’s Bottom Line

According to the research, increasing your dietary citrate is a good thing for most kidney stone sufferers, in particular potassium citrate. In my personal experience, increasing my potassium citrate intake has helped prevent stones. I try to drink water with lemon or fake lemonade several times a week, if not daily. Along with taking Clear Kidneys™ every day, this has helped me to keep me relatively kidney stone free.*

References:

• Assessment of citrate concentrations in citrus fruit-based juices and beverages
• Wikipedia – Citrate
• Wikipedia – Potassium Citrate
• WebMD – Potassium Citrate for Kidney Stones

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I missed my blog post from last week due to the Labor Day holiday here in the US. To make it up to my loyal readers, I’ll give you two posts this week.