Presentation Authors: Tim Large*, James Williams, INDIANAPOLIS, IN, Ignacio Granga, John Asplin, Chicago, IL, Amy Krambeck, INDIANAPOLIS, IN
Introduction: Potassium citrate is the primary therapy for recurrent stone formers with hypocitraturia and aciduria. Gastrointestinal side effects, large pill size, and frequent dosing and cost of the medication have limited patient compliance. The goal of our study was to identify a low calorie beverage that can adequately alkalinize human urine
Methods: Ion chromatography was used to evaluate the available alkali and citrate content of 5 beverages. The best performers were then utilized in a prospective randomized cross over trial involving 10 volunteers without a history of nephrolithiasis. Over 8 weeks volunteers drank 2L of water or 1L of water and 1L of crystal light lemon (CCLF), Kroger brand low-cal OJ (KROG), or Tropicana50 OJ (TRP50). Participants were given a random drink order and did a washout week between trial beverages. After a trial week participants would complete a 24-hr urine collection which was evaluated by Litholink laboratories. Participants were asked to keep their diet and exercise regimen the same each trial week and to keep a detailed diet and symptom journal. Statistical analysis involved a one-way ANOVA comparison of means.
Results: The chemical analyses in Table 1 show that both low-cal OJâ€™s (KROG/TRP50) have equivalent alkali (140 & 158 vs 165 mEq/L) but with half the sugar content compared to regular OJ. In a paired match analysis with water consumption as the control, changes in 24-hr urine volume and pH was statistically higher with KROG compared to CLLF, TRP50 with collective average pH 6.93, 6.63, 6.44 respectively. Low volume with TRP50 corresponded with dietary journals of 7/10 patients who reported GI issues with TRP50 (perhaps from the sweetener used).
Conclusions: Conclusions: Low-cal OJ can alkalinize urine; however, the palatability of beverage is equally important to the alkali potential of the beverage. CLLF should also be recommended as an alkalinizing dietary alternative.
Source of Funding: This study was funded by an AUA Research Scholars Award