Biochemical Effect of Dietary Natural Fruit Juice in the Patients with Hypocitraturic Calcium Urolithiasis / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Citrate is a well recognized inhibitor of the formation of urinary calcium stones, and hypocitraturia plays an important role in the recurrent calcium urolithiasis. We evaluated the biochemical effects of dietary natural fruit juice in calcium stone formers with hypocitraturia in an attempt to decrease or eliminate the need for pharmacological therapy. MATERIALS AND METHODS: This prospective study included 26 women and 34 men (mean age 42.5 years) with documented calcium urolithiasis. Among 60 patients, hypocitraturia(0.05). But, levels of urinary citrate were significantly increased in 29(97%) patients in orange juice group(n=30) and were normalized in 19(95%) patients with hypocitraturia. In grape juice group(n=30), levels of urinary citrate were significantly increased in 28(93%) patients and were normalized in 18(90%) patients with hypocitraturia. But, in hypocitraturic patients taking orange juice, urinary oxalate increased in 12(60%) patients. The natural juice therapy was well tolerated. Some G-I trouble occured(11%) but did not require cessation of therapy. Cirtate supplementation with natural fruit juice increased urinary citrate more than 1.5-2 times, but increased urinary oxalate value in orange juice group with hypocitraturia. CONCLUSIONS: Natural fruit juices, orange and grape, are well tolerated dietary source of citrate, and may be useful as adjunctive treatment for patients with hypocitraturic calcium urolithiasis.