Lemon is an abundant, natural source of citrate and citric acid. Citrates help block the formation of new kidney stones while critic acid assists in dissolving any current stones. That's why we use REAL-WHOLE lemons that have been freeze-dried to remove water and make then shelf-stable.
A Lemon a Day Keeps the Urologist Away
Citrate has been proven to bind with stone-forming compounds such as oxalate (oxalic acid), uric acid, and phosphoric acid to expel them through the urine. Once removed, these compounds can no longer form crystals that would eventually become kidney stones.
Related research studies
European Urology Supplements- 2008
Two studies demonstrate that lemon interventions reduce urinary calcium level and increases urine output more effectively than potassium citrate.11,18 The effect is most likely due to the fact that lemons contain the highest concentration citrate acid and sodium, and the lowest concentration of calcium compared with other citrus fruits.
Citrus fruits can be used as an alternative to potassium citrate in the treatment of hypocitraturic urolithiasis. Citrus fruits are rich sources of natural citrate and they can supply enough citrate levels equal to routine potassium citrate treatment. When the most consumed citrus fruits were compared with each other, it has been found that lemon contains the highest level of citrate concentration which was approximately five folds of the concentration in orange. A half glass of lemon juice can supply a daily citrate intake which is comparable to pharmacologic treatment.
Citric acid makes urine less favorable for the formation of stones. In its natural form, such as from citrus fruits, citric acid does not alkalinize the urine as citrate (from medication) does. Rather, it prevents small stones from becoming “problem stones” by coating them and preventing other material from attaching and building onto the stones.
The citrate group showed a significantly increased urine pH (P < 0.001) and daily citrate excretion (P < 0.001) over the study period. The non-citrate group showed increased numbers of microcalculi at study completion (P = 0.002); over the same period, the number of microcalculi in the citrate group decreased significantly (P = 0.03). Additionally, multivariable analysis showed more asymptomatic microcalculi disappearances (odds ratio 2.84, 95% confidence interval 1.49–5.39) and fewer pain events (odds ratio 0.37, 95% confidence interval 0.16–0.72) in the citrate group than in the non-citrate group. A sex-adjusted analysis showed more asymptomatic microcalculi disappearances (odds ratio 3.96, 95% confidence interval 1.57–10.02) and fewer pain events (odds ratio 0.22, 95% confidence interval 0.07–0.70) in women than in men after citrate treatment.
Potassium-sodium citrate prevents the development of renal microcalculi into symptomatic stones in calcium stone-forming individuals.
Journal of the American Society of Nephrology- 2015
Citrate has been used after lithotripsy to prevent stone recurrence. In a randomized controlled study, potassium and sodium citrate appeared to reduce the risk of stone recurrence after extracorporeal shockwave lithotripsy or percutaneous nephrolithotomy. In another randomized controlled study, K-cit appeared effective in reducing lower caliceal calculi after shockwave lithotripsy.
Potassium citrate supplementation resulted in reduction of sodium concentration and increased pH of urine. However, urine volume, citrate level, and uric acid level, as well as elemental magnesium, phosphorus, and potassium, remained unchanged after 5 days of supplementation with potassium citrate or lemonade.
Potassium citrate supplementation is an effective therapy for preventing pediatric urolithiasis, with acceptable adverse effects.
About 10% of the people is the subject of an episode of kidney stones during their lifetime, about 70% of these people undergoes relapses. About 80% of the urinary stones contains calcium, of wich 80% is formed of calcium oxalate, in pure form or associated with calcium phosphate. Therefore we can saythat in most cases (about 65%) the urinary stones are composedof calcium oxalate. Use of supplements of potassium citrate and magnesium citrate can help in the prevention of kidney stones of calcium oxalate, but mostly they can be used in the days before a shockwaves lithotripsy treatment to make the stones more fragile to the effect of the shock waves. A case of successful treatment with magnesium potassium citrate of a SWL resistant ureteral stone is presented.
Metabolic anomalies (hypercalciuria, hypocitraturia, hyperuricuria and hyperoxaluria) were present in 83% of the patients. Follow-up before and after alkali citrate therapy was comparable. Medical treatment significantly reduced rates of stone formation from 2.0+/-1.0 to 0.2+/-0.5 pt/yr, ureteroscopy (URS) from 0.9+/0.8 to 0.4+/-0.5 pt/yr, extratracoporeal lithotripsy (ESWL) from 1.1+/-0.8 to 0.4+/-0.6 pt/yr, urinary tract infections (UTIs) from 0.8+/-1.2 to 0.3+/-0.5 pt/yr and hospitalization from 1.1+/-0.6 to 0.2+/-0.3 pt/yr, p < 0.001. This effect was observed also in MSK patients without metabolic anomalies. In 35 patients the asymptomatic disappearance of calcium stones was also observed.
Our study documents the effectiveness of potassium citrate therapy in preventing neprolithiasis in MSK patients also in the absence of distal tubular acidosis. It suggests that in MSK patients alkali citrate may promote calcium stone dissolution by oral administration.
Out of 67, 48 patients reported for follow up. 10 (15%) had complete dissolution and 13 (19%) had partial dissolution. Alkalinization was unsuccessful in achieving dissolution in 25 (37%). Stenting before alkalinization, patient weight (< 60 vs. > 75kg) and serum uric acid levels (≤ 6 vs. > 6) were the only factors to significantly affected dissolution rates (p = 0.039, p 0.035, p 0.01 respectively).
A policy of offering dissolution therapy to patients with radiolucent calculi had a successful outcome in 34% of patients.
Of 46 patients 31 completed the treatment course. A full response was obtained in 22 (71%) and a partial response in 4 (12.9%) cases. The basic factors found to affect the success of treatment were stone surface area, pre-treatment urine pH and serum uric acid levels.
Low-density urinary stones can be successfully treated with dissolution therapy. In patients with radiolucent stones, the stone density should be measured by using non-enhanced computed tomograms. In cases examined with suitable stone density, dissolution treatment can be started without determining the exact type of the stone.
Regardless of stone size, oral dissolution therapy was an effective treatment approach for lucent renal stones. The initial response to oral dissolution therapy after 3 months was the key factor in determining the potential oral dissolution therapy response after 6 months. In addition, treatment compliance in achieving the targeted urine pH and low stone density has an independent role in the oral dissolution therapy response.
Stone-free children undergoing no specific therapy had significant new stone formation compared with the group receiving potassium citrate on a regular basis (34.6% and 7.6%, respectively). Children with residual fragments receiving no specific preventive measure also showed significant new stone formation, along with enlargement of the fragments.
Treatment with potassium citrate is effective in patients with primary or secondary hypocitraturia and acidification disorders, which cause unduly acidic urine pH persistently. Adverse effects are low and are referred to the gastrointestinal tract. While there are various preparations of citrate (potassium citrate, sodium citrate, potassium citrate, magnesium) in our country is available only potassium citrate powder that is useful to correct both the hypocitraturia and the low urinary pH and reduce markedly the recurrence of kidney stones.
Polycitra K was administered to 198 children preventatively overall, 4 (2.0%) of whom developed kidney stones, compared with 11 (10.5%) of 105 who did not receive Polycitra K (P = .003). Two children since 2006 refused Polycitra K, 1 of whom developed a kidney stone. Successful empiric administration of Polycitra K at KD onset resulted in a kidney-stone incidence of 0.9% (1 of 106) compared with administration only because of hypercalciuria, 6.7% (13 of 195; P = .02). Polycitra K resulted in less acidic urine (mean pH: 6.8 vs 6.2; P = .002) but not reduced serum acidosis. No adverse effects of oral citrates were reported.
Oral potassium citrate is an effective preventive supplement against kidney stones in children who receive the KD, achieving its goal of urine alkalinization. Universal supplementation is warranted.