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  • Review Article
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Dietary therapy for patients with hypocitraturic nephrolithiasis

Nature Reviews Urology volume 8, pages 146–152 (2011)Cite this article

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Abstract

Citrate is an inhibitor of urinary stone formation. Clinical and in vitro data suggest that increasing urine citrate levels will decrease the precipitation of calcium stones. Historically, low urinary citrate has been treated with oral potassium citrate or sodium citrate supplementation, but recent studies have shown the potential of dietary interventions to raise urine citrate levels. Dietary therapy with commercial or homemade beverages is attractive to patients who would prefer nonpharmacological intervention. To date, several drinks have shown promise but no single beverage has been found to consistently raise urine citrate levels in a reproducible fashion. Further research is necessary to develop the ideal dietary therapy for hypocitraturic calcium nephrolithiasis.

Key Points

  • Low urinary citrate (hypocitraturia) is a common finding in patients with calcium oxalate nephrolithiasis

  • Pharmacological treatments that increase urine citrate levels have been shown to prevent stone recurrence in patients with hypocitraturia

  • Dietary therapy with ready-made or homemade beverages is attractive to patients who would prefer nonpharmacological intervention

  • To date, several beverages have shown promise but no single drink has been found to consistently raise urine citrate levels in a reproducible fashion

  • Future research is necessary to develop the ideal dietary therapy for hypocitraturic calcium nephrolithiasis

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Acknowledgements

The authors would like to thank Dr John Asplin for his critical review of this manuscript.

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Authors and Affiliations

  1. Department of Urology, GRB 1102, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, 02114, MA, USA

    Michael P. Kurtz & Brian H. Eisner

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  1. Michael P. Kurtz
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Contributions

M. P. Kurtz was responsible for researching data for the article. M. P. Kurtz and B. H. Eisner contributed equally to discussion of content, and writing the article. B. H. Eisner was responsible for reviewing the manuscript before submission.

Corresponding author

Correspondence to Brian H. Eisner.

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Competing interests

B. H. Eisner has acted as a consultant for Boston Scientific, PercSys and The Ravine Group. M. P. Kurtz declares no competing interests.

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Kurtz, M., Eisner, B. Dietary therapy for patients with hypocitraturic nephrolithiasis. Nat Rev Urol 8, 146–152 (2011). https://doi.org/10.1038/nrurol.2011.9

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