2254 a prospective randomized comparison of regular and diet lemonade upon risk for urinary stone formation

You have accessJournal of UrologyStone Disease: Evaluation & Medical Management II1 Apr 20122254 A PROSPECTIVE RANDOMIZED COMPARISON OF REGULAR AND DIET LEMONADE UPON RISK FOR URINARY STONE FORMATION Damien Smith, Amy Schlaifer, Jonathan Heldt, Kirk Anderson, Joseph Fargusson, John Asplin, Jonathan Heldt, Catherine Chen, Georgia Hodgkin, and D. Duane Baldwin Damien SmithDamien Smith Loma Linda, CA More articles by this author , Amy SchlaiferAmy Schlaifer Loma Linda, CA More articles by this author , Jonathan HeldtJonathan Heldt Loma Linda, CA More articles by this author , Kirk AndersonKirk Anderson Loma Linda, CA More articles by this author , Joseph FargussonJoseph Fargusson Loma Linda, CA More articles by this author , John AsplinJohn Asplin Chicago, IL More articles by this author , Jonathan HeldtJonathan Heldt Loma Linda, CA More articles by this author , Catherine ChenCatherine Chen Loma Linda, CA More articles by this author , Georgia HodgkinGeorgia Hodgkin Loma Linda, CA More articles by this author , and D. Duane BaldwinD. Duane Baldwin Loma Linda, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2431AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recurrent urinary stone formers are traditionally encouraged to consume lemonade to enhance urinary citrate excretion. However, the additional caloric intake may result in weight gain and subsequent compliance issues. The objective of this study was to compare the effects of regular and diet lemonade upon the risk for urinary stone formation. METHODS In this prospective, randomized, single-blinded, cross-over study 13 medical professionals (7 male, 6 female) with no history of urinary stones or metabolic diseases underwent six 24 hour urine determinations. All individuals underwent two 24 hour urine collections at baseline. Participants were then randomized to either consumption of 2 liters of regular or diet lemonade daily for 5 days. Urine collections were performed on days 4 and 5 while on a controlled low oxalate diet consisting of 100 to 150 mEq sodium/day, 800 – 1200 mg calcium/day, 1 to 1.2 grams protein/kg body weight/day. A 1-week washout period was given between each of the three study phases. A Friedman's non-parametric test was used to compare urinary parameters between diet and regular lemonade, and between the treatments and baseline. RESULTS Creatinine excretion varied by <15% in all 6 collections per individual demonstrating consistency in urine collection. Urine volume significantly increased with consumption of both regular and diet lemonade (p<0.001). The supersaturation ratio of CaPO4 decreased compared to baseline from 1.06 to 0.53 with consumption of regular lemonade (p=0.001) and from 1.06 to 0.58 for diet lemonade (p=0.01). When comparing diet and regular lemonade, diet lemonade resulted in decreased supersaturation of calcium oxalate 2.57 vs 3.42, respectively; p=0.021) and significantly increased urinary citrate (777 vs 610 mg/day, respectively; p=0.001). CONCLUSIONS Diet lemonade significantly increased urinary citrate while decreasing supersaturation of calcium oxalate compared to regular lemonade. This study suggests that diet lemonade is even more effective than regular lemonade consumption in improving urinary parameters for stone formation prevention, while reducing the caloric consumption from 816 to 40 calories per day. This could result in a difference of 80 pounds weight gain over one year of treatment. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e909 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Damien Smith Loma Linda, CA More articles by this author Amy Schlaifer Loma Linda, CA More articles by this author Jonathan Heldt Loma Linda, CA More articles by this author Kirk Anderson Loma Linda, CA More articles by this author Joseph Fargusson Loma Linda, CA More articles by this author John Asplin Chicago, IL More articles by this author Jonathan Heldt Loma Linda, CA More articles by this author Catherine Chen Loma Linda, CA More articles by this author Georgia Hodgkin Loma Linda, CA More articles by this author D. Duane Baldwin Loma Linda, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...