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Citrate, Malate and Alkali Content in Commonly Consumed Diet Sodas: Implications for Nephrolithiasis Treatment
c Litholink Corp., Chicago, Illinois, and Nephrology Section, New York Harbor Veterans Affairs INFIRMARY, NY, New York
d Department of Urology, St. Vincent's Hospital and New York University College of Medicine, NY, New York
Received 11 Sept 2009, Available on-line 18 April 2010
Citrate is a known inhibitor of calcium mineral stone formation. Diet citrate and alkali intake may impact citraturia. Increasing alkali intake also raises urine pH, that may help prevent uric acid stones. We decided citrate, malate and total alkali concentrations in commonly consumed diet sodas to greatly help direct dietary recommendations in patients with hypocitraturic calcium or uric acid nephrolithiasis.
Components and Methods
Citrate and malate were measured in a lemonade beverage commonly used to treat hypocitraturic calcium mineral nephrolithiasis and in 15 diet plan sodas. Anions had been assessed by ion chromatography. The pH of each beverage was measured to allow calculation from the unprotonated anion focus utilizing the known pK of citric and malic acidity. Total alkali equivalents were calculated for each drink. Statistical evaluation was completed using Pearson's relationship coefficient.
Several sodas included an amount of citrate add up to or greater than that of alkali and total alkali being a lemonade beverage commonly used to treat hypocitraturic calcium nephrolithiasis (6.30 mEq/l citrate as alkali and 6.30 as total alkali). These sodas had been Diet plan Sunkist® Orange, Diet plan 7Up®, Sprite Zero, Diet Canada Dry out® Ginger Ale, Sierra Mist® Free, Diet Orange Crush®, Fresca® and Diet plan Hill Dew®. Colas, including Caffeine Free Diet Coke®, Coke Zero, Caffeine Free Diet plan Pepsi® and Diet Coke with Lime, got the cheapest total alkali (significantly less than 1.0 mEq/l). There was no significant correlation between beverage pH and total alkali content.
Several commonly consumed diet sodas contain moderate amounts of citrate as alkali and total alkali. This information is effective for dietary suggestions in sufferers with calcium mineral nephrolithiasis, specifically those with hypocitraturia. It may also become useful in sufferers with low urine pH and the crystals stones. Drink malate content is also essential since malate ingestion increases the total alkali shipped, which in turn augments citraturia and increases urine pH.
Supplementary material because of this article can be acquired at /journalofurology.
Correspondence: Division of Urology, GRB 1102, Massachusetts General Medical center, 55 Fruit St., Boston, Massachusetts 02114 (phone: 617-726-3512; FAX: 617-726-6131)
Economic interest and/or other relationship with PercSys and Ravine Group.