Nephrolithiasis is the formation of stones in the urinary tract, commonly referred to as kidney stones. The development of stones is related to decreased urine volume or increased excretion of stone-forming components such as calcium, oxalate and phosphate. A high fluid intake is normally the general advice given to patients for the prevention of stone recurrence regardless of stone composition. Citrate, the usual form of citric acid in solution, is a well-known inhibitor of the formation of calcium oxalate and calcium phosphate stones. Quantitative analysis revealed the highest concentration of citrate among juices was in grapefruit juice, followed by lemon juice, orange juice, pineapple juice, and cranberry juice.

A systematic review and meta-analysis of intervention studies concluded that the consumption of commercial fruit juices was successful in increasing citrate levels in urine.(Pachaly) Odvina conducted a study to evaluate the value of orange juice and lemonade with respect to their effects on acid-base balance and reducing stone-forming risk and reported that orange juice consumption could result in biochemical modification of stone risk factors, however due to the short observation term of the study (each phase lasted 1 week) additional research is needed to evaluate orange juice’s role in long-term prevention of recurrent nephrolithiasis.

In a prospective study of over 194,000 men and women in the Health Professionals Follow Up Study and Nurses’ Health Studies I and II cohorts who were followed for a median of over 8 years,  consumption of orange juice was associated with a 12% reduced risk for developing kidney stones(Ferraro). Based on the available data, patients with mild to moderate hypocitraturia (low citrate in urine) may benefit from the daily intake of citrus based juices as part of a healthy diet.

References
Ferraro PM et al. Clin J Am Soc Nephrol. 2013;8:1389-1395.
Odvina CV et al. Clin J Am Soc Nephrol. 2006;1:1269-1274.
Pachaly MA et al. Nephrol Dial Transplant. 2016;31(8):1203-1211.

Additional Resources

Cancalon PF. Orange and Grapefruit Bioactive Compounds, Health Benefits and Other Attributes, in Bioactives in Fruit: Health Benefits and Functional Foods (eds M. Skinner and D. Hunter), John Wiley & Sons, Ltd, Oxford, UK. 2013. Abstract.

Cancalon PF, King D. Health benefits of polyphenol-rich orange and grapefruit juices. Acta Hortic. 2015;1065:727-734. Abstract.

A review and critical analysis of the scientific literature related to 100% fruit juice and human health. Adv Nutr. 2015;6:37-51. Abstract.

100% citrus juice: nutritional contribution, dietary benefits, and association with anthropometric measures.Crit Rev Food Sci Nutr. 2017;57(1):129-140. Abstract.

100% fruit juice: perspectives amid the sugar debate. Public Health Nutrition. 2016;19:906-913. Abstract.