Dietary citrate, the usual form of citric acid in solution, is a well-known inhibitor of the formation of calcium oxalate and calcium phosphate stones, as it increases alkalinity of urine (increases pH) and increases citrate excretion.5 Citrus and citrus juices contain both citrate and potassium, which may aid in pH balance of the urine and reduce the risk of calcium loss from the bones.5,6
Multiple reviews, including a meta-analysis, concluded that the consumption of fruit juices, as a source of dietary citrate, can provide alkalization of urine and increase citrate excretion while providing fluid, which in turn reduces the risk of kidney stone formation.5-7 Indeed, researchers have observed the beneficial effects of increased urinary citrate with lemon juice.8-10 Orange juice has also been shown to increase urine pH and citrate and to reduce the supersaturation of calcium oxalate.11 Researchers continue to evaluate orange juice’s role in the prevention of kidney stones.
A prospective analysis of a Japanese cohort found that the consumption of 100% fruit juice was not associated with 5-year changes in kidney function in adults aged 35-69 years.12 High blood levels of uric acid may increase the risk for gout and kidney stones. In a longitudinal analysis of the Brazilian Longitudinal Study of Adult Health, consumption of unsweetened fruit juice was not associated with the incidence of hyperuricemia in adults aged 35-74 years.13 A systematic review and meta-analysis of controlled feeding trials found that 100% fruit juice decreased uric acid levels in certain trials. The certainty of evidence was considered high for the beneficial effect observed with 100% fruit juice.14
Based on the available data, citrus juice, such as 100% orange juice, may be beneficial in some cases to prevent the formation of kidney stones. 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. It is best to check with your doctor before making any dietary changes.
*Values based on a 2000 calorie diet. Calculated Daily Value (DV) percentages rounded to nearest whole percent. FDA rounding rules for nutrition labeling not applied when calculating percent DV. Information is not intended for labeling food in packaged form.