In vitro and in vivo study of effect of lemon juice on urinary lithogenesis
TL;DR: The results show that the lemon juice presents an important inhibitory effect in vitro, which seems to dissipate a effect of great quantity of citrates which in turn increases the excretion of oxalates.
Abstract: Summary.- OBJECTIVES: The diversity of experimental results obtained in the study of the effect of citrus juice on urinary lithogenicity moved us to study the effect of these substances in vitro and in-vivo. The in-vitro study is based on the turbidimetric method on calcium oxalate crystallization. In vivo, we studied the effect of lemon juice consumption on urinary chemistry and we tested it on calcium oxalate crystallization in natural urine. METHODS: The formation of crystals is induced by the addition of the oxalate and calcium solution. Optical density (OD) is measured in a closed system at physiological conditions. The effects of the various juices of lemon, was evaluated by the addition of 50 ml of juice. A male volunteer with no history of kidney stone participated in this study, by lemon juice ingestion. The pH, concentration of oxalate, calcium and citrate were determined before and after ingestion and urine was freshly analyzed by microscopy. RESULTS AND CONCLUSIONS: In synthetic urine, the inhibition rate of calcium oxalate crystallization increases gradually with the lemon juice concentration. In natural urine, we noted that the kinetics of crystallization of calcium oxalate, before and after ingestion of lemon juice, are comparable. In vivo, after ingestion, a small increase in mean urinary pH (from 6.7 ± 0.1 to 6.9 ± 0.1) was noted. Indeed, oxalate calcium means and citrate excretion increased during this period with 33. 41%, 6. 85 % and 3. 53% respectively. This increase in the oxalate excretion is probably explained by the conversion of the exogenous ascorbic acid contained in the lemon juice. These results show that the lemon juice presents an important inhibitory effect in vitro. The ingestion of the lemon juice seems to dissipate a effect of great quantity of citrates which in turn increases the excretion of oxalates. The presence of these two elements simultaneously: citrate and oxalate compensate for their opposite effect.
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TL;DR: In spite of substantial progress in the study of the biological and physical manifestations of kidney stones, there is no satisfactory drug to use in clinical therapy and the potential usefulness of herbal medicines in the management of urolithiasis is critically evaluated.
Abstract: Kidney stone formation or urolithiasis is a complex process that results from a succession of several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention within the kidneys. Epidemiological data have shown that calcium oxalate is the predominant mineral in a majority of kidney stones. Among the treatments used are extracorporeal shock wave lithotripsy (ESWL) and drug treatment. Even improved and besides the high cost that imposes, compelling data now suggest that exposure to shock waves in therapeutic doses may cause acute renal injury, decrease in renal function and an increase in stone recurrence. In addition, persistent residual stone fragments and the possibility of infection after ESWL represent a serious problem in the treatment of stones. Furthermore, in spite of substantial progress in the study of the biological and physical manifestations of kidney stones, there is no satisfactory drug to use in clinical therapy. Data from IN VITRO, IN VIVO and clinical trials reveal that phytotherapeutic agents could be useful as either an alternative or an adjunctive therapy in the management of urolithiasis. The present review therefore critically evaluates the potential usefulness of herbal medicines in the management of urolithiasis.
149 citations
TL;DR: The acid fraction of the extract of Tamarix gallica L gives an activity remarkable in the formation of urinary lithiasis (calcium oxalate); this effectiveness is due to the presence of functions of acid.
Abstract: The main objective is to study the inhibitor effect of acid fraction of the extract of Tamarix gallica L on the crystallization of calcium oxalate. The extract of Tamarix gallica L is very rich by acid compounds that are used as an inhibitor of nephrolithiasis (calcium oxalate). Our study of the calcium oxalate crystallization is based on the model of turbidimetry by means of a spectrophotometer. The calcium oxalate formation is induced by the addition of oxalate solutions of sodium and of calcium chloride. The addition of inhibitor with various concentrations enabled us to give information on the percentage of inhibition. The comparison between the turbidimetric slopes with and without inhibitor gives the effectiveness of inhibitor for the acid fraction. By comparing the photographs of with and without inhibitor, we concluded that the extract of Tamarix gallica L acts at the stage of growth. The acid fraction of the extract of Tamarix gallica L gives an activity remarkable in the formation of urinary lithiasis (calcium oxalate); this effectiveness is due to the presence of functions of acid.
54 citations
Cites background from "In vitro and in vivo study of effec..."
...Finally, majority of the work is directed toward studying the inhibiting effect of the extracts of medicinal plants on the lithiasis urinary [17, 18]....
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TL;DR: Effective prevention of urinary stone formation should aim at restoring the urine’s ability to inhibit calcium oxalate crystallization and more emphasis should be given to dietary measures.
Abstract: In recent years significant progress has been made in identifying and quantitating physico-chemical processes involved in urinary stone formation. The ability of urine to inhibit calcium oxalate crystallization is an important mechanism against stone formation. Dietary factors appear to affect the ability of urine to inhibit calcium oxalate crystallization. These factors encouraged us to study the effects of lemon and orange juices on calcium oxalate crystallization in vitro. The nucleation and aggregation of calcium oxalate monohydrate crystals were studied using turbidimetric 30-min time course measurements of optic density at 620 nm after mixing solutions containing calcium chloride and sodium oxalate at 37°C, pH 5.7. The formation of crystals is induced by the addition of the oxalate and calcium solution. The effects on calcium oxalate crystal growth of trisodium citrate, lemon and orange juices were examined. The effects of lemon and orange juices were evaluated by the addition of 50 ml of juices. The optical density is measured at physiological conditions. The maximum increase of optic density with time, termed SN, reflects maximum rate of formation of new particles. After an equilibrium has been reached, a progressive decrease of optic density with time is observed. Rate of aggregation, SA, is derived from the maximum decrease in optic density. Among the modifiers studied, citrate decreased both SN and SA (P 0.05). These results show that effective prevention of urinary stone formation should aim at restoring the urine’s ability to inhibit calcium oxalate crystallization and more emphasis should be given to dietary measures.
34 citations
Cites methods from "In vitro and in vivo study of effec..."
...The effects of lemon and orange juices were evaluated by the addition of 50 ll of each juice [7]....
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Journal Article•
TL;DR: The present research evaluating the scientific basis of antilithiatic potential of various plants and role of plant proteins as therapeutic agents thus opening new vista in the management of urolithiasis is focused on.
Abstract: Role of herbal drugs and medicinal plant extracts in the successful treatment of urolithiasis, classified as the third most common urinary tract diseases is well documented. Ayurvedic plants and their components mediate antilithogenic effects by altering ionic composition of urine, being diuretic, antioxidant or having antimicrobial activity. Therapeutic peptides and proteins have unique place in pharmaceutical biotechnology due to their critical roles in cell biology. The innovation in antilithiatic proteins is that they are anionic, rich in acidic amino acids which make oxalate unavailable by interacting with calcium and have EF Hand domain which is a characteristic feature of various calcium binding protein like calgranulin, osteopontin. The review provides a background on the pathogenesis of urolithiasis and medical treatments. It focusses on the present research evaluating the scientific basis of antilithiatic potential of various plants and role of plant proteins as therapeutic agents thus opening new vista in the management of urolithiasis. Further investigations are required to fully decipher the mode of action of the potent biomolecules so as to exploit their preventive and therapeutic potential.
33 citations
Journal Article•
TL;DR: Ethanolic extracts of fruits were more effective than aqueous extracts and highest antibacterial activity was recorded against S. aureus and least was recorded for K. pneumoniae.
Abstract: The present study describes the antibacterial activity of five selected fruits on four pathogenic bacteria isolated from patients suffering with wound infections. Ethanolic extracts of fruits were more effective than aqueous extracts. Punica granatum has shown highest antibacterial activity followed by Malus domestica, Citrus limonium and Citrus limetta. Lowest antibacterial activity was recorded for Solanum lycospersicum. Among all bacteria tested highest antibacterial activity was recorded against S. aureus and least was recorded for K. pneumoniae.
25 citations
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TL;DR: A high dietary calcium intake decreases the risk of symptomatic kidney stones in a cohort of 45,619 men, 40 to 75 years of age, who had no history of kidney stones.
Abstract: Background A high dietary calcium intake is strongly suspected of increasing the risk of kidney stones. However, a high intake of calcium can reduce the urinary excretion of oxalate, which is thought to lower the risk. The concept that a higher dietary calcium intake increases the risk of kidney stones therefore requires examination. Methods We conducted a prospective study of the relation between dietary calcium intake and the risk of symptomatic kidney stones in a cohort of 45,619 men, 40 to 75 years of age, who had no history of kidney stones. Dietary calcium was measured by means of a semiquantitative food-frequency questionnaire in 1986. During four years of follow-up, 505 cases of kidney stones were documented. Results After adjustment for age, dietary calcium intake was inversely associated with the risk of kidney stones; the relative risk of kidney stones for men in the highest as compared with the lowest quintile group for calcium intake was 0.56 (95 percent confidence interval, 0.43 to 0.73; P f...
1,053 citations
TL;DR: It is concluded that beverage type may have an effect on stone formation that involves more than additional fluid intake alone.
Abstract: Patients with kidney stones are routinely advised to increase their fluid intake to decrease the risk of stone recurrence. However, there has been no detailed examination to determine whether the effect on recurrence varies by the type of beverage consumed. The authors conducted a prospective study of the relation between the intake of 21 different beverages and the risk of symptomatic kidney stones in a cohort of 45,289 men, 40-75 years of age, who had no history of kidney stones. Beverage use and other dietary information was measured by means of a semiquantitative food frequency questionnaire in 1986. During 6 years of follow-up (242,100 person-years), 753 incident cases of kidney stones were documented. After adjusting simultaneously for age, dietary intake of calcium, animal protein and potassium, thiazide use, geographic region, profession, and total fluid intake, consumption of specific beverages significantly added to the prediction of kidney stone risk (p < 0.001). After mutually adjusting for the intake of other beverages, the risk of stone formation decreased by the following amount for each 240-ml (8-oz) serving consumed daily: caffeinated coffee, 10% (95% confidence interval 4-15%); decaffeinated coffee, 10% (3-16%); tea, 14% (5-22%); beer, 21% (12-30%); and wine, 39% (10-58%). For each 240-ml serving consumed daily, the risk of stone formation increased by 35% (4-75%) for apple juice and 37% (1-85%) for grapefruit juice. The authors conclude that beverage type may have an effect on stone formation that involves more than additional fluid intake alone.
283 citations
TL;DR: Whether the individual type of fluid ingested is important in women, the relation between 17 different beverages and risk for symptomatic kidney stones in a cohort of 81 093 women in the United States is examined.
Abstract: Background: An increase in fluid intake is routinely recommended for patients who have had kidney stones to decrease the likelihood of recurrence. However, data on the effect of particular beverage...
271 citations
TL;DR: Orange juice should be beneficial in the control of calcareous and uric acid nephrolithiasis and lacked the ability of potassium citrate to decrease urinary saturation of calcium oxalate.
233 citations
TL;DR: Lemonade therapy may improve patient compliance, and may be useful as adjunctive treatment for patients with hypocitraturic calcium nephrolithiasis, as well as increasing urinary citrate levels more than 2-fold without changing total urinary volume.
201 citations