PD21-07 EFFECT OF A HIGH CITRATE BEVERAGE ON URINE CHEMISTRY IN KIDNEY STONE FORMERS

Abstract

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (PD21)1 Sep 2021PD21-07 EFFECT OF A HIGH CITRATE BEVERAGE ON URINE CHEMISTRY IN KIDNEY STONE FORMERS Lama Nazzal, Frank Modersitzki, John Asplin, and David Goldfarb Lama NazzalLama Nazzal More articles by this author , Frank ModersitzkiFrank Modersitzki More articles by this author , John AsplinJohn Asplin More articles by this author , and David GoldfarbDavid Goldfarb More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002010.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Moonstone is a high citrate, over-the-counter beverage designed to prevent recurrent kidney stones. Popular lore has promoted citrus juice for stone prevention, but the amount required to have meaningful benefits (increased urine citrate and pH) is not well-established. Thus, there are no evidence-based beverages that serve as an alternative to water, designed to increase urine volume and alter urine chemistry, in order to achieve stone prevention. We sought to demonstrate the effects of Moonstone on urine chemistry in a group of stone formers of various compositions. METHODS: Participants mixed 1 packet of powder in water and drank it twice a day for one week. Patients temporarily discontinued alkali supplements but continued other meds. Total Moonstone dose comprised 9.2 meq Na, 11.3 meq K, 32 meq Mg, 30 calories, and 66 meq net alkali. We compared 24h urine chemistry to the result of a similar amount of water only. 16 patients participated: 11 with calcium, 2 with uric acid, 3 with cystine stones. Participants replicated self-selected diets on days 6 and 7 of the week, and performed 24h urine collection on day 7. Urine was sent to and analyzed by Litholink. We surveyed participants about preferences for a stone prevention regimen, comparing Moonstone to water alone or K-citrate if patients had previously taken that (12/16). RESULTS: Compared to water (table; *=p<0.05) Moonstone caused an increase in 24h urine citrate from 469.1 +231.9 mg/d to 635.4 +349.1 mg/day (delta 166.3 mg/day; P<0.05 by paired t test). 24h urine pH went up from 6.21 +0.78 to 6.61 +0.69 (delta 0.40, P<0.05). Patients expressed a preference for Moonstone compared to water alone or Urocit-K (Figure). CONCLUSIONS: 2 packets of Moonstone caused increases in 24h urine citrate and urine pH. In table, we compare the result to that of 60 meq of K-Mg-citrate which was associated with an 85% reduction in kidney stone recurrence in 3 years in patients with calcium stones (Ettinger et al, J Urol 158:2069, 1997; PMID 9366314). The effect on pH would also be expected to benefit patients with uric acid and cystine stones. Patients preferred Moonstone as a stone prevention regimen. Source of Funding: NYU Langone discretionary research funds © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e377-e377 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lama Nazzal More articles by this author Frank Modersitzki More articles by this author John Asplin More articles by this author David Goldfarb More articles by this author Expand All Advertisement Loading ...