Evidence supporting the use of: Citric acid
For the health condition: Kidney Stones

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Citric acid, primarily in the form of citrate (such as potassium citrate), is scientifically validated as a supportive treatment for certain types of kidney stones, particularly calcium oxalate stones. The rationale is based on citrate’s ability to bind calcium in the urine, reducing supersaturation of calcium oxalate and thus inhibiting stone formation and growth. Additionally, citrate can increase urine pH, which helps prevent the formation of uric acid stones. Several clinical studies and guidelines, including those from the American Urological Association, recommend citrate supplementation for patients with recurrent calcium stones, especially in those with low urinary citrate (hypocitraturia).

It is important to distinguish between citric acid (as found in citrus fruits) and pharmaceutical citrate salts. While consuming citrus juices like lemonade may modestly increase urinary citrate, the effect is generally less pronounced and less reliable than with prescribed citrate salts. Clinical trials have shown that potassium citrate supplementation can significantly reduce stone recurrence rates. However, citric acid itself (as found in dietary sources) is less potent, and not all patients respond equally.

In summary, there is robust scientific evidence supporting the use of citrate (and, to a lesser degree, citric acid from dietary sources) for the prevention of certain kidney stones. This practice is reflected in clinical guidelines and supported by randomized controlled trials, earning it a strong evidence rating.

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Kidney Stones