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Urological Research

, Volume 37, Issue 1, pp 41–46 | Cite as

Effect of two sports drinks on urinary lithogenicity

  • Jeffrey W. Goodman
  • John R. Asplin
  • David S. GoldfarbEmail author
Original Paper

Abstract

The effect of commercial oral rehydration solutions (“sports drinks”) relative to water on risk of nephrolithiasis has not been studied previously. We studied the effect of two sports drinks, Performance (Shaklee Corp., Pleasanton, CA, USA) and Gatorade (Gatorade, Chicago, IL, USA) on urinary chemistry and measures of lithogenicity in non-stone formers. Performance has a pH of 4.3, and contains 21 mmol/L of sodium, 5.3 mmol/L of potassium, 0.8 mmol/L of calcium, and 19.5 mmol/L of citrate. Gatorade pH ranges from 2.9 to 3.2, and contains 20 mmol/L of sodium, 3.2 mmol/L of potassium, negligible calcium, and 13.9 mmol/L of citrate. Subjects drank 946 ml (32 oz) of tap water daily for 3 days, and recorded diet history. This was followed by a second 3-day experimental period during which subjects drank 946 ml (32 oz) of sports drink daily, duplicating diets from part 1. In each 3-day period, urine was collected for 24 h during days 2 and 3. Urine chemical analysis was performed, and supersaturations of calcium oxalate, calcium phosphate and uric acid were calculated. Nine subjects completed the study using Performance, ten used Gatorade. Urine volumes and creatinine excretions were not different during the control and experimental periods. Performance increased mean citrate excretion by 170 mg/day (95% CI 57–284 mg/day; P = 0.01) and increased urine pH by 0.31 (95% CI 0.03–0.59; P = 0.03). Gatorade did not significantly change urinary citrate excretion or pH. Neither drink caused significant differences in the excretion of sodium and calcium or any supersaturation value. Ingestion of Performance, but not Gatorade, led to an increase in mean urinary citrate excretion and pH as compared to water. The increase in citrate is likely to be a clinically significant effect. pH is an important determinant of alkali load in beverages containing organic anions. Performance, with more citrate and a higher pH than Gatorade, could represent a superior alternative to water for reducing urinary lithogenicity. Most sports drinks with significant carbohydrate content however may contain too many calories, and fructose, to be preferred beverages for stone prevention.

Keywords

Beverages Calculi, renal Citrate Diet Fructose Kidney stones Oxalate Rehydration solutions Urolithiasis 

Notes

Acknowledgments

This work was supported in part by NIH grant 2R44DK59086-02 and by the Dept. of Veterans Affairs. We appreciate the administrative support of Frank Modersitzki.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Jeffrey W. Goodman
    • 1
  • John R. Asplin
    • 2
  • David S. Goldfarb
    • 3
    • 4
    Email author
  1. 1.Nephrology SectionNYU School of MedicineNew YorkUSA
  2. 2.Litholink Corp and Renal SectionSchool of Medicine, University of ChicagoChicagoUSA
  3. 3.Nephrology Section, New York Harbor VAMC, Department of UrologySt Vincents Hospital, NYU School of MedicineNew YorkUSA
  4. 4.NYU School of MedicineNew YorkUSA

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