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.
Material and methods
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 < 0.001). Lemon juice was also found to inhibit the rate of crystal nucleation and aggregation. But orange juice did not have any effect on the calcium oxalate crystallization (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.