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14 We have used this technique to measure citric acid in different fruit juices. In the past decade, ion chromatography using suppressed conductivity has become the method of choice for measuring organic acids and other anions in a variety of matrices. These techniques are subject to interference, may be relatively insensitive, and can be laborious.
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Several methods have been used to measure citrate content of foods, including polarographic, enzymatic, and ion-exclusion chromatography. Knowledge of the citric acid content of fruit juices and commercially-available lemonade and limeade products may be clinically applicable to patients requiring enhancement or maintenance of therapeutic urinary citrate concentrations. While the citric acid content of lemon juice has been reported, 2 no published information exists about the citric acid content of commercially-available beverages in the U.S. Department of Agriculture Nutrient Database does not provide information on the citric acid content of foods.
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2 Two retrospective studies showed an effect in calcium stone formers of lemon juice and/or lemonade consumption on urinary citrate, 3, 4 but a recent clinical trial showed no influence of lemonade on urinary citrate. 9 Nonetheless, a prior study reported increased urinary citrate after 1 week on 4 ounces lemon juice per day, diluted in 2 L water, in stone formers with hypocitraturia. The amount of diet-derived citrate that may escape in vivo conversion to bicarbonate is reportedly minor. 7 Medical interventions to increase urinary citrate are a primary focus in the medical management of urolithiasis. 6 There is also evidence that citrate blocks the adhesion of calcium oxalate monohydrate crystals to renal epithelial cells. Citrate binds to the calcium oxalate crystal surface, inhibiting crystal growth and aggregation.
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Citrate retards stone formation by inhibiting the calcium oxalate nucleation process and the growth of both calcium oxalate and calcium phosphate stones, largely by its ability to bind with urinary calcium and reduce the free calcium concentration, thereby reducing the supersaturation of urine. The activity of citrate is thought to be related to its concentration in urine, where it exhibits a dual action, opposing crystal formation by both thermodynamic and kinetic mechanisms. Hypocitraturia, defined as <320 mg (1.67 mmol) urinary citrate/day, 5 is a major risk factor for calcium urolithiasis. Citrate is the most abundant organic ion found in urine. Approximately 10% to 35% of urinary citrate is excreted the remainder is absorbed in various ways, depending on urine pH and other intra-renal factors. Citrate is freely filtered in the proximal tubule of the kidney. Urinary citrate is a potent, naturally-occurring inhibitor of urinary crystallization. Gastrointestinal absorption of citric acid from dietary sources has been associated with a modest increase in urinary citrate excretion. A major source of citric acid in vivo results from endogenous metabolism in the mitochondria via the production of ATP in the citric acid cycle. Among fruits, citric acid is most concentrated in lemons and limes, 1 comprising as much as 8% of the dry fruit weight. Citrate salts of various metals are used to deliver minerals in biologically-available forms examples include dietary supplements and medications. Citric acid is frequently used as a food additive to provide acidity and sour taste to foods and beverages. At physiologic blood pH, and to a lesser extent in urine, it exists mainly as the trivalent anion. Citric acid (2-hydroxy-1,2,3-propanetricar-boxylic acid) is a weak tricarboxylic acid that is naturally concentrated in citrus fruits.