Introduction:
Calcium oxalate kidney stones, is a prevalent urological disorder affecting millions worldwide, characterized by high recurrence rates and significant morbidity. The standard approach to reducing stone formation involves the use of potassium magnesium citrate supplements, which are effective but often limited by gastrointestinal side effects. To address this limitation, we investigated the efficacy and safety of a novel Lime Powder Regimen (LPR) derived from natural sources—lime juice and peel—in preventing the recurrence of calcium oxalate kidney stones.
Methods:
We conducted a multi-center, randomized, double-blind, placebo-controlled trial across six hospitals in Thailand from 2018 to 2022. A total of173 patients who underwent a surgical removal of calcium oxalate were enrolled and randomly assigned to either the treatment group or the control group. The treatment group received 7.5 g of LPR daily, while the control group received an identical-appearing placebo composed of maltodextrin. The primary outcome measured was the rate of kidney stone recurrence, assessed using computed tomography (CT) scans at baseline, 12-month and the end of the study period. Secondary outcomes included the evaluation of kidney and liver function through serum creatinine, estimated glomerular filtration rate (eGFR), liver enzymes, and nutritional markers in both groups. Safety assessments focused on adverse events, changes in vital signs, and overall tolerability of the LPR.
Results:
Over the 24-month study period, 151 patients completed the trial, with 86 patients in the LPR group and 65 in the placebo group. Results showed that the LPR group had a significantly lower stone recurrence rate compared to the placebo group, with a recurrence rate reduction of 38% (15.1% versus 50.7%, 95% CI 0.1270 - 0.4679, p < 0.001). Notably, the LPR group demonstrated improved urinary citrate levels and a favorable urinary pH profile, which are well-established inhibitors of stone formation. No significant changes in kidney or liver function were observed between the two groups, as indicated by stable serum creatinine, eGFR, and liver enzyme levels. Moreover, the LPR was well-tolerated, with no reports of gastrointestinal discomfort or other adverse effects commonly associated with conventional citrate supplementation.
Conclusions:
The LPR significantly reduced stone recurrence rates in patients with calcium oxalate nephrolithiasis over a 24-month period without any adverse effects on kidney or liver function, suggesting its potential as an alternative treatment strategy for recurrent urolithiasis.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.