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Urolithiasis

, Volume 47, Issue 4, pp 311–320 | Cite as

Hydroxycitrate: a potential new therapy for calcium urolithiasis

  • Doyoung Kim
  • Jeffrey D. Rimer
  • John R. AsplinEmail author
Invited Review
  • 172 Downloads

Abstract

Alkali supplements are used to treat calcium kidney stones owing to their ability to increase urine citrate excretion which lowers stone risk by inhibiting crystallization and complexing calcium. However, alkali increases urine pH, which may reduce effectiveness for patients with calcium phosphate stones and alkaline urine. Hydroxycitrate is a structural analog of citrate, widely available as an over-the-counter supplement for weight reduction. In vitro studies show hydroxycitrate has the capacity to complex calcium equivalent to that of citrate and that it is an effective inhibitor of calcium oxalate monohydrate crystallization. In fact, hydroxycitrate was shown to dissolve calcium oxalate crystals in supersaturated solution in vitro. Hydroxycitrate is not known to be metabolized by humans, so it would not be expected to alter urine pH, as opposed to citrate therapy. Preliminary studies have shown orally ingested hydroxycitrate is excreted in urine, making it an excellent candidate as a stone therapeutic. In this article, we detail the crystal inhibition activity of hydroxycitrate, review the current knowledge of hydroxycitrate use in humans, and identify gaps in knowledge that require appropriate research studies before hydroxycitrate can be recommended as a therapy for kidney stones.

Keywords

Crystal Inhibitor Calcium oxalate Calcium phosphate Supplement 

Abbreviations

ACO

Amorphous calcium oxalate

AFM

Atomic force microscopy

CA

Citrate

CaP

Calcium phosphate

CaOx

Calcium oxalate

COD

Calcium oxalate dihydrate

COM

Calcium oxalate monohydrate

COT

Calcium oxalate trihydrate

FDA

Food and drug administration

GC

Garcinia Cambogia

GHS

Genetic hypercalciuric stone forming

HCA

Hydroxycitrate

OTC

Over the counter

Ox

Oxalate

S

Supersaturation ratio

ULM

Upper limit of metastability

Notes

Funding

J.D.R. acknowledges support from the Welch Foundation (grant E-1794).

Compliance with ethical standards

Conflict of interest

J.R.A. and J.D.R. have filed patent applications on the use of hydroxycitrate and other modifiers as growth inhibitors of pathological calcification.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Chemical and Biomolecular EngineeringUniversity of HoustonHoustonUSA
  2. 2.Litholink Corporation, Laboratory Corporation of America® HoldingsChicagoUSA

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