This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Although increased fluid intake is a cornerstone of medical management of urolithiasis, the particular fluid ingested may promote or inhibit stone formation. A positive association has been noted between soda consumption and urinary stone disease. Such studies grouped soft drinks together, although some small studies have suggested that the negative metabolic effects occur with cola. Unlike colas which are acidified with phosphates, several soft drinks are acidified only with citrate, which has a well-established role in the treatment of urinary calculus disease. As citrate is a potent inhibitor of calculus formation, some patients with hypocitraturic nephrolithiasis may be treated with a daily supplement of potassium citrate. Our preliminary assays revealed that 1 liter of Fresca (Coca-Cola, Atlanta, GA) contains 3 grams of citrate. Fresca potentially offers an inexpensive, palatable, and sugar-free delivery vehicle for dietary citrate. As many patients continue to imbibe soda as their primary beverage, we hope to identify a soft drink less likely to promote (and potentially inhibit) stone formation. We thus propose a trial to investigate the metabolic effects of Fresca as compared with water and diet cola in normal volunteers on a standardized diet to assess the effect of soda consumption on urinary composition as it relates to the risk of stone formation.
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