Articles

The Effectiveness of Lime Juice (Citrus aurantifolia) in Preventing Calcium Oxalate Crystal Formation: An In Vitro Model

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Background: Calcium oxalate (CaOx) stones are the most prevalent type of urolithiasis and are associated with high recurrence rates. Preventive approaches targeting early crystallization stages, particularly nucleation and aggregation, are therefore crucial. Citrate is a recognized inhibitor of CaOx crystallization; however, pharmacological citrate therapy may face limitations in long-term use. Lime juice (Citrus aurantifolia), a natural source of citrate, may serve as an alternative preventive agent.

Objective: To evaluate the inhibitory effect of lime juice (Citrus aurantifolia) on calcium oxalate crystal formation in vitro.

Methods: A true experimental study with a post-test only control group design was conducted using a synthetic urine model. Five groups were assessed: negative control, positive control (potassium citrate 0.6%), and lime juice at concentrations of 2.5%, 5%, and 10% (v/v). Crystallization was monitored turbidimetrically at 620 nm for 60 minutes. Nucleation slope (SN), aggregation slope (SA), time to maximum absorbance (Tmax), and inhibition percentages were analyzed using one-way ANOVA and Tukey’s HSD test.

Results: All lime juice concentrations significantly reduced aggregation and prolonged Tmax compared with the negative control. The 5% concentration showed the strongest nucleation inhibition among natural treatments, while 2.5% demonstrated the highest aggregation inhibition.

Conclusion: Lime juice effectively inhibits CaOx crystallization in vitro and shows potential as a natural, accessible preventive strategy.

The Effectiveness of Pineapple Juice (Ananas comosus (L.) Merr) in Preventing the Formation of Calcium Oxalate Crystals In Vitro

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Background: Kidney stones (urolithiasis), particularly those composed of calcium oxalate (CaOx), remain a global health issue with a high recurrence rate. Non-pharmacological approaches using natural compounds are considered valuable alternatives to invasive treatments. Pineapple (Ananas comosus) contains citric acid and bromelain, which have potential inhibitory effects on CaOx crystallization, although scientific evidence is still limited.

Methods: A true experimental study with a post-test only control group design was conducted using four crystallization parameters (Tmax, SN, SA, and percentage of inhibition) across five groups: negative control, positive control (0.5% potassium citrate), and pineapple juice at concentrations of 25%, 50%, and 100%. Absorbance measurements were performed using a UV-Vis spectrophotometer at two-minute intervals for 60 minutes. Data were analyzed using Shapiro–Wilk, Levene’s Test, Kruskal–Wallis, and Dunn’s Post Hoc tests with a 95% confidence level.

Results: Pineapple juice exhibited strong inhibitory activity against CaOx crystal formation. All treatment concentrations reduced SN by more than 90% and achieved complete aggregation inhibition, along with increased Tmax compared to the negative control. The 25% concentration produced the most optimal inhibition effect, showing substantial SN reduction and a significant rise in Tmax. The Kruskal–Wallis test showed significant differences between groups for SN and Tmax, though pairwise comparison with Dunn’s Post Hoc indicated no significant differences after correction.

Conclusion: Pineapple juice effectively inhibited CaOx crystallization in vitro by delaying nucleation and preventing crystal aggregation, suggesting its potential role as a natural non-pharmacological preventive agent for kidney stone formation.