{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T14:11:48Z","timestamp":1779372708233,"version":"3.53.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009913","name":"Naval Medical Center San Diego","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009913","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urol Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the potential stone-preventative effects of apple cider vinegar (ACV) supplementation on 24-h urinary citrate, pH, and volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a randomized crossover trial testing ACV, coconut water, lemon water, and orange soda. Participants were non-stone formers randomized to two of the four beverages. Participants consumed one assigned beverage daily for one week, underwent a two-week washout period, and then consumed the second assigned beverage. Three 24-h urine collections were planned: one baseline collection prior to beverage consumption, one following completion of the first treatment week, and one following completion of the second week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty participants were enrolled. Eight were female. Six consumed ACV, six coconut water, eight lemon water, and six diet orange soda. ACV did not significantly change 24-h urinary parameters. Coconut water (+\u2009273.8\u00a0mg\/24\u00a0h, 95% CI 67.9\u2013480\u00a0mg\/24\u00a0h) and lemon water (+\u2009167.7\u00a0mg\/24\u00a0h, 95% CI 16\u2013319\u00a0mg\/24\u00a0h) were associated with increased urinary citrate. Effects on urine pH and volume were not significant in any treatment arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACV did not significantly change 24-h urine parameters. Coconut water and lemon water increased urinary citrate. Further study is necessary to validate these findings in a larger cohort. Registered with ClinicalTrials.gov (NCT04073719, 8\/28\/2019).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11255-025-04944-x","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T09:50:40Z","timestamp":1765014640000},"page":"1989-1994","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Apple cider vinegar for prevention of urinary lithiasis (APUL): a randomized crossover trial"],"prefix":"10.1007","volume":"58","author":[{"given":"Benjamin","family":"Baker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Herforth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josiah","family":"Low","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Craig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Christman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,6]]},"reference":[{"issue":"1","key":"4944_CR1","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.eururo.2012.03.052","volume":"62","author":"CD Scales","year":"2012","unstructured":"Scales CD, Smith AC, Hanley JM, Saigal CS, Urologic Diseases in America Project (2012) Prevalence of kidney stones in the United States. Eur Urol 62(1):160\u2013165","journal-title":"Eur Urol"},{"issue":"3","key":"4944_CR2","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1097\/01.ju.0000152082.14384.d7","volume":"173","author":"MS Pearle","year":"2005","unstructured":"Pearle MS, Calhoun EA, Curhan GC, Urologic Diseases of America Project (2005) Urologic diseases in America project: urolithiasis. J Urol 173(3):848\u2013857","journal-title":"J Urol"},{"issue":"5","key":"4944_CR3","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1038\/ki.1979.173","volume":"16","author":"CM Johnson","year":"1979","unstructured":"Johnson CM, Wilson DM, O\u2019Fallon WM, Malek RS, Kurland LT (1979) Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int 16(5):624\u2013631","journal-title":"Kidney Int"},{"issue":"2","key":"4944_CR4","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1016\/j.juro.2012.04.015","volume":"188","author":"M Bryant","year":"2012","unstructured":"Bryant M, Angell J, Tu H, Goodman M, Pattaras J, Ogan K (2012) Health related quality of life for stone formers. J Urol 188(2):436\u2013440","journal-title":"J Urol"},{"issue":"2","key":"4944_CR5","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.juro.2014.05.006","volume":"192","author":"MS Pearle","year":"2014","unstructured":"Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR et al (2014) Medical management of kidney stones: AUA guideline. J Urol 192(2):316\u2013324","journal-title":"J Urol"},{"issue":"6","key":"4944_CR6","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1089\/end.2019.0040","volume":"33","author":"D Golomb","year":"2019","unstructured":"Golomb D, Nevo A, Goldberg H, Ehrlich Y, Margel D, Lifshitz D (2019) Long-term adherence to medications in secondary prevention of urinary tract stones. J Endourol 33(6):469\u2013474","journal-title":"J Endourol"},{"key":"4944_CR7","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.urology.2021.05.084","volume":"156","author":"A Joshi","year":"2021","unstructured":"Joshi A, Tallman JE, Calvert JK, Brewer T, Miller NL, Yang L et al (2021) Complementary and alternative medicine use in first-time and recurrent kidney stone formers. Urology 156:58\u201364","journal-title":"Urology"},{"issue":"1","key":"4944_CR8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/S0022-5347(17)46962-X","volume":"134","author":"CYC Pak","year":"1985","unstructured":"Pak CYC, Fuller C, Sakhaee K, Preminger GM, Britton F (1985) Long-term treatment of calcium nephrolithiasis with potassium citrate. J Urol 134(1):11\u201319","journal-title":"J Urol"},{"issue":"3","key":"4944_CR9","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1038\/ki.1986.201","volume":"30","author":"CY Pak","year":"1986","unstructured":"Pak CY, Sakhaee K, Fuller C (1986) Successful management of uric acid nephrolithiasis with potassium citrate. Kidney Int 30(3):422\u2013428","journal-title":"Kidney Int"},{"issue":"6","key":"4944_CR10","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/S0022-5347(17)35888-3","volume":"150","author":"P Barcelo","year":"1993","unstructured":"Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak CY (1993) Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 150(6):1761\u20131764","journal-title":"J Urol"},{"issue":"2","key":"4944_CR11","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s00240-005-0464-8","volume":"33","author":"D Mattle","year":"2005","unstructured":"Mattle D, Hess B (2005) Preventive treatment of nephrolithiasis with alkali citrate\u2014a critical review. Urol Res 33(2):73\u201379","journal-title":"Urol Res"},{"issue":"8","key":"4944_CR12","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.2215\/CJN.11661112","volume":"8","author":"PM Ferraro","year":"2013","unstructured":"Ferraro PM, Taylor EN, Gambaro G, Curhan GC (2013) Soda and other beverages and the risk of kidney stones. Clin J Am Soc Nephrol 8(8):1389\u20131395","journal-title":"Clin J Am Soc Nephrol"},{"issue":"9","key":"4944_CR13","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1089\/end.2012.0092","volume":"26","author":"LdaC Baia","year":"2012","unstructured":"Baia LdaC, Baxmann AC, Moreira SR, Holmes RP, Heilberg IP (2012) Noncitrus alkaline fruit: a dietary alternative for the treatment of hypocitraturic stone formers. J Endourol 26(9):1221\u20131226","journal-title":"J Endourol"},{"issue":"3","key":"4944_CR14","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/S0022-5347(01)65659-3","volume":"156","author":"MA Seltzer","year":"1996","unstructured":"Seltzer MA, Low RK, McDonald M, Shami GS, Stoller ML (1996) Dietary manipulation with lemonade to treat hypocitraturic calcium nephrolithiasis. J Urol 156(3):907\u2013909","journal-title":"J Urol"},{"issue":"6","key":"4944_CR15","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1016\/j.urology.2007.02.008","volume":"69","author":"SG Koff","year":"2007","unstructured":"Koff SG, Paquette EL, Cullen J, Gancarczyk KK, Tucciarone PR, Schenkman NS (2007) Comparison between lemonade and potassium citrate and impact on urine pH and 24-hour urine parameters in patients with kidney stone formation. Urology 69(6):1013\u20131016","journal-title":"Urology"},{"key":"4944_CR16","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3061742","volume":"2018","author":"RM Patel","year":"2018","unstructured":"Patel RM, Jiang P, Asplin J, Granja I, Capretz T, Osann K et al (2018) Coconut water: an unexpected source of urinary citrate. Biomed Res Int 2018:3061742","journal-title":"Biomed Res Int"},{"issue":"1","key":"4944_CR17","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.urology.2013.03.002","volume":"82","author":"VB Pinheiro","year":"2013","unstructured":"Pinheiro VB, Baxmann AC, Tiselius HG, Heilberg IP (2013) The effect of sodium bicarbonate upon urinary citrate excretion in calcium stone formers. Urology 82(1):33\u201337","journal-title":"Urology"},{"issue":"4","key":"4944_CR18","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1016\/S0022-5347(17)37437-2","volume":"147","author":"K Sakhaee","year":"1992","unstructured":"Sakhaee K, Alpern R, Poindexter J, Pak CY (1992) Citraturic response to oral citric acid load. J Urol 147(4):975\u2013976","journal-title":"J Urol"},{"issue":"6","key":"4944_CR19","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.1016\/j.juro.2010.02.2388","volume":"183","author":"BH Eisner","year":"2010","unstructured":"Eisner BH, Asplin JR, Goldfarb DS, Ahmad A, Stoller ML (2010) Citrate, malate and alkali content in commonly consumed diet sodas: implications for nephrolithiasis treatment. J Urol 183(6):2419\u20132423","journal-title":"J Urol"},{"issue":"3","key":"4944_CR20","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1089\/end.2007.0304","volume":"22","author":"KL Penniston","year":"2008","unstructured":"Penniston KL, Nakada SY, Holmes RP, Assimos DG (2008) Quantitative assessment of citric acid in lemon juice, lime juice, and commercially-available fruit juice products. J Endourol 22(3):567\u2013570","journal-title":"J Endourol"},{"key":"4944_CR21","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing;"}],"container-title":["International Urology and Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11255-025-04944-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11255-025-04944-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11255-025-04944-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T13:41:11Z","timestamp":1779370871000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11255-025-04944-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,6]]},"references-count":21,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["4944"],"URL":"https:\/\/doi.org\/10.1007\/s11255-025-04944-x","relation":{},"ISSN":["1573-2584"],"issn-type":[{"value":"1573-2584","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,6]]},"assertion":[{"value":"27 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. I am a military Service member or employee of the U.S. Government. This work was prepared as part of my official duties. Title 17, U.S.C., \u00a7105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C., \u00a7101 defines a U.S. Government work as a work prepared by a military Service member or employee of the U.S. Government as part of that person\u2019s official duties.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}