Citric Acid (Citrate), Urine

Citrate is an organic acid produced during cellular energy metabolism (the citric acid cycle). It is measured in blood or urine to assess metabolic function and kidney stone risk, since citrate helps prevent calcium stone formation.

When elevated: Elevated citrate in urine is generally protective and reduces kidney stone risk. High blood citrate is uncommon and may reflect certain metabolic or kidney conditions, but is not typically a concern on its own. When low: Low urine citrate increases the risk of kidney stone formation, particularly calcium oxalate and calcium phosphate stones. Low citrate can result from metabolic acidosis, certain medications, or dietary factors.

Urine citrate is moderately relevant to athletes because intense or prolonged exercise increases dehydration and urine concentration, which can reduce citrate excretion and raise kidney stone risk—a concern for endurance athletes and those in hot climates. Adequate hydration and electrolyte balance help maintain normal citrate levels and reduce stone formation risk, supporting training consistency and long-term musculoskeletal health.