Long-term effects of potassium citrate therapy on hypocitraturic calcium stones: a prospective randomized study
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH - Year 2016, Vol 8, Issue 3
Abstract
Background: Potassium citrate effectively reduces recurrence of hypocitraturic calcium nephrolithiasis. Objective: To evaluate the impact of long-term potassium citrate therapy on urinary metabolic parameters and stone recurrence rates in patients with hypocitraturic calcium stones. Design, Setting, Participants: This prospectively randomized controlled trial was conducted from January 2003 to December 2012. Patients aged over 40 years old, with a history of hypocitraturic calcium stones were eligible: of 347 patients, 101 were in the control group, and 102 patients were in the potassium citrate group. Baseline examinations and patient recruitment occurred in 2001. Intervention: Potassium citrate therapy consisted of Urocit®-K 60 mEq. per day. All patients met with a dietitian and were instructed to maintain a diet restricted to 2 g of sodium and 65 g of protein. The patients were asked to consume sufficient fluid to urinate ≥2 L daily. Main Outcome Measure: The primary outcome was mean change in urinary citrate level, measured throughout the entire follow-up period at an outpatient clinic for up to 10 years. Results: The final analysis included 101 (control) and 102 (Potassium citrate) patients. In the Potassium citrate group, mean urinary citrate levels increased from 197.8 (baseline) to 523.7 mg/day (9th year), with a response rate of 67.65% (P<0.001 vs. control). The stone recurrence rate ranged from 6.90% (1st year) to 68.32% (9th year) in the control group and from 2.94% (1st year) to 28.43% (9th year) in the potassium citrate group (P<0.001). Limitations: Enrolled patients was diagnosed complete stone free. The study cannot elucidate the role of residual fragments in the recurrent stones. Conclusions: Potassium citrate provides a significant alkali and citraturic response during long term therapy with a sustained change in urinary parameters. Moreover, long term potassium citrate therapy significantly decreases the stone formation rate, confirming usefulness in patients with hypocitraturic calcium stones.
Authors and Affiliations
Chung-Jing Wang, MD, Po-Chao Tsai, MD and Chien-Hsing Chang, MD
Keywords
Related Articles
- EP ID EP405049
- DOI -
- Views 114
- Downloads 0
ARE DENTISTS PRONE TO SUICIDE ?
According to WHO, 300 million suffer from depression. Suicide accounted for 1.4% of all deaths worldwide, making it the 17th leading cause of death in 2015.Medical training has reported to be very stressful. Global pre...
Analysis Of Serum Magnesium Level In Type 2 Diabetes Mellitus Patients
Background: Magnesium (Mg) deficiency is a common problem in diabetic patients. Hypomagnesemia increase the incidence of diabetes mellitus and occurrence of diabetic complications1 Diabetic peripheral neuropathy affects...
A very rare case of pycnodysostosis with concurrent osteomyelitis of mandible
Pycnodysostosis is a rare clinical entity, first described in 1962 by Maroteaux and Lamy. It is an autosomal recessive genetic disorder characterized by osteosclerosis, brittle bones, short stature, delayed closure of th...
Autopsy study of adrenals - a prospective study
Background: Adrenal glands are the least studied organ. Aim and objective: To study the gross and histomorphological changes of adrenals in various stress related conditions including mainly the non-neoplasti...
Sleep disorders in asthmatic children: an under noticed entity
Objective: To evaluate to pattern and proportion of sleep disorders in asthmatic children aged 6 to 18 years. Material & Method: It was a validated questionnaire based observational study, performed from May 2013 to Apr...