Korean J Urol.  2006 Jun;47(6):631-634. 10.4111/kju.2006.47.6.631.

Clinical Significance of Hypocitraturia in Patients with Nephrolithiasis

• Lee SY
• Moon YT

• KMID: 2294238
• DOI: http://doi.org/10.4111/kju.2006.47.6.631

Abstract

PURPOSE: Hypocitraturia is cited as one of the risk factors promoting stone formation or recurrence of nephrolithiasis. We estimated the relationship between hypocitraturia and other metabolic abnormalities, such as hypercalciuria, hyperuricosuria and hyperoxaluria. The effects of potassium citrate medication were also investigated.
MATERIALS AND METHODS
We selected 706 renal stone patients with hypocitraturia (<320mg/day), who had received extracorporeal shock wave lithotripsy (ESWL) treatment, and examined the relationship between hypocitraturia and other metabolic abnormalities according to sex and age. We also examined the increment effect of urinary citrate and stone-free rate following potassium citrate (Urocitra(R)) medication.
RESULTS
Complicated hypocitraturia (coexistence with other metabolic abnormalities) was found in 332 of the 706 patients (47.0%). Of the 706 patients, 242 (34.3%), 112 (15.9%) and 33 (4.7%) had hyperoxaluria, hyperuricosuria and hypercalciuria, respectively. Complicated hypocitraturia was higher in the male than female subjects, and was statistically significant (50.4% vs. 39.8%). In 287 (77%) of the 373 patients who received potassium citrate treatment, the urinary citrate level was increased. The mean urinary citrate level was significantly increased (142.5 vs. 336.2 mg/day) (p<0.01), but the stone free rate was not following the citrate treatment.
CONCLUSIONS
Potassium citrate was effective in increasing the urinary citrate level. However, prophylactic effects of potassium citrate against recurrent nephrolithiasis must be proved by appropriate comparative studies.

Keyword

Hypocitraturia; Potassium citrate (Urocitra(R)); Nephrolithiasis

MeSH Terms

Citric Acid
Female
Humans
Hypercalciuria
Hyperoxaluria
Lithotripsy
Male
Nephrolithiasis*
Potassium Citrate
Recurrence
Risk Factors
Shock
Citric Acid
Potassium Citrate

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