Effect of Potassium Citrate Therapy on Stone Recurrence and Residual Fragments after Shockwave Lithotripsy in Lower Caliceal Calcium Oxalate Urolithiasis: A Randomized Controlled Trial

Soygür, Tarkan; Akbay, Ayşegül; Küpeli, Sadettin

doi:10.1089/089277902753716098

Cited by 142 publications

(70 citation statements)

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“…Following these treatments, the achievement of stone-free condition or of residual fragments with a diameter smaller than 4 mm is de- fined as a therapeutical success (1,2). The presence of residual fragments is commonly found following these modern treatments, particularly after ESWL (1,2,8). It is clinically relevant, as a recognized predisposing factor for new stone formation (1-4), recurrent urinary tract infections, pain and, in general, for need of further additional treatments (1).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies demonstrated the effect of alkaline citrate in prevention and/or reduction of the stone recurrence and stone growth (1)(2)(3)(4). In the current study, we evaluated the preventive effects of potassium-sodium citrate on stone recurrence as well as stone growth post-ESWL or PCNL, in patients with calcium-containing stones.…”

Section: Introductionmentioning

confidence: 96%

“…(low urinary citrate) is an important risk factor for calcium nephrolithiasis (1)(2)(3)(4). Several studies demonstrated the effect of alkaline citrate in prevention and/or reduction of the stone recurrence and stone growth (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

“…Stone recurrence is usually found after either treatment, even in those with a stone-free post-therapy status. In addition, retained stone fragments following those therapies may reaggregate or constitute a nucleus for new stone formation, thereby causing a high rate of stone growth (1)(2)(3)(4). The patient's chances of first episode recurrent stone formation range between 27% and 50% (5,6).…”

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Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy

et al. 2011

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Objective: To evaluate the preventive effects of alkaline citrate on stone recurrence as well as stone growth post-ESWL or PCNL in patients with calcium-containing stones. Materials and Methods: A total of 76 patients with calcium calculi who were stone-free or had residual stones less than 4 mm following ESWL and PCNL were enrolled. All patients were independently randomized into two groups. The treated group (N = 39) was given 81 mEq per day of oral potassium-sodium citrate (27 mEq three times a day), and the untreated group (N = 37) serving as controls. Blood, twenty-four hour urine analysis, and plain KUB were measured and compared at the baseline and after 12 months. Results: At baseline, hypocitraturia was found in 20 of 39 patients (46.05%) of Group I and 15 of 37 patients (40.5%) of Group II. At 12 months, hypocitraturia was found in 3 of 39 (7.69%) and 14 of 37 (37.83%) of Group I and Group II, respectively (p = 0.007). At the 12 month follow-up, of the stone-free group, 92.3% of the treated group and 57.7% of the control group were still stone free. Of the residual stone group, 30.8% and 9.1 % of treated and control group were stone-free, respectively. The increased stone size found in 7.7% and 54.5% of treated and control groups, respectively. Conclusion: Sodium-potassium citrate provides positive effects on stone-forming activities in calcium stone patients suffering from urolithiasis following treatment with ESWL and PCNL procedures at the 12-month follow-up. With the advantage of high efficiency and low morbidity rates, extracorporeal shock wave lithotripsy (ESWL) has become the therapy of choice for small renal stones. Percutaneous nephrolithotomy (PCNL) is also becoming the therapy of choice for large renal stones due to the less invasive procedure as compared to open nephrolithotomy. These therapies provide good results, associated with an acceptable rate of complications, but unfortunately they do not change the underlying metabolic abnormality. Stone recurrence is usually found after either treatment, even in those with a stone-free post-therapy status. In addition, retained stone fragments following those therapies may reaggregate or constitute a nucleus for new stone formation, thereby causing a high rate of stone growth (1-4). The patient's chances of first episode recurrent stone formation range between 27% and 50% (5,6). Medical treatment should therefore be considered following these interventions, in order to prevent further secondary treatments and hospitalizations. Among the metabolic disorders usually found in recurrent stone forming patients, hypocitraturia Clinical Urology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy

et al. 2011

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“…Stone recurrence usually occurs after treatment, even in those with a stonefree status after treatment. In addition, retained stone fragments following this therapy may reform or compose a nucleus for another stone formation, hence causes a high rate of stone growth [2][3][4][5]. The patient's chances of first episode recurrent stone formation range between 27% and 50% [6,7].…”

Section: Introductionmentioning

confidence: 99%

Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients

Gadalla¹

2016

Med Surg Urol

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Objectives: To evaluate the factors that affect the success rate of ESWL for treatment of renal stones and to estimate the prevalence of stone recurrence during a 1-year period. Materials and Methods:During the period of January, 2010 and December, 2010, prospective study of 142 subjects with single or multiple renal stones (<30 mm, largest diameter) undergone ESWL monotherapyby Siemens-LITHOSKOP lithotriptor. The results of treatment were assessedafter a follow-up period of 3 months. Treatment success was a complete clearance of the stones or presence of insignificantresidual fragments<4 millimeters. Correlation of the success rate with the characteristics of the subjects, conditionsof the urinary tract and features of the stone was done.Results: During the 3-months follow-up period, the success rate was 111/142 (78%). Re-treatment was needed in 75 patients (52.8%). Post-treatment procedures were done in 12 subjects (8.4%). Post-ESWL complications were observed in 5 subjects (3.5%). Out of 10 prognosticfactors studied, 5 had a powerful influence on the success rate, which are: renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number. Other factors including age, sex, nationality, stonenature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. Conclusions:Prediction of success of treatment with ESWL and the recurrence depends and may be predicted by renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number.

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Pharmacological interventions for preventing complications in idiopathic hypercalciuria

Escribano

Balaguer

Pagone

et al. 2009

Cochrane Database of Systematic Reviews

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There is some evidence that in patients with idiopathic hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) reduced the number of stone recurrences and decreased the stone formation rate. Thiazides and neutral potassium phosphate decreased calciuria in symptomatic patients with idiopathic hypercalciuria. There were no studies investigating the effect of pharmacological treatment on other clinical complications or asymptomatic idiopathic hypercalciuria.

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Effect of Potassium Citrate Therapy on Stone Recurrence and Residual Fragments after Shockwave Lithotripsy in Lower Caliceal Calcium Oxalate Urolithiasis: A Randomized Controlled Trial

Abstract: Potassium citrate therapy significantly alleviated calcium oxalate stone activity after SWL for lower pole stones in patients who were stone free. An important observation was the beneficial effect of medical treatment on stone activity after SWL among patients with residual calculi.

Cited by 142 publications

References 10 publications

Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy

Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy

Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients

Pharmacological interventions for preventing complications in idiopathic hypercalciuria

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