Einfluß von Oxalyt-C auf Urinausscheidungsparameter und die relative Übersättigung von Kalziumoxalat unter standardisierten Ernährungsbedingungen

Alkali Citrate for Preventing Recurrence of Calcium Oxalate Stones

“…This explains why it is that, given the wide interindividual range of variations in dietary-dependent calcium excretion and that urinary investigations were performed only once in 3 months, the effects of citrate on calcium excretion were un doubtedly in part obscured by dietary factors. This is the reason why significant decreases in calcium excretion, as described by other research groups [6,12] carrying out investigations under different conditions, were not al ways obtained. The calcium/citrate ratios observed dur ing therapy were, however, lower than the initial values, and it therefore seems reasonable to assume that the product was being taken regularly ( fig.…”

“…During administration of alkali citrate there is a significant rise in urinary citrate excretion together with decreases in total and ionized calcium. These shifts produce measurable changes in the stone forming milieu [6], and these changes are claimed to pro vide a controllable and successful means of preventing recurrences of calcium-containing stones [4, 5,7], In the course of two clinical trials in recurrent calcium oxalate formers, the effect of raising citrate levels was investigated as a metaphylactic measure.Removal of stones from the urinary tract, whether by conservative measures designed to promote spontaneous passage of by surgical procedures, which range from instrumental manipulation to the now widely adopted technique of extracorporeal shockwave lithotripsy (ESWL), merely relieves the patient's symptoms without attacking the cause of the condition. Without appro priate treatment based on up-to-date knowledge of the etiological factors involved in stone formation, recur rence rates of 50-70% must therefore be expected [1, 2], These high rates -based on epidemiological dataunderline the need for carefully planned medical mea sures for preventing recurrences in patients who are at risk.…”