Impact of Long-Term Potassium Citrate Therapy on Urinary Profiles and Recurrent Stone Formation

Robinson, Marnie R.; Leitão, Victor A.; Haleblian, George E.; Scales, Charles D.; Chandrashekar, Aravind; Pierre, Sean A.; Preminger, Glenn M.

doi:10.1016/j.juro.2008.11.014

Cited by 59 publications

(33 citation statements)

References 7 publications

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“…This diagnosis was also more frequent in men 60.75 % than women, 39.25 %, similar percentages as in our previous sample of 2612 patients, 60 % of men [10], and as the 62 % described by Robinson et al [41]. The uric acid crystallization risk was 60 % in a subgroup of 25 tested patients.…”

Section: Discussionsupporting

confidence: 90%

“…Hypocitraturia was present as a single abnormality and associated with others in 10.55 % of the whole sample, less frequent than in the series of Robinson et al [41], 14.9 % of 503 patients, or in other series where hypocitraturia represented 20-60 % [42]. This diagnosis was also more frequent in men 60.75 % than women, 39.25 %, similar percentages as in our previous sample of 2612 patients, 60 % of men [10], and as the 62 % described by Robinson et al [41].…”

Section: Discussionmentioning

confidence: 50%

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Biochemical diagnosis in 3040 kidney stone formers in Argentina

et al. 2015

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Nephrolithiasis is a frequent condition in urology that has an important recurrence and high impact in health economy. Knowing the biochemical abnormalities implicated in its pathogenesis is mandatory to establish therapeutic aims. Our objectives are to present the results in 3040 kidney stone formers in Argentina. All patients were selected after completing an ambulatory metabolic protocol with diagnostic purposes. There were 1717 men, (56.48%), with a mean age of 45±12 years, and 1323 women, (43.52%), mean age 44±12 years. 2781 patients had biochemical abnormalities, (91.49%), and were arbitrarily divided in two groups: those who had only one (single) biochemical abnormality (n=2156) and those who had associated abnormalities (n=625). No biochemical abnormalities were found in 259 patients (8.51%). The abnormalities present, single and associated, in order of frequency, were idiopathic hypercalciuria, (56.88%), hyperuricosuria (21.08%), unduly acidic urine (10.95%), hypocitraturia (10.55%), hypomagnesuria (7.9%), primary hyperparathyroidism (3.01%), hyperoxaluria (2.6%), and cystinuria (0.32%). We performed in 484 patient's stone composition and found calcium oxalate stones related to idiopathic hypercalciuria predominantly while uric acid stones to unduly acidic urine. In conclusion, the biochemical abnormalities described are similar to those found in a previous series of our own and to those reported in the literature. Its diagnosis is important to therapeutic purposes to avoid eventual recurrence.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 50%

Biochemical diagnosis in 3040 kidney stone formers in Argentina

et al. 2015

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“…The balance of Th17 and Treg was important in the progression of various kidney diseases [22,23]. Recent studies demonstrated citrate's positive influence on chronic kidney disease [24]. It was normally used as an anticoagulant to correct the acidity of blood or urine in hemodialysis during CRF treatment [25].…”

Section: Discussionmentioning

confidence: 99%

Citrate Attenuates Adenine-Induced Chronic Renal Failure in Rats by Modulating the Th17/Treg Cell Balance

Zhu

et al. 2015

Inflammation

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Citrate is commonly used as an anticoagulant in hemodialysis for chronic renal failure (CRF) and for the regulation of the immune dysfunction in CRF patients. The objective of this study was to investigate the effect of citrate on the balance of T helper 17 (Th17) and regulatory T (Treg) cells in CRF. The levels of blood urea nitrogen (BUN) and serum creatinine (Scr) were significantly increased in the CRF model group compared to the control group, and were decreased in the citrate-treated groups. Citrate treatment inhibited the viability of Th17 cells while elevating the viability of Treg cells in CRF rats. Moreover, Th17-related cytokines significantly decreased while the Treg-related cytokines significantly increased with citrate treatment. Moreover, citrate had a negative influence on the deviation of Th17/Treg cells in CRF rats. Therefore, our study suggests that citrate had an anti-inflammatory effect on CRF through the modulation of the Th17/Treg balance.

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“…The inhibitory effect of citrate on calcium oxalate crystal growth and aggregation is also linked to a direct effect on the crystal surface (3,10). Consequently, and because of lack of significant adverse effects, citrate preparations are widely used in subjects with calcium oxalate nephrolithiasis (2,(11)(12)(13).…”

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Urine Calcium/Citrate Ratio in Children With Hypercalciuric Stones

et al. 2009

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Hypercalciuria is a common cause for stone formation in children. The aim was to delineate the role of urinary citrate in hypercalciuric children for protection against calcium stone formation. We evaluated random urine calcium, citrate, and creatinine in 149 controls, 78 hypercalciuric nonstone formers, and 34 hypercalciuric children with stone. Urine citrate/creatinine was highest in hypercalciuric nonstone formers 899 Ϯ 351 compared with controls 711 Ϯ 328 and stone formers 595 Ϯ 289 (p Ͻ 0.01 vs. both). Calcium/creatinine ratio was similar in hypercalciuric stone and nonstone formers, but significantly higher than controls. Consequently, urine Calcium/citrate ratio (mg/mg) increased from control 0.17 Ϯ 0.17 to 0.41 Ϯ 0.23 (p Ͻ 0.001) in hypercalciuric nonstone formers, and to 0.65 Ϯ 0.46 in stone formers (p Ͻ 0.001 compared with other groups). Area under receiver operating characteristic curve combined with multilevel risk analyses found calcium/citrate ratio of 0.326 to provide good discrimination between control and stone formers. We found 5th percentile for random urine citrate/creatinine ratio in school-aged children to be 176 mg/g, elevated urinary citrate excretion in hypercalciuric children to be protective against stone formation, and urine calcium/citrate ratio to be a good indicator for risk of stone formation. Whether intervention in hypercalciuric children to lower urine calcium/citrate Ͻ0.326 will provide protection against stone formation needs to be studied. (Pediatr Res 66: 85-90, 2009) T he incidence of urolithiasis in children has increased in recent years (1). The risk factors for urolithiasis commonly observed in children are low urine volume, increased urine calcium excretion, and low normal or decreased urinary citrate level (2). Citrate inhibits the spontaneous nucleation of calcium oxalate, crystal growth of calcium oxalate and calcium phosphate, and the heterogeneous nucleation of calcium oxalate by monosodium urate (3-8). Bisaz et al. (9) reported that citrate is responsible for 50% of the inhibitory activity against calcium phosphate precipitation in normal urine. The inhibitory effect of citrate on calcium oxalate crystal growth and aggregation is also linked to a direct effect on the crystal surface (3,10). Consequently, and because of lack of significant adverse effects, citrate preparations are widely used in subjects with calcium oxalate nephrolithiasis (2,11-13).In adult studies, Welshman and McGeown (14), Hobarth and Hofbauer (15) and Nikkila et al. (16) observed that urine calcium/citrate ratio was able to discriminate between stone formers and control population; the latter exhibiting a significantly lower calcium/citrate ratio. However, it was the impression in the above studies that the clinical use of urine calcium/citrate ratio was limited because of its wide range of variability and the influence of age and gender on urinary excretion of citrate. There is limited data on urine calcium/ citrate ratio in either healthy, hypercalciuric, or stone forming child...

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Impact of Long-Term Potassium Citrate Therapy on Urinary Profiles and Recurrent Stone Formation

Cited by 59 publications

References 7 publications

Biochemical diagnosis in 3040 kidney stone formers in Argentina

Biochemical diagnosis in 3040 kidney stone formers in Argentina

Citrate Attenuates Adenine-Induced Chronic Renal Failure in Rats by Modulating the Th17/Treg Cell Balance

Urine Calcium/Citrate Ratio in Children With Hypercalciuric Stones

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