Long-term Follow-up of Stone Formers Treated with a Low Dose of Sodium Potassium Citrate

Jendle-Bengten, Cecilia; Tiselius, Hans‐Göran

doi:10.1080/003655900750016869

Cited by 31 publications

(13 citation statements)

References 26 publications

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“…Both sodium potassium citrate and potassium citrate alter urinary composition favourably [63][64][65][66][67][68][69], but the admixture of sodium might result in an increased calcium excretion or a less pronounce reduction in urinary calcium [37,70]. Clinical studies subsequently indicated that potassium citrate is superior to sodium potassium citrate in counteracting stone formation [71].…”

Section: Alkaline Citratementioning

confidence: 99%

“…In the average population of recurrent stone formers the annual frequency of stone formation is <0.15-0.20 [35,36], thus no definite conclusions can be drawn from treatment periods of <5-7 years! To maintain patients on placebo treatment for so long is not easy, particularly as compliance even among patients given active medication is surprisingly low [37,38].…”

Section: Theoretical Possibilities For Preventing Recurrence In Patiementioning

confidence: 99%

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Epidemiology and medical management of stone disease

2003

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SUMMARYRecurrent stone formation in the urinary tract is a common and important problem that must be considered in daily urological practice. With a prevalence of> 10% and an expected recurrence rate of ≈ 50%, stone disease has an important effect on the healthcare system. It is generally agreed that patients with uric acid/urate, cystine or infection stones always should be treated pharmacologically. For calcium stone formers the treatment should be chosen according to the severity of the disease. Recurrence in patients with calcium‐stone disease can be prevented with general or specific dietary and drinking advice, and with pharmacological therapy. For idiopathic calcium stone formers the most convincing therapeutic effects have been reported with thiazide and alkaline citrate.

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Section: Alkaline Citratementioning

confidence: 99%

Section: Theoretical Possibilities For Preventing Recurrence In Patiementioning

confidence: 99%

Epidemiology and medical management of stone disease

2003

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“…Despite its proven efficacy, compliance with potassium citrate therapy is poor. In one study that looked at long-term follow-up of stone formers who were treated with potassium citrate, only 62% consistently took the medication [ 14 ]. In addition, given that potassium citrate therapy is costly, upward off $180 USD/month for three times daily dosing of 20 meq, alternative dietary therapies have been evaluated [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Coconut Water: An Unexpected Source of Urinary Citrate

Jiang

Asplin

Granja

et al. 2018

BioMed Research International

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Purpose Coconut water has long been touted for its medicinal qualities including natural hydration. We sought to determine whether its consumption would induce changes to urinary lithogenic factors beyond changes in urine volume. Materials and Methods After Institutional Review Board approval, volunteers with no prior history of nephrolithiasis were recruited. Each participant was randomized initially to either the coconut water or the water phase of the study. Participants kept meticulous food and fluid intake logs during the first phase of the study and were asked to replicate that diet for the second phase. For each phase the participant consumed 2L of either Taste of Nirvana® pure coconut water or tap water daily for four days. Participants were not restricted to consume additional fluid of their choice during their assigned study phase. During days 3 and 4 of each phase the participant collected a 24-hour urine specimen. Coconut water citrate and malate content were measured and were used along with the beverage pH to calculate the total alkali content of the coconut water. Supersaturation levels were calculated using Equil2. Nonparametric paired analysis using the Wilcoxon test was performed for statistical analysis. Results There were 4 adult male and 4 adult female participants. Each individual's 24-hour urine collection had a creatinine excretion within 20% of the mean for each subject's four samples corroborating that all samples were collected properly. The two samples from each phase for each individual were averaged. The coconut water itself was also analyzed and it was calculated to have a total alkali content of 13.8 mEq/L. Consumption of coconut water significantly increased urinary citrate (29%, p=0.02), urinary potassium (130%, p=0.01), and urinary chloride (37%, p=0.03), without affecting urine pH (p=0.16) or volume beyond that of tap water (p=1.00). Conclusions Coconut water consumption increases urinary potassium, chloride, and citrate in nonstone forming individuals.

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“…Other data have suggested that patients taking citrate supplementation regress toward baseline stone risk as the interval from treatment initiation increases. 17 It is unclear whether this latter observation resulted from homeostatic conservation of body acid base status or poor long-term compliance. In any case, the relationship between urinary citrate and pH evidently is far from clear.…”

Section: Commentmentioning

confidence: 99%