Urinary Citrate Levels Do Not Correlate with Urinary pH in Patients with Urinary Stone Formation

Whitson, Jared M.; Cooperberg, Matthew R.; Stackhouse, G. Bennett; Stoller, Marshall L.

doi:10.1016/j.urology.2007.04.052

Cited by 10 publications

(4 citation statements)

References 18 publications

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“…Urinary pH was significantly increased in this study after the administration of potassium citrate therapy for patients with recurrent stone disease. Whitson and his followers in 2007 [14] found that no relation existed between potassium citrate therapy and urinary pH, and change in urinary pH was mainly caused by change in patients diet. The increase in urinary pH in this study can be explained by the increase in alkaline load caused by potassium citrate therapy.…”

Section: Discussionmentioning

confidence: 99%

Changes in Some Urinary Variables After Potassium Citrate Therapy In Patients With Recurrent Urinary Stone Disease In Tikrit City, Iraq

Abdul-Aziz¹,

Hilal²,

Alkumait³

2020

IJFMT

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Objective: to determine the effect of oral potassium citrate (k-citrate) on urinary calcium, magnesium, volume, and pH in patients with recurrent stone disease.Patients & Method: Interventional clinical trial study was implemented from June 2016 to February 2019 in Tikrit city, Iraq. 94 patients with recurrent urinary stone disease were enrolled in this study. Oral k-citrate therapy was given to patients in a dose of 15 meq three times daily for 2 weeks. Patients instructed for 24 hours urinary collection before and after therapy. Urinary calcium, magnesium, volume, and pH were measured before and after therapy to examine the effect of k-citrate.Results: mean age was 38.5 (SD 17.4) years. Male patients were 64% while 36% of patients were females. Mean urinary calcium level decreased significantly after k-citrate therapy, p value < 0.001. Mean urinary volume and pH increased significantly after therapy, p value < 0.01 and < 0.05 respectively. No significant change was identified in mean urinary magnesium level after therapy, p value = 0.14. No adverse effects related to k-citrate therapy were reported by patients during study period. Conclusion:Urinary volume and pH increased significantly in patients after potassium citrate therapy. Also k-citrate therapy significantly produced marked decrease in urinary calcium level. No change was observed in mean urinary magnesium level before and after k-citrate therapy. No adverse effects related to k-citrate therapy were reported by patients during study period.

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Section: Discussionmentioning

confidence: 99%

Changes in Some Urinary Variables After Potassium Citrate Therapy In Patients With Recurrent Urinary Stone Disease In Tikrit City, Iraq

Abdul-Aziz¹,

Hilal²,

Alkumait³

2020

IJFMT

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“…However, their respective contributions in the lithiasis process are still a mater of debate (Rodgers et al, 2006;Whitson et al, 2007). Possible actions of citrate are numerous.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, citrate is a clinically important inhibitor of stone formation (Park, 2007) that potentially reduces crystal attachment to cells (Lieske et al, 1996a). Conversely, the mechanisms by which pH and citrate influence stone formation remain unclear (Pak, 1998;Rodgers et al, 2006;Park, 2007;Whitson et al, 2007). To further investigate the mechanism governing the interaction between HA and COM crystals, we characterized the respective influence of pH and citrate on HA and crystal interaction.…”

Section: Introductionmentioning

confidence: 99%

Characterization of hyaluronic acid interaction with calcium oxalate crystals: implication of crystals faces, pH and citrate

Lamontagne

Plante

Grandbois

2011

J of Molecular Recognition

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Interaction between hyaluronic acid (HA) present at the surface of tubular epithelial cells and calcium oxalate monohydrate (COM) crystals is thought to play an important role in kidney stone formation. AFM-based force spectroscopy, where HA is covalently attached to AFM-probes, was used to quantify the interaction between HA and the surfaces of COM crystals. The work of adhesion of the HA-probe as well as the rupture force of single HA molecules were quantified in order to understand the molecular regulation of HA binding to COM crystals. Our results reveal that HA adsorbs to the crystal surface in physiological conditions. We also observed increased adhesion when the pH is lowered to a value that increases the risk of kidney stone formation. HA adhesion to the COM crystal surface can be suppressed by citrate, a physiological inhibitor of stone retention currently used in the treatment and prevention of kidney stone formation. Interestingly, we also observed preferential binding of HA onto the [100] face versus the [010] face, suggesting a major contribution of the [100] faces in the crystal retention process at the surface of tubular epithelial cells and the promotion of stone formation. Our results clearly establish a direct role for the glycosaminoglycan HA present at the surface of kidney tubular epithelium in the process of COM crystal retention.

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“…Urinary citrate (Cit) is strategically targeted because it has the capacity to decrease the risk of stone formation by thermodynamic and kinetic mechanisms. [15][16][17][18] Administration of alkali citrate increases urinary citrate and also raises urinary pH. 13,[19][20][21] The increase in pH enhances the complexation of Ca +2 by citrate, thereby further reducing supersaturation of CaOx [SS(CaOx)] and SS(CaP) 22 and enhances the excretion of citrate itself by reducing its tubular reabsorption and its metabolism.…”

Section: Introductionmentioning

confidence: 99%

Malic Acid Supplementation Increases Urinary Citrate Excretion and Urinary pH: Implications for the Potential Treatment of Calcium Oxalate Stone Disease

Rodgers

Webber

Charmoy

et al. 2014

Journal of Endourology

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We speculate that consumption of malic acid induced systemic alkalinization leading to reduced renal tubular reabsorption and metabolism of citrate, and an increase in excretion of the latter. The decrease in SS(CaOx) was caused by enhanced complexation of Ca(+2) by citrate. We conclude that malic acid supplementation may be useful for conservative treatment of calcium renal stone disease by virtue of its capacity to induce these effects.

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Urinary Citrate Levels Do Not Correlate with Urinary pH in Patients with Urinary Stone Formation

Cited by 10 publications

References 18 publications

Changes in Some Urinary Variables After Potassium Citrate Therapy In Patients With Recurrent Urinary Stone Disease In Tikrit City, Iraq

Changes in Some Urinary Variables After Potassium Citrate Therapy In Patients With Recurrent Urinary Stone Disease In Tikrit City, Iraq

Characterization of hyaluronic acid interaction with calcium oxalate crystals: implication of crystals faces, pH and citrate

Malic Acid Supplementation Increases Urinary Citrate Excretion and Urinary pH: Implications for the Potential Treatment of Calcium Oxalate Stone Disease

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