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Related Experiment Videos

Does citrate prevent nephrocalcinosis in preterm neonates?

Eveline A Schell-Feith1, Aukje Moerdijk, Paul H T van Zwieten

  • 1Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands.

Pediatric Nephrology (Berlin, Germany)
|October 14, 2006
PubMed
Summary
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Sodium citrate supplementation in preterm neonates is safe and increases urinary citrate levels. However, this study found it did not significantly reduce the incidence of nephrocalcinosis in this vulnerable population.

Area of Science:

  • Neonatology
  • Pediatric Nephrology
  • Clinical Pharmacology

Background:

  • Nephrocalcinosis (NC) is a common complication in preterm neonates.
  • Elevated urinary calcium and low urinary citrate are risk factors for NC development.
  • Citrate supplementation is an established preventive therapy for kidney stones in children and adults.

Purpose of the Study:

  • To investigate the efficacy of sodium citrate therapy in preventing nephrocalcinosis in preterm neonates (<32 weeks gestational age).
  • To assess the impact of citrate supplementation on urinary calcium, citrate, and pH levels in this population.

Main Methods:

  • A randomized controlled trial involving 74 preterm neonates (gestational age <32 weeks).
  • The treatment group (38 neonates) received sodium citrate (0.52 mmol/kg/day) from day 8 until term.

Related Experiment Videos

  • The control group (36 neonates) received no citrate treatment. Urinary parameters and renal ultrasonography were assessed.

    • Main Results:

    • Citrate-treated neonates showed significantly higher urinary citrate/creatinine and urinary pH.
    • Urinary calcium/citrate ratios were significantly lower in the citrate group.
    • The incidence of nephrocalcinosis was not significantly different between the citrate (34%) and control (44%) groups.

    Conclusions:

    • Sodium citrate therapy at 0.52 mmol/kg/day is safe for preterm neonates and improves urinary citrate excretion.
    • This dosage and formulation of sodium citrate did not demonstrate a significant preventive effect on nephrocalcinosis.
    • Further research is needed to explore higher doses or alternative citrate formulations (e.g., potassium citrate) for NC prevention.