Therapeutic effects of potassium sodium hydrogen citrate on melamine-induced urinary calculi in China
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1Department of Nephrology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.
Insights
Potassium sodium hydrogen citrate (PSHC) effectively treats melamine-induced urinary calculi in children. Higher doses and longer treatment durations with PSHC significantly improved stone expulsion rates and reduced expulsion time.
Area of Science:
- Pediatric Nephrology
- Toxicology
- Public Health
Background:
- A 2008 outbreak in China led to 9,433 diagnosed cases of melamine-induced urinary calculi in children.
- Infant formula contaminated with melamine was identified as the cause of this pediatric health crisis.
- This study investigated a potential treatment for these specific urinary calculi.
Purpose of the Study:
- To evaluate the therapeutic efficacy of potassium sodium hydrogen citrate (PSHC) for treating melamine-induced urinary calculi in children.
- To determine the optimal dosage and influencing factors for PSHC treatment effectiveness.
- To compare PSHC treatment outcomes against a control group.
Main Methods:
- Seventy-two children diagnosed with urinary calculi were randomized into three groups: low-dose PSHC (1 g/d), high-dose PSHC (2 g/d), and a control group (no PSHC).
- Dosage was adjusted based on urinary pH, and efficacy was assessed by cure rate, effective treatment, and stone expulsion.
- Factors analyzed included PSHC dose, patient age, stone size and position, and urinary pH.
Main Results:
- After 1-6 months, cure rates were 19/group 1, 5/group 2, and 6/group 3. Effective treatment rates were 5/group 1, 5/group 2, and 4/group 3.
- Significant differences in therapeutic efficacy were observed between PSHC doses after 3 and 6 months, indicated by increased successful expulsion rates and reduced expulsion times.
- Mean expulsion time for urinary calculi was significantly shorter in the PSHC treatment groups (1 and 2) compared to the control group after 6 months.
Conclusions:
- Potassium sodium hydrogen citrate (PSHC) significantly enhances the successful expulsion rate and reduces the time required for clearing melamine-induced urinary calculi.
- Treatment efficacy is influenced by PSHC dosage, treatment duration, stone location, and urinary pH.
- Patient age and stone size did not demonstrate a significant relationship with therapeutic efficacy.
Background:
In 2008, a sharp increase of the number of children diagnosed with urinary calculi was observed in China, 9433 children were diagnosed as having melamine-induced urinary calculi at outpatient clinic in Beijing Children's Hospital. This study examined the therapeutic efficacy of potassium sodium hydrogen citrate (PSHC) used to treat melamine-induced urinary stones in Chinese children who consumed melamine-containing infant formula.
Methods:
Seventy-two infants and children (average age (18.2 +/- 7.7) months) who were diagnosed with urinary calculi were randomly divided into three treatment groups using the SAS Plan program. Group 1 was given a low dose (1 g/d) of PSHC, group 2 was given high dose of PSHC (2 g/d) and group 3 was given no PSHC (control group). The dose of drug was adjusted according to the baseline urinary pH. This study analyzed the influence of the dose of PSHC, the age of patients, stone size and position, and urinary pH on the level of efficacy of PSHC (cured, effectively treated or not cured).
Results:
After 1 - 6 months of therapy, 19 patients from group 1, five patients from group 2 and six patients from group 3 were cured. Five patients from group 1, five patients from group 2 and four patients from group 3 were effectively treated. There were significant differences in therapeutic efficacy between the two treatment doses after 3 and 6 months as measured by the increase in the successful expulsion rate and time of melamine-induced urinary calculi. After 6 months the mean time of expulsion of urinary calculi in groups 1 and 2 was significantly shorter than in the control group.
Conclusions:
PSHC can significantly increase the successful expulsion rate and time of melamine-induced urinary calculi. The therapeutic efficacy is affected by PSHC dose, treatment duration, calculi position, and urinary pH. There is no relationship between the therapeutic efficacy and the stone size or patient age.
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