Effect of Polycitra-K and Bicitra in the Treatment of Pediatric Nephrolithiasis: A Double-Blind Randomized Trial

Area of Science:

• Pediatric Nephrology
• Urology
• Clinical Pharmacology

Background:

• Urolithiasis (kidney stones) is a prevalent, painful, and costly condition with high recurrence rates.
• Pediatric urolithiasis necessitates effective treatment strategies to prevent long-term complications.
• Hypocitraturia is a common risk factor for kidney stone formation in children.

Purpose of the Study:

• To compare the efficacy of Polycitra-K (potassium citrate) versus Bicitra (sodium citrate) in treating kidney stones in children.
• To evaluate the impact of these citrate-based therapies on stone passage and bladder stone incidence.
• To assess the role of urine alkalization in managing pediatric urolithiasis.

Main Methods:

• A double-blind randomized clinical trial involving 176 children (aged 5-18) with kidney stones and hypocitraturia.
• Patients received either Polycitra-K or Bicitra at a dose of 1 mL/kg.
• Treatment outcomes were assessed using kidney ureter bladder (KUB) X-rays, with statistical analysis using chi-square or Fisher exact tests.

Main Results:

• A significant difference was observed in bladder stone incidence, with 18.2% in the Polycitra-K group versus 33% in the Bicitra group (p=0.025).
• Stone passage was higher in the Polycitra-K group (65.9%) compared to the Bicitra group (40.9%).
• Both treatments demonstrated effectiveness in managing pediatric kidney stones through urine alkalization.

Conclusions:

• Oral Polycitra-K is a beneficial supplement for pediatric kidney stones due to urine alkalization.
• Both Polycitra-K and Bicitra exhibit comparable therapeutic effects in managing kidney stones in children.
• Further research may elucidate specific advantages of potassium citrate in certain pediatric urolithiasis cases.