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Citrate and renal calculi: an update
1Center on Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center at Dallas 75235-8885, USA.
Mineral and Electrolyte Metabolism
|January 1, 1994
Summary
Potassium citrate is a proven treatment for preventing kidney stones by increasing urinary citrate levels. It effectively inhibits new stone formation in calcium and uric acid nephrolithiasis, with ongoing research exploring new applications and formulations.
Area of Science:
- Nephrology
- Biochemistry
- Urology
Background:
- Hypocitraturia, a deficiency in urinary citrate, is a significant risk factor for calcium-based kidney stone formation.
- Citrate naturally inhibits the crystallization of stone-forming calcium salts.
Purpose of the Study:
- To review the role of potassium citrate in managing nephrolithiasis.
- To discuss new findings on the causes of hypocitraturia and the mechanisms of potassium citrate action.
- To highlight potential new applications and formulations of citrate therapy.
Main Methods:
- Review of existing research and clinical trials on potassium citrate and hypocitraturia.
- Analysis of factors contributing to hypocitraturia, including dietary sodium and intestinal absorption.
- Evaluation of potassium citrate's physiological and physicochemical effects on stone formation.
Main Results:
- Potassium citrate effectively inhibits new stone formation in both calcium and uric acid nephrolithiasis, validated by randomized trials.
- Additional causes of hypocitraturia identified include sodium excess and reduced intestinal alkali absorption.
- New insights reveal citrate absorption, meal timing, and potential bone-sparing effects of potassium citrate.
Conclusions:
- Potassium citrate is a valuable therapeutic agent for preventing kidney stone recurrence.
- Further research has elucidated mechanisms of action and identified new potential applications, including calcium citrate supplements and potassium-magnesium citrate formulations.