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[Citrate and kidney stones]

P J Osther1

  • 1Odense Universitet, Klinisk Institut.

Ugeskrift for Laeger
|November 22, 1993
PubMed
Summary

Low urinary citrate levels are common in patients with calcium kidney stones. While hypocitraturia is more prevalent in stone formers, other factors are crucial for calcium stone formation. The citrate-calcium ratio effectively distinguishes stone formers.

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Area of Science:

  • Nephrology
  • Urology
  • Biochemistry

Background:

  • Citrate is a key endogenous inhibitor of calcium nephrolithiasis.
  • Understanding urinary citrate levels is vital for calcium stone disease management.

Purpose of the Study:

  • To investigate urinary citrate excretion in patients with recurrent idiopathic calcium nephrolithiasis.
  • To compare citrate levels between stone formers and healthy controls.
  • To evaluate the role of urinary citrate in calcium stone pathophysiology.

Main Methods:

  • Enzymatic technique for measuring urinary citrate.
  • Analysis of 24-hour urine samples for citrate and creatinine.
  • Comparison of citrate-creatinine ratios between patient and control groups.

Main Results:

  • Hypocitraturia (< 1.6 mmol/24h) was observed in 33% of stone formers versus 12% of controls (p=0.03).
  • Stone formers exhibited significantly lower urinary citrate-creatinine ratios than healthy controls (p=0.03).
  • Healthy males showed lower citrate excretion than healthy females (p=0.006).
  • Significant overlap in urinary citrate levels between groups suggests other contributing factors.

Conclusions:

  • Urinary citrate levels vary widely, and hypocitraturia is more frequent in calcium stone formers.
  • Factors beyond urinary citrate excretion are important in calcium stone formation.
  • The urine citrate-calcium ratio is a reliable indicator for differentiating stone formers from healthy individuals.

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