Tags

Type your tag names separated by a space and hit enter

Successful treatment of hyperuricosuric calcium oxalate nephrolithiasis with potassium citrate.
Arch Intern Med. 1986 May; 146(5):863-7.AI

Abstract

Calcium stone (renal) formation in patients with hyperuricosuria has been ascribed to the urate-induced crystallization of calcium oxalate. Citrate (0.5mM), added to synthetic medium metastably supersaturated with respect to calcium oxalate, was shown to inhibit heterogeneous nucleation of calcium oxalate by monosodium urate (2 mg/mL). Long-term trial with potassium citrate (60 to 80 mEq/day) was therefore undertaken to determine whether induced hypercitraturia would prevent calcium oxalate stone formation in 19 patients with hyperuricosuria. The treatment produced a sustained rise in urinary pH by 0.55 to 0.85 to the high normal range (6.5 to 7.0). Urinary citrate levels rose by 249 to 402 mg/day to approximate the normal mean value of 643 mg/day. Commensurate with these changes, urinary saturation of calcium oxalate (relative saturation ratio) and the amount of undissociated uric acid declined significantly. However, the urinary uric acid and saturation of monosodium urate remained elevated. Stone formation declined from 1.55 +/- 2.70 per patient-year to 0.38 +/- 1.22 per patient-year during mean treatment period of 2.35 +/- 0.88 years. Stones ceased to form in 16 of 19 patients during treatment. The results provide physicochemical and clinical evidence for the utility of potassium citrate in the management of hyperuricosuric calcium oxalate nephrolithiasis.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3963975

Citation

Pak, C Y., and R Peterson. "Successful Treatment of Hyperuricosuric Calcium Oxalate Nephrolithiasis With Potassium Citrate." Archives of Internal Medicine, vol. 146, no. 5, 1986, pp. 863-7.
Pak CY, Peterson R. Successful treatment of hyperuricosuric calcium oxalate nephrolithiasis with potassium citrate. Arch Intern Med. 1986;146(5):863-7.
Pak, C. Y., & Peterson, R. (1986). Successful treatment of hyperuricosuric calcium oxalate nephrolithiasis with potassium citrate. Archives of Internal Medicine, 146(5), 863-7.
Pak CY, Peterson R. Successful Treatment of Hyperuricosuric Calcium Oxalate Nephrolithiasis With Potassium Citrate. Arch Intern Med. 1986;146(5):863-7. PubMed PMID: 3963975.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful treatment of hyperuricosuric calcium oxalate nephrolithiasis with potassium citrate. AU - Pak,C Y, AU - Peterson,R, PY - 1986/5/1/pubmed PY - 1986/5/1/medline PY - 1986/5/1/entrez SP - 863 EP - 7 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 146 IS - 5 N2 - Calcium stone (renal) formation in patients with hyperuricosuria has been ascribed to the urate-induced crystallization of calcium oxalate. Citrate (0.5mM), added to synthetic medium metastably supersaturated with respect to calcium oxalate, was shown to inhibit heterogeneous nucleation of calcium oxalate by monosodium urate (2 mg/mL). Long-term trial with potassium citrate (60 to 80 mEq/day) was therefore undertaken to determine whether induced hypercitraturia would prevent calcium oxalate stone formation in 19 patients with hyperuricosuria. The treatment produced a sustained rise in urinary pH by 0.55 to 0.85 to the high normal range (6.5 to 7.0). Urinary citrate levels rose by 249 to 402 mg/day to approximate the normal mean value of 643 mg/day. Commensurate with these changes, urinary saturation of calcium oxalate (relative saturation ratio) and the amount of undissociated uric acid declined significantly. However, the urinary uric acid and saturation of monosodium urate remained elevated. Stone formation declined from 1.55 +/- 2.70 per patient-year to 0.38 +/- 1.22 per patient-year during mean treatment period of 2.35 +/- 0.88 years. Stones ceased to form in 16 of 19 patients during treatment. The results provide physicochemical and clinical evidence for the utility of potassium citrate in the management of hyperuricosuric calcium oxalate nephrolithiasis. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/3963975/Successful_treatment_of_hyperuricosuric_calcium_oxalate_nephrolithiasis_with_potassium_citrate_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/146/pg/863 DB - PRIME DP - Unbound Medicine ER -