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Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients.
J Urol. 1994 Jan; 151(1):5-9.JU

Abstract

The natural history of post-extracorporeal shock wave lithotripsy residual stone fragments (clearance, growth and aggregation) is incompletely known, even though they are believed to constitute a risk in terms of new stone formation and persistent infection of the urinary tract. We addressed this issue and the hypothesis that alkaline citrate therapy improves residual stone fragment clearance in a 12-month followup study. There were 40 sterile calcium and 30 struvite stone patients with residual fragments after extracorporeal shock wave lithotripsy (diameter less than 5 mm.) consecutively enrolled and randomly assigned to a citrate therapy (6 to 8 gm. per day) or control (hygienic measures only) group. Infection stone patients also received adequate antibiotic therapy throughout the study. Among the patients in the untreated sterile group 21% and 32% were stone-free at 6 and 12 months, respectively. In the infection group these figures were 27% and 40%, respectively. Among the untreated sterile calcium stone patients in whom clearance was not achieved a high percentage experienced residual fragment growth or reaggregation. Citrate therapy significantly improved the stone clearance rate in the sterile (at 6 and 12 months 65% and 74% were stone-free, respectively) and infection (71% and 86%, respectively) stone patients, and prevented residual fragment growth or reaggregation in subjects in whom clearance was not achieved. The data show that growth and persistence are common in the natural history of residual stone fragments. Citrate ameliorated the outcome of these residual fragments by reducing the growth or agglomeration, and by increasing the clearance rate in calcium oxalate and in infection stone patients.

Authors+Show Affiliations

Department of Urology, Treviso General Hospital, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

8254832

Citation

Cicerello, E, et al. "Effect of Alkaline Citrate Therapy On Clearance of Residual Renal Stone Fragments After Extracorporeal Shock Wave Lithotripsy in Sterile Calcium and Infection Nephrolithiasis Patients." The Journal of Urology, vol. 151, no. 1, 1994, pp. 5-9.
Cicerello E, Merlo F, Gambaro G, et al. Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients. J Urol. 1994;151(1):5-9.
Cicerello, E., Merlo, F., Gambaro, G., Maccatrozzo, L., Fandella, A., Baggio, B., & Anselmo, G. (1994). Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients. The Journal of Urology, 151(1), 5-9.
Cicerello E, et al. Effect of Alkaline Citrate Therapy On Clearance of Residual Renal Stone Fragments After Extracorporeal Shock Wave Lithotripsy in Sterile Calcium and Infection Nephrolithiasis Patients. J Urol. 1994;151(1):5-9. PubMed PMID: 8254832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients. AU - Cicerello,E, AU - Merlo,F, AU - Gambaro,G, AU - Maccatrozzo,L, AU - Fandella,A, AU - Baggio,B, AU - Anselmo,G, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 5 EP - 9 JF - The Journal of urology JO - J Urol VL - 151 IS - 1 N2 - The natural history of post-extracorporeal shock wave lithotripsy residual stone fragments (clearance, growth and aggregation) is incompletely known, even though they are believed to constitute a risk in terms of new stone formation and persistent infection of the urinary tract. We addressed this issue and the hypothesis that alkaline citrate therapy improves residual stone fragment clearance in a 12-month followup study. There were 40 sterile calcium and 30 struvite stone patients with residual fragments after extracorporeal shock wave lithotripsy (diameter less than 5 mm.) consecutively enrolled and randomly assigned to a citrate therapy (6 to 8 gm. per day) or control (hygienic measures only) group. Infection stone patients also received adequate antibiotic therapy throughout the study. Among the patients in the untreated sterile group 21% and 32% were stone-free at 6 and 12 months, respectively. In the infection group these figures were 27% and 40%, respectively. Among the untreated sterile calcium stone patients in whom clearance was not achieved a high percentage experienced residual fragment growth or reaggregation. Citrate therapy significantly improved the stone clearance rate in the sterile (at 6 and 12 months 65% and 74% were stone-free, respectively) and infection (71% and 86%, respectively) stone patients, and prevented residual fragment growth or reaggregation in subjects in whom clearance was not achieved. The data show that growth and persistence are common in the natural history of residual stone fragments. Citrate ameliorated the outcome of these residual fragments by reducing the growth or agglomeration, and by increasing the clearance rate in calcium oxalate and in infection stone patients. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/8254832/Effect_of_alkaline_citrate_therapy_on_clearance_of_residual_renal_stone_fragments_after_extracorporeal_shock_wave_lithotripsy_in_sterile_calcium_and_infection_nephrolithiasis_patients_ L2 - https://www.jurology.com/doi/10.1016/s0022-5347(17)34858-9?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -