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Alkali action on the urinary crystallization of calcium salts: contrasting responses to sodium citrate and potassium citrate.

Publication ,  Journal Article
Preminger, GM; Sakhaee, K; Pak, CY
Published in: J Urol
February 1988

Alkali therapy is used commonly to prevent recurrent stone formation in patients with distal renal tubular acidosis. We compared the effects of potassium citrate to those of sodium citrate in 6 well defined cases of incomplete distal renal tubular acidosis. The patients were studied during a control phase, during potassium citrate treatment (80 mEq. per day) and during sodium citrate treatment (80 mEq. per day) chosen in random order. Potassium citrate caused a decrease in urinary calcium and a significant increase in urinary citrate that resulted in a significant decrease in the urinary saturation of calcium oxalate. It did not alter the saturation of brushite and sodium urate. However, while sodium citrate also was able to increase the urinary citrate level, there was no decrease in the urinary calcium (owing to the increased sodium load). Thus, the urinary saturation of calcium oxalate did not decrease as much as with potassium citrate and the saturation of brushite increased significantly. Moreover, the urinary saturation of sodium urate increased significantly owing to the enhanced sodium excretion. The results suggest that potassium citrate therapy may retard the crystallization of calcium oxalate and may not cause calcium phosphate crystallization. In contrast, sodium citrate may have no effect or it sometimes may accentuate the crystallization of calcium salts. Thus, our study supports the potential clinical advantage of potassium citrate therapy over sodium alkali treatment in patients with incomplete distal renal tubular acidosis and recurrent calcium nephrolithiasis.

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Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

February 1988

Volume

139

Issue

2

Start / End Page

240 / 242

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Sodium
  • Recurrence
  • Middle Aged
  • Male
  • Kidney Calculi
  • Hydrogen-Ion Concentration
  • Humans
  • Female
  • Crystallization
 

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Preminger, G. M., Sakhaee, K., & Pak, C. Y. (1988). Alkali action on the urinary crystallization of calcium salts: contrasting responses to sodium citrate and potassium citrate. J Urol, 139(2), 240–242. https://doi.org/10.1016/s0022-5347(17)42374-3
Preminger, G. M., K. Sakhaee, and C. Y. Pak. “Alkali action on the urinary crystallization of calcium salts: contrasting responses to sodium citrate and potassium citrate.J Urol 139, no. 2 (February 1988): 240–42. https://doi.org/10.1016/s0022-5347(17)42374-3.
Preminger, G. M., et al. “Alkali action on the urinary crystallization of calcium salts: contrasting responses to sodium citrate and potassium citrate.J Urol, vol. 139, no. 2, Feb. 1988, pp. 240–42. Pubmed, doi:10.1016/s0022-5347(17)42374-3.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

February 1988

Volume

139

Issue

2

Start / End Page

240 / 242

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Sodium
  • Recurrence
  • Middle Aged
  • Male
  • Kidney Calculi
  • Hydrogen-Ion Concentration
  • Humans
  • Female
  • Crystallization