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    Korean J Urol. 2006 Jun;47(6):631-634. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4111/kju.2006.47.6.631
    Copyright © 2006 The Korean Urological Association
    Original Article

    Clinical Significance of Hypocitraturia in Patients with Nephrolithiasis

    Shin Young Lee and Young Tae Moon
      • Department of Urology, Chung-Ang University Medical Center, Seoul, Korea.
    • Corresponding author (Email: moon13579@hanafos.com )
    Received February 03, 2006; Accepted May 06, 2006.

    Abstract

    Purpose

    Hypocitraturia is cited as one of the risk factors promoting stone formation or recurrence of nephrolithiasis. We estimated the relationship between hypocitraturia and other metabolic abnormalities, such as hypercalciuria, hyperuricosuria and hyperoxaluria. The effects of potassium citrate medication were also investigated.

    Materials and Methods

    We selected 706 renal stone patients with hypocitraturia (<320mg/day), who had received extracorporeal shock wave lithotripsy (ESWL) treatment, and examined the relationship between hypocitraturia and other metabolic abnormalities according to sex and age. We also examined the increment effect of urinary citrate and stone-free rate following potassium citrate (Urocitra®) medication.

    Results

    Complicated hypocitraturia (coexistence with other metabolic abnormalities) was found in 332 of the 706 patients (47.0%). Of the 706 patients, 242 (34.3%), 112 (15.9%) and 33 (4.7%) had hyperoxaluria, hyperuricosuria and hypercalciuria, respectively. Complicated hypocitraturia was higher in the male than female subjects, and was statistically significant (50.4% vs. 39.8%). In 287 (77%) of the 373 patients who received potassium citrate treatment, the urinary citrate level was increased. The mean urinary citrate level was significantly increased (142.5 vs. 336.2 mg/day) (p<0.01), but the stone free rate was not following the citrate treatment.

    Conclusions

    Potassium citrate was effective in increasing the urinary citrate level. However, prophylactic effects of potassium citrate against recurrent nephrolithiasis must be proved by appropriate comparative studies.

    Keywords
    Hypocitraturia; Potassium citrate (Urocitra®); Nephrolithiasis

    Tables

    Table 1
    Diagnostic criteria of various metabolic aberrations

    Table 2
    Characteristics of hypocitraturia according to gender

    Table 3
    Characteristics of hypocitraturia according to age

    Table 4
    Comparison of 24hr urine citrate before and after Urocitra® medication (more than 1 month)

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    MeSH Terms
    Citric Acid
    Female
    Humans
    Hypercalciuria
    Hyperoxaluria
    Lithotripsy
    Male
    Nephrolithiasis*
    Potassium Citrate
    Recurrence
    Risk Factors
    Shock
    Metrics
    Share
    Tables
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