TY - JOUR
T1 - Correction of hypocitraturia and prevention of stone formation by combined thiazide and potassium citrate therapy in thiazide-unresponsive hypercalciuric nephrolithiasis
AU - Pak, Charles Y C
AU - Peterson, Roy
AU - Sakhaee, Khashayar
AU - Fuller, Cindy
AU - Preminger, Glenn
AU - Reisch, Joan
N1 - Funding Information:
From the Section on Mineral Metabolism, South-western Medical School, University of Texas Health Science Center at Dallas, Dallas, Texas. This work was supported by United States Public Health Service Grants POI-AM20543, MOl-RR00633, and 5T32-AM07307. Requests for reprints should be addressed to Dr. Charles Y. C. Pak, Section on Mineral Metabolism, Southwestern Medical School, University of Texas Health Science Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75235. Manuscript accepted December 13, 1964.
PY - 1985/9
Y1 - 1985/9
N2 - Thirteen patients with hypercalciuric calcium nephrolithiasis continued to form calcium stones when treated with thiazide (4.69 ± 6.62 [mean ± SD] stones per patient-year to 5.12 ± 10.87 stones per patient-year), despite adequate hypocalciuric response (a reduction in urinary calcium levels from 303 ± 119 mg per day to 193 ± 88 mg per day, p < 0.01). Because they had hypocitraturia (250 ± 86 mg per day versus 643 ± 236 mg per day in normal subjects, p < 0.001), potassium citrate (10 to 20 meq three times per day) was added to the ongoing treatment program. During combined treatment with thiazide and potassium citrate, urinary pH significantly rose, and normal levels of urinary citrate were restored. Ten patients stopped forming new stones and all 13 had reduced stone formation rate. Thus, potassium citrate supplementation should be considered in patients requiring thiazide therapy for the control of hypercalciuric nephrolithiasis, especially if they have concurrent hypocitraturia or If it develops during thiazide therapy.
AB - Thirteen patients with hypercalciuric calcium nephrolithiasis continued to form calcium stones when treated with thiazide (4.69 ± 6.62 [mean ± SD] stones per patient-year to 5.12 ± 10.87 stones per patient-year), despite adequate hypocalciuric response (a reduction in urinary calcium levels from 303 ± 119 mg per day to 193 ± 88 mg per day, p < 0.01). Because they had hypocitraturia (250 ± 86 mg per day versus 643 ± 236 mg per day in normal subjects, p < 0.001), potassium citrate (10 to 20 meq three times per day) was added to the ongoing treatment program. During combined treatment with thiazide and potassium citrate, urinary pH significantly rose, and normal levels of urinary citrate were restored. Ten patients stopped forming new stones and all 13 had reduced stone formation rate. Thus, potassium citrate supplementation should be considered in patients requiring thiazide therapy for the control of hypercalciuric nephrolithiasis, especially if they have concurrent hypocitraturia or If it develops during thiazide therapy.
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U2 - 10.1016/0002-9343(85)90305-5
DO - 10.1016/0002-9343(85)90305-5
M3 - Article
C2 - 4036979
AN - SCOPUS:0021926909
SN - 0002-9343
VL - 79
SP - 284
EP - 288
JO - The American Journal of Medicine
JF - The American Journal of Medicine
IS - 3
ER -