TY - JOUR
T1 - Pharmacotherapy of kidney stones
AU - Pak, Charles Y C
N1 - Funding Information:
This work was supported by USPHS grant P01 DK020543. The work of the author led to the approval of potassium citrate by the FDA. However, potassium citrate is now available as a generic product and stone risk analysis is offered by several companies. The author would like to thank Faye Britton for editorial assistance.
PY - 2008/6
Y1 - 2008/6
N2 - Background: Kidney stones are associated with various biochemical disturbances in urine. Various drugs and dietary changes have been recommended to halt stone recurrence. Objective: To determine whether a correction of urinary abnormalities by appropriate pharmacological agents and dietary modification may ameliorate stone disease. Methods: A review of the literature was conducted on the role of diet, metabolic disorders and drugs for stone prevention. Results/conclusion: Metabolic risk factors are hypercalciuria, hypocitraturia, hyperoxaluria, hyperuricosuria, and abnormally low urinary pH. Dietary-environmental risk factors include high urinary sodium and low urine volume. Rare or less commonly encountered risk factors are high urinary cystine, and alkaline urine from an infection with urea-splitting organisms. To ameliorate or correct the above disturbances, all patients should be offered dietary modification, including restricted intake of sodium, oxalate and animal proteins. Useful drugs include thiazide or indapamide to control hypercalciuria, potassium citrate to correct hypocitraturia and undue urinary acidity, and allopurinol for co-existing hyperuricemia or marked hyperuricosuria.
AB - Background: Kidney stones are associated with various biochemical disturbances in urine. Various drugs and dietary changes have been recommended to halt stone recurrence. Objective: To determine whether a correction of urinary abnormalities by appropriate pharmacological agents and dietary modification may ameliorate stone disease. Methods: A review of the literature was conducted on the role of diet, metabolic disorders and drugs for stone prevention. Results/conclusion: Metabolic risk factors are hypercalciuria, hypocitraturia, hyperoxaluria, hyperuricosuria, and abnormally low urinary pH. Dietary-environmental risk factors include high urinary sodium and low urine volume. Rare or less commonly encountered risk factors are high urinary cystine, and alkaline urine from an infection with urea-splitting organisms. To ameliorate or correct the above disturbances, all patients should be offered dietary modification, including restricted intake of sodium, oxalate and animal proteins. Useful drugs include thiazide or indapamide to control hypercalciuria, potassium citrate to correct hypocitraturia and undue urinary acidity, and allopurinol for co-existing hyperuricemia or marked hyperuricosuria.
KW - Hypercalciuria
KW - Hyperxaluria
KW - Potassium citrate
KW - Renal stone
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U2 - 10.1517/14656566.9.9.1509
DO - 10.1517/14656566.9.9.1509
M3 - Review article
C2 - 18518781
AN - SCOPUS:46749139508
SN - 1465-6566
VL - 9
SP - 1509
EP - 1518
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
IS - 9
ER -