New drug therapy for kidney stones: a review of cellulose sodium phosphate, acetohydroxamic acid, and potassium citrate.
Kidney stones have an overall incidence of two to three percent in western countries. In many patients, the disease process is difficult to control and recurrence rates are high: 20 to 50 percent over the subsequent ten years. The pathogenesis and standard methods of treatment for the five major types of stones (i.e., calcium oxalate, struvite, calcium phosphate, uric acid, and cystine) are reviewed. Three new drugs are reviewed in the context of their roles in the selective treatment of kidney stones. Cellulose sodium phosphate (Calcibind) is a nonabsorbable ion-exchange resin with a limited indication for the treatment of calcium stones associated with absorptive hypercalciuria Type I. Acetohydroxamic acid (Lithostat) is an urease-inhibitor that is indicated as adjunctive therapy in patients with chronic urea-splitting urinary tract infections and struvite stones. Potassium citrate (Urocit) is an investigational agent that has clinical efficacy in patients with calcium oxalate and calcium phosphate stones who are hypocitraturic. In addition, potassium citrate is an alkalinizing agent that can be used in patients with uric acid stones.
D000328:Adult; D002129:Calcium Oxalate; D002130:Calcium Phosphates; D002482:Cellulose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002951:Citrates / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D019343:Citric Acid; D003553:Cystine; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006877:Hydroxamic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D007669:Kidney Calculi / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D008274:Magnesium; D017616:Magnesium Compounds; D008297:Male; D010710:Phosphates; D000069877:Struvite; D014527:Uric Acid
D002130:Calcium Phosphates; D002951:Citrates; D006877:Hydroxamic Acids; D017616:Magnesium Compounds; D010710:Phosphates; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; D002129:Calcium Oxalate; D014527:Uric Acid; D019343:Citric Acid; D003553:Cystine; C006358:acetohydroxamic acid; C485838:calcium phosphate, monobasic, anhydrous; D002482:Cellulose; C008881:phosphocellulose; C020243:calcium phosphate; D000069877:Struvite; D008274:Magnesium; C485829:calcium phosphate, dibasic, anhydrous