Therapeutic effects of potassium sodium hydrogen citrate on melamine-induced urinary calculi in China.
BACKGROUND
In 2008, a sharp increase of the number of children diagnosed with urinary calculi was observed in China, 9433 children were diagnosed as having melamine-induced urinary calculi at outpatient clinic in Beijing Children's Hospital. This study examined the therapeutic efficacy of potassium sodium hydrogen citrate (PSHC) used to treat melamine-induced urinary stones in Chinese children who consumed melamine-containing infant formula.


METHODS
Seventy-two infants and children (average age (18.2 +/- 7.7) months) who were diagnosed with urinary calculi were randomly divided into three treatment groups using the SAS Plan program. Group 1 was given a low dose (1 g/d) of PSHC, group 2 was given high dose of PSHC (2 g/d) and group 3 was given no PSHC (control group). The dose of drug was adjusted according to the baseline urinary pH. This study analyzed the influence of the dose of PSHC, the age of patients, stone size and position, and urinary pH on the level of efficacy of PSHC (cured, effectively treated or not cured).


RESULTS
After 1 - 6 months of therapy, 19 patients from group 1, five patients from group 2 and six patients from group 3 were cured. Five patients from group 1, five patients from group 2 and four patients from group 3 were effectively treated. There were significant differences in therapeutic efficacy between the two treatment doses after 3 and 6 months as measured by the increase in the successful expulsion rate and time of melamine-induced urinary calculi. After 6 months the mean time of expulsion of urinary calculi in groups 1 and 2 was significantly shorter than in the control group.


CONCLUSIONS
PSHC can significantly increase the successful expulsion rate and time of melamine-induced urinary calculi. The therapeutic efficacy is affected by PSHC dose, treatment duration, calculi position, and urinary pH. There is no relationship between the therapeutic efficacy and the stone size or patient age.
Department of Nephrology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.
Jie
J
Gao
Ying
Y
Shen
Ning
N
Sun
Li-qun
LQ
Jia
Yue-song
YS
Pan
Qiang
Q
Sun
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China; D002951:Citrates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014227:Triazines / Q000633:toxicity*; D014545:Urinary Calculi / Q000139:chemically induced* / Q000188:drug therapy* / Q000652:urine; D014556:Urine / Q000737:chemistry; D055815:Young Adult
D002951:Citrates; D014227:Triazines; C011907:melamine