title: Alkaline citrate reduces stone recurrence and regrowth after shockwave lithotripsy and percutaneous nephrolithotomy.
abstract: OBJECTIVE
  To evaluate the preventive effects of alkaline citrate on stone recurrence as well as stone growth post-ESWL or PCNL in patients with calcium-containing stones.
  
  
  METHODS
  A total of 76 patients with calcium calculi who were stone-free or had residual stones less than 4 mm following ESWL and PCNL were enrolled. All patients were independently randomized into two groups. The treated group (N = 39) was given 81 mEq per day of oral potassium-sodium citrate (27 mEq three times a day), and the untreated group (N = 37) serving as controls. Blood, twenty-four hour urine analysis, and plain KUB were measured and compared at the baseline and after 12 months.
  
  
  RESULTS
  At baseline, hypocitraturia was found in 20 of 39 patients (46.05%) of Group I and 15 of 37 patients (40.5%) of Group II. At 12 months, hypocitraturia was found in 3 of 39 (7.69%) and 14 of 37 (37.83%) of Group I and Group II, respectively (p = 0.007). At the 12 month follow-up, of the stone-free group, 92.3% of the treated group and 57.7% of the control group were still stone free. Of the residual stone group, 30.8% and 9.1% of treated and control group were stone-free, respectively. The increased stone size found in 7.7%) and 54.5%) of treated and control groups, respectively.
  
  
  CONCLUSIONS
  Sodium-potassium citrate provides positive effects on stone-forming activities in calcium stone patients suffering from urolithiasis following treatment with ESWL and PCNL procedures at the 12-month follow-up.
authors.affiliation: Division of Urology and Department of surgery, Chiangmai University, Thailand. blojanap@mail.med.cmu.ac.th
authors.forename: B
authors.initials: B
authors.lastname: Lojanapiwat
authors.forename: M
authors.initials: M
authors.lastname: Tanthanuch
authors.forename: C
authors.initials: C
authors.lastname: Pripathanont
authors.forename: S
authors.initials: S
authors.lastname: Ratchanon
authors.forename: S
authors.initials: S
authors.lastname: Srinualnad
authors.forename: T
authors.initials: T
authors.lastname: Taweemonkongsap
authors.forename: S
authors.initials: S
authors.lastname: Kanyok
authors.forename: S
authors.initials: S
authors.lastname: Lammongkolkul
mesh_terms: D000328:Adult; D002951:Citrates / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000517:prevention & control* / Q000628:therapy; D008096:Lithotripsy / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000592:standards; D019357:Potassium Citrate / Q000627:therapeutic use*; D055502:Secondary Prevention; D000077559:Sodium Citrate; D016896:Treatment Outcome; D014527:Uric Acid / Q000652:urine; D055815:Young Adult
chemical_list: D002951:Citrates; D004232:Diuretics; D000077559:Sodium Citrate; D014527:Uric Acid; D019357:Potassium Citrate