title: Potassium-sodium citrate prevents the development of renal microcalculi into symptomatic stones in calcium stone-forming patients.
abstract: To evaluate the effect of potassium-sodium citrate on the development of computed tomography-detected renal microcalculi into symptomatic stones in calcium stone-forming patients.
  
  
  
  Patients (aged 20-80 years) with history of calcium component stones who visited Nagoya City Hospital, Nagoya, Aichi, Japan, between April 2009 and June 2014 were included. They were retrospectively divided into those who did not receive potassium-sodium citrate (non-citrate group, n = 157) and those who did (citrate group, n = 60). For patients in both groups, we evaluated blood and urine biochemistry and sediment, number of computed tomography-detected microcalculi, number of asymptomatic microcalculi disappearances, and pain events. Observations were made at study initiation and 12 months later.
  
  
  
  The citrate group showed a significantly increased urine pH (P < 0.001) and daily citrate excretion (P < 0.001) over the study period. The non-citrate group showed increased numbers of microcalculi at study completion (P = 0.002); over the same period, the number of microcalculi in the citrate group decreased significantly (P = 0.03). Additionally, multivariable analysis showed more asymptomatic microcalculi disappearances (odds ratio 2.84, 95% confidence interval 1.49-5.39) and fewer pain events (odds ratio 0.37, 95% confidence interval 0.16-0.72) in the citrate group than in the non-citrate group. A sex-adjusted analysis showed more asymptomatic microcalculi disappearances (odds ratio 3.96, 95% confidence interval 1.57-10.02) and fewer pain events (odds ratio 0.22, 95% confidence interval 0.07-0.70) in women than in men after citrate treatment.
  
  
  
  Potassium-sodium citrate prevents the development of renal microcalculi into symptomatic stones in calcium stone-forming individuals.
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Unno
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Taguchi
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okada
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ando
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Hamamoto
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Yasue
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: Department of Urology, Changzhou Second Hospital of Nanjing Medical University, Changzhou, Jiangsu, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zuo
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasui
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases / Q000628:therapy*; D002129:Calcium Oxalate / Q000737:chemistry*; D019343:Citric Acid / Q000652:urine; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007668:Kidney / Q000000981:diagnostic imaging; D007669:Kidney Calculi / Q000737:chemistry / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D019357:Potassium Citrate / Q000627:therapeutic use*; D012189:Retrospective Studies; D012737:Sex Factors; D000077559:Sodium Citrate / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D000077559:Sodium Citrate; D002129:Calcium Oxalate; D019343:Citric Acid; D019357:Potassium Citrate
keywords: calcium stone former; hypocitraturia; kidney stone; microcalculi; potassium-sodium citrate