title: Effect of potassium citrate supplement on stone recurrence before or after lithotripsy: systematic review and meta-analysis.
abstract: This meta-analysis summarizes the available evidence on the effectiveness of citrate supplement for preventing the recurrence of nephrolithiasis in patients undergoing extracorporeal shock wave lithotripsy (SWL). Electronic searches were conducted using Medline-PubMed, Web of Science, Embase, BVS (Scielo, Lilacs), and Google Scholar literature databases. The authors worked in pairs to select studies that met the following criteria: randomized controlled trials that were conducted in adults and assessed the effect of potassium citrate supplement before or after SWL therapy for urolithiasis. Our primary aim was to asses the stone-free rate among the groups included in the studies. Fixed effect was used in the meta-analysis with 95% confidence interval (95% CI). Heterogeneity was analyzed by the I2value. A total of 2505 references were initially selected. Of those, four were subjected to meta-analysis contributing five samples. These four studies included 374 participants who were followed for a period of 12 months after SWL. Mean potassium citrate dosage was approximately 55 mEq/day (18 mmol). The results showed that citrate supplement significantly protected against the recurrence of nephrolithiasis during 1 year after SWL [RR; 95% CI 0.21 (0.13, 0.31)]. The heterogeneity was not significant across the analyzed studies (p = 0.224). The quality of the analyzed studies was generally low. The available evidence shows that citrate supplement effectively reduces the recurrence of nephrolithiasis in patients undergoing SWL. However, statistical analysis of a larger trial conducted with methodological rigor is warranted.
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.|Hospital de Clínicas, UFPR-Universidade Federal do Paraná, Rua General Carneiro, 181-Alto da Glória, Curitiba, Paraná, Brazil.
authors.forename: Maurício
authors.initials: M
authors.lastname: Carvalho
authors.affiliation: Hospital de Clínicas, UFPR-Universidade Federal do Paraná, Rua General Carneiro, 181-Alto da Glória, Curitiba, Paraná, Brazil. bruoe@hotmail.com.
authors.forename: Bruna Olandoski
authors.initials: BO
authors.lastname: Erbano
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.
authors.forename: Eduardo Yukio
authors.initials: EY
authors.lastname: Kuwaki
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.
authors.forename: Halyson Pinheiro
authors.initials: HP
authors.lastname: Pontes
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.
authors.forename: Jonathan Wei Ting Wen
authors.initials: JWTW
authors.lastname: Liu
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.
authors.forename: Luis Henrique
authors.initials: LH
authors.lastname: Boros
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.
authors.forename: Marcelo Oliveira
authors.initials: MO
authors.lastname: Asinelli
authors.affiliation: Escola de Medicina, PUCPR-Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155-Prado Velho, Curitiba, Paraná, Brazil.|Hospital Marcelino Champagnat, Av. Pres. Affonso Camargo, 1399-Cristo Rei, Curitiba, Paraná, Brazil.
authors.forename: Cristina Pellegrino
authors.initials: CP
authors.lastname: Baena
mesh_terms: D019587:Dietary Supplements; D006801:Humans; D008096:Lithotripsy; D053040:Nephrolithiasis / Q000517:prevention & control* / Q000628:therapy; D019357:Potassium Citrate / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019357:Potassium Citrate
keywords: Lithotripsy; Potassium citrate; Stone recurrence; Urolithiasis