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Citrate and renal calculi: an updateCitrate is an inhibitor of the crystallization of stone-forming calcium salts. Hypocitraturia, frequently encountered in patients with nephrolithiasis, is therefore an important risk factor for stone formation. Potassium citrate provides physiological and physicochemical correction and inhibits new stone formation, not only in hypocitraturic calcium nephrolithiasis but also in uric acid nephrolithiasis. Inhibition of stone recurrence has now been validated by a randomized trial. Ongoing research has disclosed additional causes of hypocitraturia (sodium excess, low intestinal alkali absorption, but not primary citrate malabsorption). Moreover, new insights on potassium citrate action have been shown, notably that some of absorbed citrate escapes oxidation and contributes to the citraturic response, that ingestion with a meal does not sacrifice physiological or physicochemical action, that orange juice mimics but does not completely duplicate its actions, that potassium citrate may have a beneficial bone-sparing effect, that it may reduce stone fragments following ESWL, and that danger of aluminum toxicity is not great in subjects with functioning kidneys. Finally, the research on potassium citrate has led to two promising products, calcium citrate as an optimum calcium supplement and potassium-magnesium citrate which may be superior to potassium citrate in the management of stone disease.
Document ID
Document Type
Reprint (Version printed in journal)
Pak, C. Y. (University of Texas Southwestern Medical Center at Dallas 75235-8885 United States)
Date Acquired
August 22, 2013
Publication Date
January 1, 1994
Publication Information
Publication: Mineral and electrolyte metabolism
Volume: 20
Issue: 6
ISSN: 0378-0392
Subject Category
Life Sciences (General)
Distribution Limits
NASA Discipline Regulatory Physiology
Non-NASA Center
Review, Tutorial