Objectives
Potassium citrate is prescribed to patients with calcium oxalate (CaOx) stone formation
to increase urinary citrate and pH, thus reducing CaOx crystal formation. Lemonade
therapy (LT) might also increase urinary citrate and the total urine volume. We compared
the effects of LT alone (group 1, n = 63) and potassium citrate plus LT (group 2,
n = 37) in patients with CaOx stone formation on the urinary citrate and total urine
volume to determine the efficacy of LT.
Methods
Adult patients with CaOx stone formation and three or more clinic visits from 1996
to 2005 and three or more UroRisk profiles were included in our retrospective analysis.
Results
Urinary citrate increased maximally by 203 and 346 mg/day for groups 1 and 2, respectively.
The maximal total urine volume increase was 763 and 860 mL/day for groups 1 and 2,
respectively. The urinary citrate and total urine volume increased sooner during follow-up
for group 1. By the last clinic visit, the urinary citrate and total urine volume
had decreased in both groups. However, group 1 sustained a greater total urine volume
than did group 2 (2.35 ± 0.10 standard error versus 2.17 ± 0.12 L/day). Urinary citrate
was greater in group 1 (765 ± 56 standard error versus 548 ± 56 mg/day for group 2),
but the change from baseline to the last visit was significant (P = 0.008) only in group 2.
Conclusions
LT resulted in favorable changes in urinary citrate and total urine volume in our
series. Potassium citrate with LT was more effective than LT alone at increasing urinary
citrate. Because maximal changes for urinary citrate and total urine volume were achieved
earlier in follow-up, individualized encouragement and motivation should be provided
to patients at each visit for sustained prevention.
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Article info
Publication history
Published online: October 05, 2007
Accepted:
June 29,
2007
Received:
February 3,
2007
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
