The tolerability of Potassium Citrate Tablet in patients with intolerance to Potassium Citrate Powder form
Vol. 15 No. 1 (2018),
23 January 2018
AbstractPurpose: To assess the tolerability of Potassium Citrate (KCit) tablets in patients with kidney stones that were not able to use the powder form of this drug due to unfavorable salty taste and /or gastrointestinal complications.
Materials and Methods: Twenty-three stone formers, with intolerance to potassium citrate powder form, which had referred to Labbafinejad stone preventive clinic in 2015, were included in this study. All of the patients took two potassium citrate tablets (10 meq), three times a day for two weeks. Spot urine samples and the 24-hour urine collections were performed before and after KCit therapy. In addition, a visual analog taste scale was completed to gauge the taste and palatability of the KCit tablets in comparison with the powder form.
Results: All of the patients claimed that they consumed the tablets as prescribed. The urine pH (5.7 ± 0.6 to 6.1 ± 0.8, p = 0.006), 24-hour citrate (235.8 ± 190.2 to 482.5 ± 323.2, p = 0.0002) and potassium (45.25 ± 22.5 to 75.27 ± 37, p = 0.002) were significantly higher after the treatment. In addition, the mean visual analog scale score was significantly improved in KCit therapy with tablet form versus to powder form of the drug (good vs. terrible score).
Conclusion: Oral tolerance of KCit therapy is improved with the use of Potassium Citrate tablet, with beneficial effects on 24-hour urine citrate, potassium, and pH.
How to Cite
Phillips R, Hanchanale VS, Myatt A, Somani B, Nabi G, Biyani CS. Citrate salts for preventing and treating calcium containing
kidney stones in adults. Cochrane Database Syst Rev. 2015CD010057.
Rahman F, Birowo P, Widyahening IS, Rasyid N. Effect of citrus-based products on urine profile: A systematic review and metaanalysis. F1000Res. 2017;6:220.
Pattaras JG, Moore RG. Citrate in the management of urolithiasis. J Endourol. 1999;13:687-92.
Pak CY, Poindexter JR, Adams-Huet B, Pearle MS. Predictive value of kidney stone composition in the detection of metabolic
abnormalities. Am J Med. 2003;115:26-32.
Bultitude MF. Campbell‐Walsh Urology Tenth Edition. Bju International. 2012;109.
Moe OW, Abate N, Sakhaee K. Pathophysiology of uric acid nephrolithiasis. Endocrinol Metab Clin North Am. 2002;31:895-914.
Joly D, Rieu P, Mejean A, Gagnadoux MF, Daudon M, Jungers P. Treatment of cystinuria. Pediatr Nephrol. 1999;13:945-50.
Pak CY. Citrate and renal calculi: new insights and future directions. Am J Kidney Dis. 1991;17:420-5.
Pak CY, Fuller C, Sakhaee K, Preminger GM, Britton F. Long-term treatment of calcium nephrolithiasis with potassium citrate. J Urol. 1985;134:11-9.
Fegan J, Khan R, Poindexter J, Pak CY. Gastrointestinal citrate absorption in nephrolithiasis. J Urol. 1992;147:1212-4.
Jendle-Bengten C, Tiselius HG. Long-term follow-up of stone formers treated with a low dose of sodium potassium citrate. Scand J Urol Nephrol. 2000;34:36-41.
Robinson MR, Leitao VA, Haleblian GE, et al. Impact of long-term potassium citrate therapy on urinary profiles and recurrent stone formation. J Urol. 2009;181:1145-50.
Meyer JL, Smith LH. Growth of calcium oxalate crystals. II. Inhibition by natural urinary crystal growth inhibitors. Invest Urol.
Nicar MJ, Hill K, Pak CY. Inhibition by citrate of spontaneous precipitation of calcium oxalate in vitro. J Bone Miner Res. 1987;2:215-20.
Hess B, Zipperle L, Jaeger P. Citrate and calcium effects on Tamm-Horsfall glycoprotein as a modifier of calcium oxalate crystal aggregation. Am J Physiol. 1993;265:F784-91.
Sheng X, Jung T, Wesson JA, Ward MD. Adhesion at calcium oxalate crystal surfaces and the effect of urinary constituents. Proc Natl Acad Sci U S A. 2005;102:267-72.
Domrongkitchaiporn S, Stitchantrakul W, Kochakarn W. Causes of hypocitraturia in recurrent calcium stone formers: focusing on urinary potassium excretion. Am J Kidney Dis. 2006;48:546-54.
Zuckerman JM, Assimos DG. Hypocitraturia: Pathophysiology and Medical Management. Reviews in Urology. 2009;11:134-44.
Wang YH, Grenabo L, Hedelin H, Pettersson S. The effects of sodium citrate and oral potassium citrate on urease-induced
crystallization. Br J Urol. 1994;74:409-15.
Mattle D, Hess B. Preventive treatment of nephrolithiasis with alkali citrate--a critical review. Urol Res. 2005;33:73-9.
Hesse A, Bach D, May P. Der Harnsäurestein. In: Vahlensieck W, ed. Das Harnsteinleiden: Ursachen · Diagnose · Therapie. Berlin, Heidelberg: Springer Berlin Heidelberg; 1987:481-518.
Nicar MJ, Peterson R, Pak CY. Use of potassium citrate as potassium supplement during thiazide therapy of calcium nephrolithiasis. J Urol. 1984;131:430-3.
Nicar MJ, Hsu MC, Fetner C. Urinary response to oral potassium citrate therapy for urolithiasis in a private practice setting. Clin Ther. 1986;8:219-25.
Lindberg J, Harvey J, Pak CY. Effect of magnesium citrate and magnesium oxide on the crystallization of calcium salts in
urine: changes produced by food-magnesium interaction. J Urol. 1990;143:248-51.
Herrmann U, Schwille PO, Schwarzlaender H, Berger I, Hoffmann G. Citrate and recurrent idiopathic calcium urolithiasis. A longitudinal pilot study on the metabolic effects of oral potassium sodium citrate administered as short-, medium- and long-term to male stone patients. Urol Res. 1992;20:347-53.
Ito H, Suzuki F, Yamaguchi K, Nishikawa Y, Kotake T. Reduction of urinary oxalate by combined calcium and citrate administration without increase in urinary calcium oxalate
stone formers. Clin Nephrol. 1992;37:14-8.
Khanniazi MK, Khanam A, Naqvi SA, Sheikh MA. Study of potassium citrate treatment of crystalluric nephrolithiasis. Biomed
Grases F, Conte A, March JG, Garcia-Ferragut L. Evolution of lithogenic urinary parameters with a low dose potassium citrate treatment. Int Urol Nephrol. 1998;30:1-8.
Schwille PO, Herrmann U, Wolf C, Berger I, Meister R. Citrate and recurrent idiopathic calcium urolithiasis. A longitudinal pilot study on the metabolic effects of oral potassium citrate administered over the short-, mediumand
long-term medication of male stone patients. Urol Res. 1992;20:145-55.
Mechlin C, Kalorin C, Asplin J, White M. Splenda(R) improves tolerance of oral potassium citrate supplementation for
prevention of stone formation: results of a randomized double-blind trial. J Endourol. 2011;25:1541-5.
- Abstract Viewed: 862 times
- PDF Downloaded: 409 times