Summary
It has been suggested that an important factor in the formation of renal calculi is a deficiency of citrate excretion by the kidney. This we have failed to confirm and consider rather that any gross diminution of urinary citrate is due simply to infection of the urinary tract. The proof of this is as follows:‐
1. In seven patients with calculi and a sterile tract the average citrate content of the urine was comparable with that found in controls.
2. Seven patients with calculi, associated with infection, were all found to have less citrate in their urine than normals.
3. Experiments in vitro confirmed that in this latter group citrate was destroyed particularly by E. colz, although with Kosers medium this splitting action was not detectable.
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