Citrate salts for preventing and treating calcium containing kidney stones in adults

Phillips, Rebecca; Hanchanale, Vishwanath; Myatt, Andy; Somani, Bhaskar K.; Nabi, Ghulam; Biyani, Chandra Shekhar

doi:10.1002/14651858.cd010057.pub2

Cited by 67 publications

(52 citation statements)

References 59 publications

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“…Nevertheless, available data are often difficult to be interpreted due to the intricate underlying biochemistry and the not well-understood regulatory mechanisms. Principal investigations conducted appear often to be not rigorous and heterogeneous; moreover, methods and outcomes are not well standardized and acid production value is indirectly estimated with different modalities across studies so that data are difficult to be compared to a large extent (Escribano et al 2014;Phillips et al 2015). Hence, in our opinion, the role of WD in inducing clinically evident chronic disorders has yet to be more accurately evaluated.…”

Section: Resultsmentioning

confidence: 99%

“…A medium size sample (477 individuals) Cochrane database metaanalysis has been performed in attempt to assess the efficacy associated with citrate salts for the treatment and prevention of calcium containing kidney stones in patient with history of oxalate stone disease and low urinary citrate. Although remarking the poor quality of the studies, the authors concluded that citrate salts are likely to reduce stone size as well as the recurrence of urinary stone formation and further stone growth in this cluster of patients (Phillips et al 2015).…”

Section: Urinary Stonesmentioning

confidence: 95%

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Diet-induced acidosis and alkali supplementation

Guardia

Roggi

Cena

2016

International Journal of Food Sciences and Nutrition

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Western diet, high in protein-rich foods and poor in vegetables, is likely to be responsible for the development of a moderate acid excess leading to metabolism deregulation and the onset or worsening of chronic disturbances. Available findings seem to suggest that diets with high protein/vegetables ratio are likely to induce the development of calcium lithiasis, especially in predisposed subjects. Moreover, some evidence supports the hypothesis of bone metabolism worsening and enhanced bone loss following acid-genic diet consumption although available literature seems to lack direct and conclusive evidence demonstrating pathological bone loss. According to other evidences, diet-induced acidosis is likely to induce or accelerate muscle wasting or sarcopenia, especially among elderlies. Furthermore, recent epidemiological findings highlight a specific role of dietary acid load in glucose metabolism deregulation and insulin resistance. The aim of this review is to investigate the role of acid-genic diets in the development of the mentioned metabolic disorders focusing on the possible clinical improvements exerted by alkali supplementation.

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Section: Resultsmentioning

confidence: 99%

Section: Urinary Stonesmentioning

confidence: 95%

Diet-induced acidosis and alkali supplementation

Guardia

Roggi

Cena

2016

International Journal of Food Sciences and Nutrition

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“…Its effectiveness in urolithiasis treatment has been established from several studies 32, 33 . From one meta-analysis conducted by Phillip et al , potassium citrate significantly reduced stone size, reduced new stone formation, and increased citrate levels 34 . The stone prevention mechanism of potassium citrate is thought to be due to alkali loading and its citrate-uric effect 35 .…”

Section: Discussionmentioning

confidence: 99%

Effect of citrus-based products on urine profile: A systematic review and meta-analysis

et al. 2017

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Background . Urolithiasis is a disease with high recurrence rate, 30-50% within 5 years. The aim of the present study was to learn the effects of citrus-based products on the urine profile in healthy persons and people with urolithiasis compared to control diet and potassium citrate. Methods. A systematic review was performed, which included interventional, prospective observational and retrospective studies, comparing citrus-based therapy with standard diet therapy, mineral water, or potassium citrate. A literature search was conducted using PUBMED, COCHRANE, and Google Scholar with “citrus or lemonade or orange or grapefruit or lime or juice” and “urolithiasis” as search terms. For statistical analysis, a fixed-effects model was conducted when p > 0.05, and random-effects model was conducted when p < 0.05. Results. In total, 135 citations were found through database searching with 10 studies found to be consistent with our selection criteria. However, only 8 studies were included in quantitative analysis, due to data availability. The present study showed a higher increased in urine pH for citrus-based products (mean difference, 0.16; 95% CI 0.01-0.32) and urinary citrate (mean difference, 124.49; 95% CI 80.24-168.74) compared with a control group. However, no differences were found in urine volume, urinary calcium, urinary oxalate, and urinary uric acid. From subgroup analysis, we found that citrus-based products consistently increased urinary citrate level higher than controls in both healthy and urolithiasis populations. Furthermore, there was lower urinary calcium level among people with urolithiasis. Conclusions. Citrus-based products could increase urinary citrate level significantly higher than control. These results should encourage further research to explore citrus-based products as a urolithiasis treatment.

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“…Several cohort studies indicate an association between low potassium intake and increased risk of kidney stones [59,60,61]. However, intervention studies failed to demonstrate an independent effect of potassium intake on the risk of kidney stones [17,62,63]. …”

Section: Preventive Aspectsmentioning

confidence: 99%

Revised Reference Values for Potassium Intake

Strohm¹,

Ellinger²,

Leschik‐Bonnet³

et al. 2017

Ann Nutr Metab

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Background: The nutrition societies of Germany, Austria and Switzerland have revised the reference values for potassium intake in January 2017. Methods: For adults, the estimated value was based on the 24-h urinary potassium excretion and on preventive considerations regarding hypertension and stroke. The estimated values for children and adolescents were extrapolated from the adult estimated value considering differences in body mass. For infants aged 0 to under 4 months, the estimated value was set based on the potassium intake via breast milk. From this reference value, the estimated value for infants aged 4 to under 12 months was also derived by extrapolation. The estimated value for lactating women takes into account the potassium loss via breast milk. Results: The estimated values for potassium intake are set at 400 mg/day for breastfed infants aged 0 to under 4 months, 600 mg/day for infants aged 4 to under 12 months, 1,100-4,000 mg/day for children and adolescents, 4,000 mg/day for adults and pregnant women and 4,400 mg/day for lactating women. Conclusions: The consumption of potassium-rich foods should be generally increased. Supplemental intake beyond the estimated values has no health benefit and is therefore not recommended.

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Citrate salts for preventing and treating calcium containing kidney stones in adults

Cited by 67 publications

References 59 publications

Diet-induced acidosis and alkali supplementation

Diet-induced acidosis and alkali supplementation

Effect of citrus-based products on urine profile: A systematic review and meta-analysis

Revised Reference Values for Potassium Intake

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