Potassium Citrate and Calcium Stones: Benefit or Risk?

Youssef, Ramy; Preminger, Glenn M.; Lipkin, Michael

doi:10.1007/978-1-4614-9575-8_9

Cited by 1 publication

(3 citation statements)

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“…According to previous studies, single oral potassium at a dose of 0.5 mmol/kg produced a minimal increase in serum potassium, while total doses of approximately 1 mmol/kg increased serum potassium by as much as 1 mmol/L in a healthy man. [ 24 , 25 ] The molecular formula of PSHC is K 6 Na 6 H 3 (C 6 H 5 O 7 ) 5 , with the molecular weight of 1321.06. According to the instructions of PSHC granules, each gram of PSHC contains 4.4 mmol potassium.…”

Section: Discussionmentioning

confidence: 99%

“…[ 17 – 19 ] Hyperkalemic ventricular fibrillation was even observed in patients with fine renal function after ingesting small amounts of PC (40–60 mmol/L). [ 23 , 24 ] It might be not harmless for patients with normal renal function even at an acceptable dosage, although there is 28 mmol potassium in 10-mL PC mixture. The recommended daily dose is up to 40 mL, more than twice the daily intake of PSHC, which means more dangers of hyperkalemia.…”

Section: Discussionmentioning

confidence: 99%

“…We would like to emphasize side effects of potassium alkaline citrate, despite its significant advantage in preventing urinary lithiasis. [ 24 ] Physicians should evaluate the role of potassium-bearing citrates besides PSHC in patients after renal transplantation, particularly in those with renal insufficiency or combination medication. It has been suggested that when coprescribing medicine, it would be better to avoid using potassium-bearing citrate that may interfere with potassium homeostasis among patients with renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Safety of potassium-bearing citrate in patients with renal transplantation

Wang

Cui²,

Zhang³

et al. 2017

Medicine

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Rationale:Urinary lithiasis is one of severe postoperative complications in patients undergoing renal transplantation, possibly leading to anuria, urinary infection, or even acute renal failure. Potassium sodium hydrogen citrate (PSHC), a potassium-bearing citrate, is commonly prescribed to prevent stone formation.Patient concerns:A 25-year-old man (patient 1) and a 31-year-old man (patient 2) receiving renal transplantation for end-stage renal disease (ESRD) were enrolled in this study. They were given 10 g/day of PSHC granules from the ninth day to the 17th day after surgery. Patient 1 presented chest tightness, nausea, muscle weakness, and ascending paralysis on the 10th day. Patient 2 presented weak waves on EGG on the 17th day. Moreover, their serum potassium concentrations (SPCs) were 7.67 and 6.05 mmol/L, respectively.Diagnosis:Acute hyperkalemia.Interventions:Hemo-filtration was performed for patient 1, while patient 2 received 10% calcium gluconate 10 mL, 5% NaHCO3 125 mL, and 10% glucose 500 mL with the addition of 10 units of insulin through intravenous drip.Outcomes:Their SPCs dropped to the normal range.Lessons:Physicians should pay close attentions to potential risks caused by PSHC, and monitor the SPCs to minimize the occurrence of hyperkalemia.

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Section: Discussionmentioning

confidence: 99%