The Effects of a Single Evening Dose of Alkaline Citrate on Urine Composition and Calcium Stone Formation

Berg, C.; Larsson, Laşse; Tiselius, Hans‐Göran

doi:10.1016/s0022-5347(17)36795-2

Cited by 25 publications

(17 citation statements)

References 30 publications

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“…Despite initially promising effects of magnesium treatment, there are no long-term studies that support an effect in preventing recurrence for either MgO or Mg(OH) 2 [11,72]. This lack of effect can probably be explained by an increased excretion of calcium parallel with that of magnesium, and that a low magnesium excretion is an uncommon finding in calcium stone formers.…”

Section: Magnesiummentioning

confidence: 99%

Epidemiology and medical management of stone disease

2003

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SUMMARYRecurrent stone formation in the urinary tract is a common and important problem that must be considered in daily urological practice. With a prevalence of> 10% and an expected recurrence rate of ≈ 50%, stone disease has an important effect on the healthcare system. It is generally agreed that patients with uric acid/urate, cystine or infection stones always should be treated pharmacologically. For calcium stone formers the treatment should be chosen according to the severity of the disease. Recurrence in patients with calcium‐stone disease can be prevented with general or specific dietary and drinking advice, and with pharmacological therapy. For idiopathic calcium stone formers the most convincing therapeutic effects have been reported with thiazide and alkaline citrate.

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Section: Magnesiummentioning

confidence: 99%

Epidemiology and medical management of stone disease

2003

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“…However, there is evidence suggesting that this is not always the case [9]. Natural mineral water rich in magnesium and hydrogen carbonate and with a slight amount of potassium citrate added offers very promising properties when one regards the well-known risk factors of calcium oxalate stone formation [10][11][12][13][14]. Potassium magnesium citrate has also been reported as the most effective means to increase urinary citrate levels [15].…”

Section: Discussionmentioning

confidence: 99%

Magnesium Hydrogen Carbonate Natural Mineral Water Enriched with K<sup>+</sup>-Citrate and Vitamin B<sub>6</sub> Improves Urinary Abnormalities in Patients with Calcium Oxalate Nephrolithiasis

Bren

Kmetec²,

Kveder³

et al. 1998

Urol Int

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The influence of drinking magnesium hydrogen carbonate natural mineral water enriched with potassium citrate on urinary metabolic abnormalities was prospectively studied in 27 patients with recurrent calcium oxalate nephrolithiasis. The mean 24-hour urinary pH shifted from 6.34 to 6.93 (p < 0.01), the mean urinary magnesium/urinary creatinine ratio rose from 0.47 to 0.67 (p < 0.01), the mean urinary citrate/urinary creatinine ratio increased from 0.26 to 0.35 (p NS), and the mean 24-hour urinary calcium decreased from 7.98 to 6.05 mmol (p < 0.05). The effects of magnesium hydrogen carbonate natural mineral water enriched with potassium citrate were found to be favorable on urinary calcium, urinary magnesium/urinary creatinine ratio and urinary pH in patients with calcium oxalate nephrolithiasis.

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“…It has recently been stated that a single dose of a potassium and sodium citrate mixture (at 20:00 h) significantly increases urinary pH in normal subjects. This lasted until 10:00 h the next day, but the authors did not state the amount by which the pH had risen (20). We do not regard the precise mechanism by which pH is changed as important, as a decrease in hydrogen ion concentration can be accomplished in a variety of ways both physiologically and in vitro.…”

Section: Bryant Et Al (3) Found Phagocytosis Ofmentioning

confidence: 94%

Effect of alkalinisation and increased fluid intake on bacterial phagocytosis and killing in urine

Gargan

Hamilton‐Miller

Brumfitt

1993

Eur. J. Clin. Microbiol. Infect. Dis.

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The effect of alkalinisation and increased fluid intake on bacterial phagocytosis and killing in urine was studied. Phagocytosis of Escherichia coli and Staphylococcus saprophyticus by polymorphonuclear neutrophils (PMN) took place in only one of three first voided early morning urine samples from volunteers, and no bacterial killing occurred. This was attributed to the high osmolality (690 to 720 mOsm) and low pH of the early morning urine; two samples were pH 5.8 and the third, in which phagocytosis occurred, was pH 6.4. Afternoon urine samples from the same volunteers had lower osmolality and a higher pH, with a high rate of phagocytosis (> or = 88%) and 55-69% killing. PMN remained viable (mean 94%) after exposure for 1 h to both early morning and afternoon urine. Volunteers taking 4 g sodium citrate showed a mean rise of urinary pH of 1 unit. Water loading in patients with urinary tract infections produced a bacteria to neutrophil ratio conducive to bacterial killing, bacterial counts being reduced by a mean of 2.5 logs after 1-3 h without a corresponding reduction in neutrophils. Thus, raising the pH and reducing the osmolality of urine increases the ability of neutrophils to eliminate infecting organisms.

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The Effects of a Single Evening Dose of Alkaline Citrate on Urine Composition and Calcium Stone Formation

Cited by 25 publications

References 30 publications

Epidemiology and medical management of stone disease

Epidemiology and medical management of stone disease

Magnesium Hydrogen Carbonate Natural Mineral Water Enriched with K<sup>+</sup>-Citrate and Vitamin B<sub>6</sub> Improves Urinary Abnormalities in Patients with Calcium Oxalate Nephrolithiasis

Effect of alkalinisation and increased fluid intake on bacterial phagocytosis and killing in urine

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