Physicochemical action of potassium‐magnesium citrate in nephrolithiasis
Physicochemical action of potassium‐magnesium citrate in nephrolithiasis
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柠檬酸钾镁治疗肾结石的理化作用
DOI：
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发表时间：
1992
影响因子：
6.2
通讯作者：
P. Padalino
中科院分区：
文献类型：
--
作者：
C. Pak;K. Koenig;Rubina Khan;S. Haynes;P. Padalino
在五名正常受试者和五名钙性肾结石患者中，比较了柠檬酸钾镁与相同钾剂量的柠檬酸钾对尿液生化和成石盐结晶的影响。与安慰剂阶段相比，尿液pH值从6.06 ± 0.27显著升高至6.48 ± 0.36（平均值± SD，p < 0.0167）和6.68 ± 0.31，分别在柠檬酸钾治疗（50 mEq/天，持续7天）和柠檬酸钾镁治疗（每天含49 mEq K、24.5 mEq Mg和73.5 mEq柠檬酸盐）期间。柠檬酸钾镁治疗期间的尿液pH值显著高于柠檬酸钾治疗期间。因此，未解离尿酸的量从安慰剂治疗期间的118 ± 61 mg/天降至柠檬酸钾治疗期间的68 ± 54 mg/天，更显著的是，柠檬酸钾镁治疗期间降至41 ± 46 mg/天。在柠檬酸钾镁治疗期间，尿镁从102 ± 25 mg/天显著升高至146 ± 37 mg/天，但在柠檬酸钾治疗期间未升高。与柠檬酸钾治疗期间（至932 ± 297 mg/天）相比，柠檬酸钾-镁治疗期间（从638 ± 252 mg/天至1027 ± 478 mg/天）的尿柠檬酸盐升高更显著。因此，在柠檬酸钾镁治疗期间，草酸钙的尿饱和度（活度积）显著下降（从1.49 × 10−8降至1.03 × 10−8 M2），在柠檬酸钾治疗期间略有下降（降至1.14 × 10−8 M2）。此外，磷酸钙（透钙磷石）的形成产物（指示对自发成核的抑制）在柠檬酸钾镁治疗期间（从4.62 × 10−7至8.78 × 10−7 M2）比柠檬酸钾治疗期间（至6.08 × 10 − 7 M2）更显著地升高。在柠檬酸钾镁治疗期间，对草酸钙凝聚的抑制作用略有增加（p = 0.02），而在柠檬酸钾治疗期间，其没有显著变化。因此，柠檬酸钾镁（相同剂量的钾）在抑制尿液中尿酸和草酸钙结晶方面比柠檬酸钾更有效。
Effect of potassium‐magnesium citrate on urinary biochemistry and crystallization of stone‐forming salts was compared with that of potassium citrate at same dose of potassium in five normal subjects and five patients with calcium nephrolithiasis. Compared to the placebo phase, urinary pH rose significantly from 6.06 ± 0.27 to 6.48 ± 0.36 (mean ± SD, p < 0.0167) during treatment with potassium citrate (50 mEq/day for 7 days) and to 6.68 ± 0.31 during therapy with potassium‐magnesium citrate (containing 49 mEq K, 24.5 mEq Mg, and 73.5 mEq citrate per day). Urinary pH was significantly higher during potassium‐magnesium citrate than during potassium citrate therapy. Thus, the amount of undissociated uric acid declined from 118 ± 61 mg/day during the placebo plase to 68 ± 54 mg/day during potassium citrate treatment and, more prominently, to 41 ± 46 mg/day during potassium‐magnesium citrate therapy. Urinary magnesium rose significantly from 102 ± 25 to 146 ± 37 mg/day during potassium‐magnesium citrate therapy but not during potassium citrate therapy. Urinary citrate rose more prominently during potassium‐magnesium citrate therapy (to 1027 ± 478 mg/day from 638 ± 252 mg/day) than during potassium citrate treatment (to 932 ± 297 mg/day). Consequently, urinary saturation (activity product) of calcium oxalate declined significantly (from 1.49 × 10−8 to 1.03 × 10−8 M2) during potassium‐magnesium citrate therapy and marginally (to 1.14 × 10−8 M2) during potassium citrate therapy. Moreover, the formation product of calcium phosphate (brushite), indicative of inhibition against spontaneous nucleation, rose more prominently during potassium‐magnesium citrate treatment (from 4.62 × 10−7 to 8.78 × 10−7 M2) than during potassium citrate therapy (to 6.08 × 10−7 M2). The inhibition against agglomeration of calcium oxalate increased marginally (p = 0.02) during potassium‐magnesium citrate therapy, whereas it did not change significantly during potassium citrate treatment. Thus, potassium‐magnesium citrate (at same dose of potassium) is more effective than potassium citrate in inhibiting the crystallization of uric acid and calcium oxalate in urine.
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高钙尿症机制的定义对于治疗复发性结石形成是必要的。
影响因子：
--
作者：
Pak,CY;Nicar,M;Northcutt,C
通讯作者：
Northcutt,C
柠檬酸钾成功治疗特发性低柠檬酸钙草酸肾结石。
影响因子：
39.2
作者：
Pak,CY;Fuller,C
通讯作者：
Fuller,C
柠檬酸钙：降低因补钙引起的高钙尿症而导致尿液中草酸钙结晶的倾向。
DOI：
10.1210/jcem-61-6-1223
发表时间：
1985
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Harvey,JA;Zobitz,MM;Pak,CY
通讯作者：
Pak,CY
影响因子：
19.6
作者：
PAK, CYC;SAKHAEE, K;FULLER, C
通讯作者：
FULLER, C
肾结石尿柠檬酸排泄量低。
影响因子：
2.1
作者：
Nicar,MJ;Skurla,C;Sakhaee,K;Pak,CY
通讯作者：
Pak,CY