PREVENTION OF RECURRENT CALCIUM STONE FORMATION WITH POTASSIUM CITRATE THERAPY IN PATIENTS WITH DISTAL RENAL TUBULAR-ACIDOSIS
PREVENTION OF RECURRENT CALCIUM STONE FORMATION WITH POTASSIUM CITRATE THERAPY IN PATIENTS WITH DISTAL RENAL TUBULAR-ACIDOSIS
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DOI：
10.1016/s0022-5347(17)46963-1
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发表时间：
1985-01-01
影响因子：
6.6
通讯作者：
PAK, CYC
中科院分区：
文献类型：
--
作者：
PREMINGER, GM;SAKHAEE, K;PAK, CYC
远端肾小管酸中毒是难治性钙性肾结石的常见原因。对9例不完全性远端肾小管酸中毒患者口服柠檬酸钾的疗效进行了检测，这些患者是根据口服氯化铵负荷的异常反应诊断出来的。在控制期和3个月后对患者进行研究。柠檬酸钾处理(60-80mEq.每日)。柠檬酸钾使尿液pH和尿柠檬酸显著升高，尿钙显著降低。治疗过程中尿草酸钙相对饱和度显著降低，而刷石尿相对饱和度无明显变化。柠檬酸钾也被证明能抑制新结石的形成。平均疗程34个月。9名患者中没有新的结石，尽管39.3。+-。每名患者在治疗前3年内形成结石79.7(标准差)。这些结果支持了柠檬酸钾治疗远端肾小管性酸中毒和复发性钙肾结石的潜在临床优势。
Distal renal tubular acidosis is a common cause of intractable Ca nephrolithiasis. The effect of oral potassium citrate therapy was examined in 9 patients with incomplete distal renal tubular acidosis diagnosed on the basis of an abnormal response to an oral ammonium chloride load. Patients were studied during a control phase and after 3 mo. of potassium citrate treatment (60-80 mEq. daily). Potassium citrate caused a significant increase in urinary pH and urinary citrate, and a decrease in urinary Ca. The urinary relative saturation ratio of Ca oxalate significantly decreased during treatment, while that of brushite did not change. Potassium citrate also was shown to inhibit new stone formation. During a mean treatment period of 34 mo. none of the 9 patients had new stones, although 39.3 .+-. 79.7 (standard deviation) stones per patient formed during the 3 yr preceding treatment. The results support the potential clinical advantage of potassium citrate therapy in patients with distal renal tubular acidosis and recurrent Ca nephrolithiasis.