Citrates in nephrolithiasis

Caudarella, Renata and Buffa, Angela and Vescini, Fabio (2004) Citrates in nephrolithiasis. Clinical cases in mineral and bone metabolism, 1 (1). pp. 53-56. ISSN 1971-3266

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Nephrolithiasis is a multisystem disease arising from the sin- ergic effects of enviromental, hormonal and genetic factors. In Europe an incidence of 2000 stones per million of population has been reported. Kidney stones are mainly composed of calcium (70-80%) with a predominance of calcium oxalate, with or without calcium phosphate. Low urinary citrate excre- tion is a common feature of idiopathic calcium stone disease. A wide range of hypocitraturia prevalence in nephrolithiasis have been reported in literature. Hypocitraturia is defined as a urinary citrate excretion lower than 320 mg/day. Many factors can modulate citrate excretion. Among them an important role is played by acid-base status, nutritional factors, strarvation, hormones and drugs. Estrogen exert an important modulating effect on urinary citrate excretion. Several authors, in fact, have described a reduction in urinary citrate excretion in healthy postmenopausal women, as well as a lower citraturia in males than in premenopausal females. Urinary citrate di- rectly inhibits stone formation by forming highly soluble com- plexes with calcium in the renal tubule and by increasing in- traluminal pH. Idiopathic calcium stone disease, but also other forms of nephrolithiasis, as well as some other pathological conditions can be treated with alkaline citrate. The most com- mon form of these salts is potassium citrate that has been successfully used in the prevention of stone ecurrence. In conclusion alkaline citrate represents an effective tool in the prevention of calcium stone formation. Last, but not least, this form of therapy presents few side effects

Item Type: Article
Uncontrolled Keywords: Nephrolithiasis, nephrocalcinosis, citrates
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Patrizia Romano
Date Deposited: 19 Mar 2014 16:41
Last Modified: 19 Mar 2014 16:41

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