24-Hour Urinary Citrate Determination Among Filipino Urinary Stone Formers After Potassium Citrate Therapy: A Prospective, Cohort Study

Abstract

Objective: Urolithiasis, a common problem in medicine, poses a significant burden with prevalence of 1-15%. Potassium citrate therapy has become one of the cornerstones of medical stone management with hypocitraturia being the most common metabolic problem in stone formers. The authors determined the effects of potassium citrate on urinary metabolic profiles and its impact on stone burden among Filipino stone formers.

Patients and Methods: This is a prospective, cohort study in patients seen at the UST Hospital between 2016 and 2018. Twenty-four hour urine citrate levels, stone sizes and urine pH pre-therapy and posttherapy were analyzed.

Results: Significant changes in urinary citrate, pH and stone sizes were noted as soon as 3 months after the onset of therapy. These changes included increase in urinary pH (6.1 to 6.7; p=0.001), increase in urinary citrate (109.1 to 253.4mg/day; p<0.001) and decrease in stone size (0.56 to 0.37cm; p=0.037). The changes in the urine citrate and the changes in the stone size were not correlated using the Pearson correlation scatter plot.

Conclusion: Potassium citrate therapy provides a significant alkali and citraturic treatment among Filipino stone formers. However, there is no significant correlation between changes in stone size and changes in urine citrate level.