Potassium Citrate Therapy for Calcium Oxalate Stones
Indications and Mechanism
- Potassium citrate is indicated for patients with recurrent calcium stones who have low or relatively low urinary citrate excretion, and it is also beneficial for calcium stone-forming patients with normal citrate excretion but low urinary pH 1, 3
- Potassium citrate provides an alkali load that increases urine pH and acts as a potent inhibitor of calcium phosphate crystallization 1
- The American Urological Association (AUA) guidelines recommend long-term therapy for patients with recurrent calcium stones 1, 3
Adjunctive Measures and Therapy Duration
- Increased fluid intake, sodium restriction, and ample fruits and vegetables may increase the safety and efficacy of citrate therapy 1
- Thiazide diuretics may be added to potassium citrate therapy for patients with hypercalciuria 1
- Potassium citrate therapy should be continued indefinitely in patients with persistent risk factors, as discontinuation may lead to stone recurrence 1