Potassium Citrate Dosing for Nephrolithiasis Prevention

Efficacy and Dosage

• The American College of Physicians recommends citrate as monotherapy when fluid intake alone fails, with potassium citrate being equally effective across different stone types 1, 2, 4, 5
• Treatment with 60-80 mEq per day of potassium citrate reduces stone formation rate from 52.3% to 11.1% in placebo-controlled trials for patients with calcium oxalate stones and hypocitraturia 1, 2

Monitoring and Dose Adjustment

• Obtain 24-hour urine collection at 6 months to verify adequate response, targeting urinary citrate >320 mg/day, ideally 400-700 mg/day 3