Hypocitraturia: pathophysiology and medical management.
- 1 January 2009
- journal article
- Vol. 11 (3), 134-44
Abstract
Low urinary citrate excretion is a known risk factor for the development of kidney stones. Citrate inhibits stone formation by complexing with calcium in the urine, inhibiting spontaneous nucleation, and preventing growth and agglomeration of crystals. Hypocitraturia is a common metabolic abnormality found in 20% to 60% of stone formers. It is most commonly idiopathic in origin but may be caused by distal renal tubular acidosis, hypokalemia, bowel dysfunction, and a high-protein, low-alkali diet. Genetic factors, medications, and other comorbid disorders also play a role. Hypocitraturia should be managed through a combination of dietary modifications, oral alkali, and possibly lemonade or other citrus juice-based therapy. This review concerns the pathophysiology of hypocitraturia and the management of stone formers afflicted with this abnormality.Keywords
This publication has 100 references indexed in Scilit:
- Prevention of Thiazide-Induced Hypokalemia Without Magnesium Depletion by Potassium-Magnesium-CitrateClinical Journal of Sport Medicine, 2006
- ETHNIC BACKGROUND HAS MINIMAL IMPACT ON THE ETIOLOGY OF NEPHROLITHIASISJournal of Urology, 2005
- The effect of fruits and vegetables on urinary stone risk factorsKidney International, 2004
- Clinical implications of abundant calcium phosphatein routinely analyzed kidney stonesKidney International, 2004
- Citrate inhibits growth of residual fragments in an in vitro model of calcium oxalate renal stonesKidney International, 2004
- SODIUM-COUPLED TRANSPORTERS FOR KREBS CYCLE INTERMEDIATESAnnual Review of Physiology, 1999
- Renal Handling of Citrate in Chronic Renal InsufficiencyNephron, 1991
- Hypocitraturia in Patients with Gastrointestinal MalabsorptionNew England Journal of Medicine, 1980
- Specificity of the transport system for tricarboxylic acid cycle intermediates in renal brush bordersThe Journal of Membrane Biology, 1980
- Substrate-utilization of the Human KidneyNature, 1966