Potassium Citrate Salts for Preventing and Treating Calcium Containing Kidney Stones in Adults

Summary

A Cochrane review [Abstract] 1 included 7 studies with a total of 477 subjects, most of whom had oxalate stones. Compared with placebo or no intervention, citrate therapy (potassium citrate, potassium-sodium citrate, potassium-magnesium citrate with various dose) significantly reduced the stone size (RR 2.35, 95% CI 1.36 to 4.05; 4 studies, n=160) and new stone formation (RR 0.26, 95% CI 0.10 to 0.68; 7 studies, n=324). The beneficial effect on stone size stability was also evident (RR 1.97, 95% CI 1.19 to 3.26; 4 studies, n=160). There were more gastrointestinal adverse events in the citrate group (mainly upper gastrointestinal disturbance); however this was not significant (RR 2.55, 95% CI 0.71 to 9.16; 4 studies, n=271). There were more dropouts due to adverse events with citrate therapy compared to control (RR 4.45, 95% CI 1.28 to 15.50; 4 studies, n=271). The need for retreatment was significantly less with citrate therapy compared to control (RR 0.22, 95% CI 0.06 to 0.89; 2 studies, n=157).