Zuckerman Jack M, Assimos Dean G
Department of Urology, Wake Forest University School of Medicine Winston-Salem, NC.
Rev Urol. 2009 Summer;11(3):134-44.
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.
低尿枸橼酸盐排泄是已知的肾结石形成风险因素。枸橼酸盐通过与尿液中的钙络合、抑制自发成核以及防止晶体生长和聚集来抑制结石形成。低枸橼酸尿症是一种常见的代谢异常，在20%至60%的结石形成者中存在。其病因大多为特发性，但也可能由远端肾小管酸中毒、低钾血症、肠道功能障碍以及高蛋白、低碱饮食引起。遗传因素、药物和其他合并症也起一定作用。低枸橼酸尿症应通过饮食调整、口服碱剂以及可能的柠檬水或其他基于柑橘汁的疗法进行处理。本综述涉及低枸橼酸尿症的病理生理学以及患有这种异常的结石形成者的管理。
