Gheissari Alaleh, Ziaee Amin, Farhang Faezeh, Farhang Fatemeh, Talaei Zahra, Merrikhi Alireza, Ghafghazi Taghi, Moslehi Mohsen
Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Pediatric Nephrology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2012 Nov;3(11):791-7.
Potassium citrate (K-Cit) is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate (CaOx) urolithiasis, the significant response to alkaline therapy with K-Cit alone does not occur. There is scarce published data on the effect of magnesium chloride (Mg-Cl(2)) on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K-Cit - MgCl(2) as oral supplements on urinary parameters in children with CaOx urolithiasis.
This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate (K-Cit) and magnesium chloride (Mg-Cl(2)). The serum and urinary electrolytes were measured before (phase 0) and after prescribing K-Cit alone (phase 1) and a combination of K-Cit and Mg-Cl(2) (phase 2). Each phase of therapy lasted for 4 weeks.
The mean age of patients was 6.46 ± 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, P < 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, P < 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications.
These results suggested that a combination of K-Cit and Mg-Cl(2) chloride is more effective on decreasing urinary oxalate excretion than K-Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1.
柠檬酸钾（K-Cit）是广泛用于尿路结石患者的药物之一。然而，在一些草酸钙（CaOx）尿路结石病例中，单独使用K-Cit进行碱性治疗并未产生显著效果。关于氯化镁（Mg-Cl₂）对小儿尿路结石影响的已发表数据很少。本研究旨在评估K-Cit - MgCl₂联合口服补充剂对CaOx尿路结石患儿尿液参数的影响。
本研究对24例CaOx尿路结石患儿进行，补充剂包括柠檬酸钾（K-Cit）和氯化镁（Mg-Cl₂）。在单独开具K-Cit（阶段1）和K-Cit与Mg-Cl₂联合使用（阶段2）之前（阶段0）和之后测量血清和尿液电解质。每个治疗阶段持续4周。
患者的平均年龄为6.46±2.7岁。分别有66%和41%的患者出现高草酸尿症和高钙尿症。与阶段0相比，阶段2血清镁显著升高。与阶段0相比，阶段1和2的尿柠檬酸盐水平显著更高，P<0.05。此外，与阶段0和1相比，阶段2的尿草酸排泄显著减少，P<0.05。有4例患者报告有软便，但严重程度不足以停药。
这些结果表明，K-Cit和Mg-Cl₂联合使用在降低尿草酸排泄方面比单独使用K-Cit更有效。伊朗临床试验注册号IRCT138707091282N1。
