两种膳食补充剂治疗尿酸盐肾结石的比较：柠檬酸盐与柠檬酸盐+可可碱。
Comparison of Two Dietary Supplements for Treatment of Uric Acid Renal Lithiasis: Citrate vs. Citrate + Theobromine.
机构信息
Urology Service of Manacor Hospital, 07500 Balearic Islands, Spain.
Laboratory of Renal Lithiasis Research, University Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, 07122 Palma de Mallorca, Spain.
出版信息
Nutrients. 2020 Jul 7;12(7):2012. doi: 10.3390/nu12072012.
BACKGROUND
Uric acid (UA) renal lithiasis has a high rate of recurrence and a prevalence ranging from 10% and 15%, depending on the population. The most important etiological factor is persistence of urinary pH below 5.5 and one of the most common treatments is alkalization with citrate. Recent studies demonstrated that theobromine, which is abundant in chocolate and cocoa, is a potent inhibitor of UA crystallization.
AIM
The aim was to compare the efficacy of citrate versus citrate + theobromine as treatment for UA lithiasis.
METHODS
This randomized cross-over trial investigated the efficacy of two treatments in 47 patients with UA renal lithiasis. Urine volume, pH, UA excretion, theobromine excretion, and risk of UA crystallization (RUAC) at baseline and at the end of each intervention period were measured.
RESULTS
Each treatment significantly reduced the risk of UA crystallization compared to basal values. The RUAC after citrate + theobromine was lower than the RUAC after citrate, although this difference was not statistically significant.
CONCLUSION
The combined consumption of citrate and theobromine may be a promising strategy for the prevention of UA kidney stones.
背景
尿酸（UA）肾结石的复发率很高，患病率在 10%至 15%之间，具体取决于人群。最重要的病因学因素是尿 pH 值持续低于 5.5，最常见的治疗方法之一是用柠檬酸盐碱化。最近的研究表明，巧克力和可可中富含的可可碱是 UA 结晶的有效抑制剂。
目的
本研究旨在比较柠檬酸盐与柠檬酸盐加可可碱治疗 UA 肾结石的疗效。
方法
这项随机交叉试验研究了 47 例 UA 肾结石患者的两种治疗方法的疗效。在基线和每个干预期结束时测量尿量、pH 值、UA 排泄量、可可碱排泄量和 UA 结晶风险（RUAC）。
结果
与基础值相比，每种治疗方法均显著降低了 UA 结晶的风险。虽然柠檬酸盐加可可碱治疗后的 RUAC 低于柠檬酸盐治疗后的 RUAC，但差异无统计学意义。
结论
联合使用柠檬酸盐和可可碱可能是预防 UA 肾结石的一种有前途的策略。
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