Preminger G M, Sakhaee K, Skurla C, Pak C Y
J Urol. 1985 Jul;134(1):20-3. doi: 10.1016/s0022-5347(17)46963-1.
Distal renal tubular acidosis is a common cause of intractable calcium nephrolithiasis. We examined the effect of oral potassium citrate therapy in 9 patients with incomplete distal renal tubular acidosis diagnosed on the basis of an abnormal response to an oral ammonium chloride load. Patients were studied during a control phase and after 3 months of potassium citrate treatment (60 to 80 mEq. daily). Potassium citrate caused a significant increase in urinary pH and urinary citrate, and a decrease in urinary calcium. The urinary relative saturation ratio of calcium oxalate significantly decreased during treatment, while that of brushite did not change. Potassium citrate also was shown to inhibit new stone formation. During a mean treatment period of 34 months none of the 9 patients had new stones, although 39.3 plus or minus 79.7 (standard deviation) stones per patient formed during the 3 years preceding treatment. The results support the potential clinical advantage of potassium citrate therapy in patients with distal renal tubular acidosis and recurrent calcium nephrolithiasis.
远端肾小管酸中毒是顽固性钙结石的常见病因。我们对9例基于口服氯化铵负荷试验反应异常而诊断为不完全性远端肾小管酸中毒的患者进行了口服柠檬酸钾治疗效果的研究。在对照期及柠檬酸钾治疗3个月（每日60至80 mEq）后对患者进行研究。柠檬酸钾使尿pH值和尿枸橼酸盐显著升高，尿钙降低。治疗期间草酸钙的尿相对饱和度显著降低，而透钙磷石的尿相对饱和度未改变。柠檬酸钾还显示出抑制新结石形成的作用。在平均34个月的治疗期内，9例患者均未出现新结石，尽管治疗前3年每位患者平均形成39.3±79.7（标准差）颗结石。这些结果支持了柠檬酸钾治疗对远端肾小管酸中毒和复发性钙结石患者的潜在临床优势。
