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KMID : 0358320140550060411
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Korean Journal of Urology
2014 Volume.55 No. 6 p.411 ~ p.416
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Effect of Potassium Magnesium Citrate and Vitamin B-6 Prophylaxis for Recurrent and Multiple Calcium Oxalate and Phosphate Urolithiasis
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Reddy S.V. Krishna
Shaik Ahammad Basha
Bokkisam Suneel
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Abstract
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Purpose: To study the effects of long-term treatment with potassium magnesium citrate and vitamin B-6 prophylaxis (Urikind-KM6; 1,100-mg potassium citrate, 375-mg magnesium citrate, and 20-mg pyridoxine hydrochloride/5 mL) every 8 hours over 3 years.
Materials and Methods: A total of 247 patients with recurrent idiopathic hypocitraturia with or without hyperuricosuria and randomized controls were studied prospectively for 3 years. The total patients were divided into three groups. Control group 1 consisted of 61 patients (24.7%) who had moderate to severe hypocitraturia with or without hyperuricosuria and were recurrent stone formers but discontinued prophylaxis because of drug intolerance within 1 month of therapy. Control group 2 constituted 53 patients (21.5%) who were first-time stone formers and who had mild hypocitraturia with or without hyperuricosuria and were not put on prophylactic therapy and were followed for 3.16±0.08 years. Control group 3 constituted 133 patients (54.8%) who were recurrent stone formers who had moderate to severe hypocitraturia with or without hyperuricosuria and were put on prophylaxis therapy and were followed for 3.16±0.08 years. All patients were followed up at 6-month intervals.
Results: Potassium magnesium citrate prophylaxis produced a sustained increase in 24-hour urinary citrate excretion from initially low values (221.79±13.39 mg/dL) to within normal to high limits (604.04±5.00 mg/dL) at the 6-month follow-up. Urinary pH rose significantly from 5.62±0.2 to 6.87±0.01 and was maintained at 6.87±0.01. The stone recurrence rate declined from 3.23±1.04 per patient per year to 0.35±0.47 per patient per year.
Conclusions: Potassium magnesium citrate prophylaxis was effective in reducing the recurrence of calcium oxalate and phosphate urolithiasis.
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KEYWORD
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Calcium oxalate, Potassium-magnesium citrate, Pyridoxine, Urolithiasis
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