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Prophylactic and therapeutic properties of a sodium citrate preparation in the management of calcium oxalate urolithiasis: randomized, placebo-controlled trial

Urological Research volume 33, pages 116–124 (2005)Cite this article

Abstract

The purpose of this study was to investigate the prophylactic and therapeutic effects of a hitherto untested preparation containing sodium citrate in the management of calcium oxalate urolithiasis. In this study, a host of calcium oxalate kidney stone risk factors was investigated using a randomised, placebo controlled, “within-patient” clinical trial. The trial involved four groups of subjects: healthy male controls, healthy female controls , calcium oxalate stone-forming males and calcium oxalate stone-forming females. There were 30 subjects in each group. Twenty subjects in each group ingested the preparation containing sodium citrate and ten subjects in each group ingested a placebo for 7 days. Collection of 24 h urines were carried out at baseline, at day 7 and day 10 (i.e. 3 days after suspension of drug/placebo ingestion). These were analysed for biochemical and physicochemical risk factors. They were also tested for their inhibitory properties in crystallization experiments. Data were statistically analyzed using analysis of variance (ANOVA). Key risk factors were significantly and beneficially altered across all groups after ingestion of the preparation. The pH and urinary citrate excretion increased while urinary oxalate and calcium excretions decreased, as did relative supersaturations of calcium oxalate and uric acid. In addition, inhibition of calcium oxalate crystallization increased. Beneficial carryover effects were observed for some risk factors. The results of this study have demonstrated, for the first time, that a sodium citrate-containing preparation favourably alters the risk factors for calcium oxalate urolithiasis.

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Acknowledgements

Funding for this study was received from the South African Medical Research Council, the South African National Research Foundation, the University of Cape Town and Adcock Ingram Limited, South Africa. There was no involvement by any of these bodies in the design of the study or in the collection, analysis and interpretation of data or in the decision to approve publication of the finished manuscript.

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  1. Department of Chemistry, University of Cape Town, Cape Town 7701, South Africa

    Shameez Allie-Hamdulay & Allen L. Rodgers

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  1. Shameez Allie-Hamdulay
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  2. Allen L. Rodgers
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Correspondence to Allen L. Rodgers.

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Allie-Hamdulay, S., Rodgers, A.L. Prophylactic and therapeutic properties of a sodium citrate preparation in the management of calcium oxalate urolithiasis: randomized, placebo-controlled trial. Urol Res 33, 116–124 (2005). https://doi.org/10.1007/s00240-005-0466-6

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  • DOI: https://doi.org/10.1007/s00240-005-0466-6

Keywords

  • Calcium oxalate urolithiasis
  • Prophylactics
  • Therapy
  • Randomized, placebo-controlled trial
  • Sodium-citrate-bicarbonate-tartrate