Treatment for Calcium Phosphate Kidney Stone Disease
Pharmacological Therapy for Calcium Phosphate Urolithiasis
The investigators will examine in two studies whether citric acid or potassium citrate can
reduce calcium phosphate saturation in urine of Calcium Phosphate stone formers.
We will examine in two short-term placebo-controlled cross-over metabolic studies whether
citric acid or potassium citrate can reduce calcium phosphate saturation in urine of CaP
stone formers. The first study will be conducted in hypocitraturic CaP stone formers without
hypercalciuria, and will compare the effects of potassium citrate, citric acid and placebo.
The second study will be conducted in hypercalciuric CaP stone formers on a thiazide
diuretic who require potassium supplementation, and will compare the effects of potassium
chloride alone, potassium chloride + citric acid, and potassium citrate alone.
Physicochemical assays will be applied in addition to computer-based stone risk prediction
programs to assess risk of stone recurrence.
- Hypocitraturic CaP stone formers
- urine citrate <320mg/d
- elevated pH as 24-hr urine pH above 6.40
- >21 years
- Hypercalciuric CaP stone formers
- 24hr urine calcium >250mg/d in women and >300mg/d in men prior to indapamide use
- high pH as >6.40 in the absence of urinary tract infection
- >21 years