신결석 환자에서 저구연산뇨증의 임상적 의미
Clinical Significance of Hypocitraturia in Patients with Nephrolithiasis
이신영, 문영태,
소속 상세정보
이신영 ( Lee Shin-Young )
중앙대학교 의과대학 비뇨기과학교실
문영태 ( Moon Young-Tae )
중앙대학교 의과대학 비뇨기과학교실
KMID : 0358320060470060631
Abstract
Purpose: Hypocitraturia is cited as one of the risk factors promoting stone formation or recurrence of nephrolithiasis. We estimated the relationship between hypocitraturia and other metabolic abnormalities, such as hypercalciuria, hyperuricosuria and hyperoxaluria. The effects of potassium citrate medication were also investigated.
Materials and Methods: We selected 706 renal stone patients with hypocitraturia(＜320mg/day), who had received extracorporeal shock wave lithotripsy(ESWL) treatment, and examined the relationship between hypocitraturia and other metabolic abnormalities according to sex and age. We also examined the increment effect of urinary citrate and stone-free rate following potassium citrate(Urocitra) medication.
Results: Complicated hypocitraturia(coexistence with other metabolic abnormalities) was found in 332 of the 706 patients(47.0%). Of the 706 patients, 242(34.3%), 112(15.9%) and 33(4.7%) had hyperoxaluria, hyperuricosuria and hypercalciuria, respectively. Complicated hypocitraturia was higher in the male than female subjects, and was statistically significant(50.4% vs. 39.8%). In 287(77%) of the 373 patients who received potassium citrate treatment, the urinary citrate level was increased. The mean urinary citrate level was significantly increased(142.5 vs. 336.2 mg/day)(p＜0.01), but the stone free rate was not following the citrate treatment.
Conclusions: Potassium citrate was effective in increasing the urinary citrate level. However, prophylactic effects of potassium citrate against recurrent nephrolithiasis must be proved by appropriate comparative studies. (Korean J Urol 2006;47:631-634)
키워드
Hypocitraturia;Potassium citrate(Urocitra);Nephrolithiasis
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