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  3. 6.24 Hours Urinary Citrate Deficiency (Hypocitraturia) in Recurrent Renal Stone Formers
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6.24 Hours Urinary Citrate Deficiency (Hypocitraturia) in Recurrent Renal Stone Formers

Shoaib Rafique


Objective: Nephrolithiasis is a common disorder and a significant number of recurrent renal stone formers have urinary citrate deficiency (hypocitraturia), which is a known risk factor for nephrolithiasis. The objective of present study was to determine the frequency of urinary citrate deficiency (hypocitraturia) in recurrent stone formers, so this knowledge can help to formulate stone preventive strategies.

Study Design: Retrospective study

Place and Duration of Study: This study was conducted at the Multan Institute of Kidney Diseases (MIKD) from 1st August, 2016 to May, 2019.

Materials and Methods: The study included 112 suitable adult patients of both genders.  Those patients who had recurrent renal stones (at least two times) within last two years were included in the study.  The patients’ demographics, family history, history of stone passage and type of intervention for stones, stone composition and 24-hour urine volume were recorded.  The 24 hour urinary citrates estimated and the differences in the citrate levels between genders, age groups, positive family history of nephrolithiasis, were analyzed.

Results: There were 96 male and 16 female patients. Family history of renal stones was present in 37(33%) patients. The mean 24 hours urinary volume was 1617.49 ±822ml and 92 (82.14%) patients had a lower 24-hour urine volume (i.e. less than 2 liters). The mean 24 hours urinary citrate was 277.26 ±173.37 mg and it ranged from 68mg to 1152mg. The female patients had lower mean urinary citrates than male patients [222.93±150.62 mg vs 286.32±175.94 mg: p=0.177) and there was no significant difference of age on citrate levels.   The patients with family history of renal stones had lower 24 hour urinary citrates and were of relatively younger age.

Conclusion: The present study revealed a high frequency of hypocitraturia in recurrent renal stone formers. However, no statistically significant differences in the frequency of hypocitraturia were observed in both genders and age groups. Patients with positive family history of nephrolithiasis had lower urinary citrate levels. This knowledge of high frequency of hypocitraturia can help in formulating stone preventive strategies.

Key Words: Nephrolithiasis, Hypocitraturia, Renal stones, Citrate, Calcium

Citation of article: Rafique S. 24 hours Urinary Citrate Deficiency (Hypocitraturia) in Recurrent Renal Stone Formers. Med Forum 2022;33(10):24-29.