Evaluating the Effectiveness of Adding Magnesium Chloride to Conventional Protocol of Citrate Alkali Therapy in Children with Urolithiasis

BACKGROUND Potassium citrate (K-Cit) is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate (CaOx) urolithiasis, the significant response to alkaline therapy with K-Cit alone does not occur. There is scarce published data on the effect of magnesium chloride (Mg-Cl(2)) on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K-Cit - MgCl(2) as oral supplements on urinary parameters in children with CaOx urolithiasis. METHODS This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate (K-Cit) and magnesium chloride (Mg-Cl(2)). The serum and urinary electrolytes were measured before (phase 0) and after prescribing K-Cit alone (phase 1) and a combination of K-Cit and Mg-Cl(2) (phase 2). Each phase of therapy lasted for 4 weeks. RESULTS The mean age of patients was 6.46 ± 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, P < 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, P < 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications. CONCLUSIONS These results suggested that a combination of K-Cit and Mg-Cl(2) chloride is more effective on decreasing urinary oxalate excretion than K-Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1.