Potassium Citrate: Treatment and Prevention of Recurrent Calcium Nephrolithiasis

Nephrolithiasis is a common problem encountered in clinical practice. Almost 2 million outpatient visits for a primary diagnosis of nephrolithiasis were recorded in the year 2000 in the United States [1]. This condition affects approximately 5-10% of adults during their lifetime and may also affect the pediatric population. Recurrence is present in almost 50% of patients within 5 years of their initial stone event. Despite successful therapy, stone-free rate will be approximately of 75% at 18 months [2]. After diagnosis of nephrolithiasis, subsequent therapy must be considered based upon the type of stone and the biochemical abnormalities that are present. Approximately 75% of patients with nephrolithiasis form calcium stones, most of which are composed primarily of calcium oxalate [3]. Medical therapy is usually undertaken in patients that have had recurrent calcium stones. The administration of potassium citrate, an oral alkalizing agent, acts as a potent inhibitor of calcium stone formation and has been used as the mainstay of medical nephrolithiasis management in the last 3 decades. This review provides an overview of the use of potassium citrate in the clinical management of calcium nephrolithiasis. Mechanism of action, benefits and possible risks of potassium citrate intake will be reviewed.