Effect of Potassium Citrate Therapy on Biochemical Parameters and Stone Burden in Patients with Recurrent Kidney Stones: A Prospective Comparative Study

Abstract

Background: This study aimed to evaluate biochemical risk factors in patients with recurrent kidney stones and to assess the pharmacological role of citrate-based therapy compared with standardised dietary modification and increased water intake alone.

Methods: An 80 adult patients with recurrent kidney stones were allocated into two groups. Group 1 included 40 patients who received standardized dietary modification and increased water intake only, whereas Group 2 included 40 patients who received potassium citrate effervescent tablets (20 mEq) twice daily for one month, in addition to the same standardized dietary modification and increased water intake. The assessments included blood biochemical parameters and ultrasonographic evaluation of stone number and size. Stones obtained through spontaneous passage during the study period were physically characterized and chemically analyzed using a qualitative/semi-quantitative chemical method to determine their composition.

Results: Stone number decreased significantly (p=0.030) in Group 2 (0.60±0.71) compared to Group 1 (1.90±3.60). Stone analysis showed that calcium oxalate stones were the predominant type in both groups, followed by uric acid-containing stones. Complete stone resolution was observed in 35% of patients in Group 2 compared with 0% in Group 1, while new stone formation was less frequent in Group 2. Conclusion: Biochemical and radiological outcomes favoured potassium citrate therapy. Potassium citrate showed promising short-term improvements, but larger randomized studies with longer follow-up are needed.